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No 

i 

Boston 

Medical   Library 

Association, 

19     BOYLSTON     PLACE. 

2.         ^ 


THE 


Peninsular  and  Independent 


MEDICAL  JOURNAL, 


DETOTED    TO 


Mem,  Sttrprg,  m^  ftarmats. 


EDITORS: 


A.  B.  PALMER,  A.  M.  M.  D. 

Professor  of  Materia  Medica,  Therapeutics,  and  Diseases  of  "Women  and  Children, 
in  the  University  of  Michigan. 

MOSES  GMN,  A.  M.  M.  D. 

Professor  of  Surgeiy  in  the  UniYersity  of  Michigan. 

^  FREDERIC  STEARNS. 

Pharmaceutist. 


VOLUME  II. 


DETROIT   MICH.: 

HIGBY    &    STEARNS,    PUBLISHERS. 

BAENS,    FRENCH    <fc   WAY,   PEENTERS. 


LIST  OF  CONTRIBUTORS. 


'A/'  HORTON",  L.  S.,  H.  P.  to  U".  S.  Ma- 

ALDEN,  JOHN  M.,  M.  D.  rine  Hospital,  Detroit. 

BEECH,    J.  H.,    M.   D.,    Coldwater'  INGLIS,  RICHARD,  M.  D.,  BeiroH. 

Mich.  JOHNSON,   W.    H.,    M.  D,    Ahion. 

BLISS,  Z.  E.,  M.  D.,  Ionia,  Mich.  Mich. 

BROWN,    J.  A.,    M.   D.,    Kankakee  PALMER,    O.  D.,    M.  D.,   Zeleinople, 

City,  III.  Pa. 

CARUTHERS,  H.,  M.  D.,  Tarrytown  PATTERSON,  M.  A.,  M.  D.,  Tecum- 

CHRISTIAN,  E.   P.,   M.  D.,    Wyan-  seh,  Mich. 

dotte,  Mich.  POTTER,  A.  0,,  M.  D.,  Mantorville, 

CORBIN,  G.  E.,  M.  D.,    Stockbridge,  Minn. 

Mich.  RYND,  CHAS.,  M.  D.,  Adrian,  Mich. 

ERNI,    HENRY,    M.   D.,    Nashville,  SAGER,   ABRAM,  M.  T>.  and  Prof., 

Tenn.  Ann  Arbor,  Mich. 

GIBBS,  Ow.  C,  M.  D.,  Frewshury,  N.  TYLER,  D.  M.,  M.  D.,   Ann  Arbor, 

York.  Mich. 

HITCHCOCK,  H.   0.,  M.  D.,   Kala-  WAGGONER,  F.  R.,   M.  D.,  Oconee, 

mazoo,  Mich.  Illinois. 


Digitized  by  tine  Internet  Arcinive 

in  2012  with  funding  from 

Open  Knowledge  Commons  and  the  National  Endowment  for  the  Humanities 


http://archive.org/details/peninsularindepe02detr 


INDEX   TO  VOL.  II. 


•  ♦  • 


Original  Communications. 

Address  to  the  G-raduating  Glass  of  the 

University  of  Michigan 65 

Air  passages,  foreign  body  in  the 81 

Alkaloids,  Detection  of 10 

Anaesthesia  during  sleep 648 

Brain  disease,  A  case  of 14 

Cannabis  Indica 12 

Carbonic  Acid  Gas  as  a  Local  Anassthe- 

tic  Agent 390 

Cathartics  in  Peritonitis 513,    586 

Chronic  Conjunctivitis,  Treatnaent  of. .     269 
Chronic  Inflammation  of  the  Uterus, 

Studies  for  the  Elucidation  of  the . . .    524 
Criminal  Abortions,  Report  to  the  State 

Medical  Society  on 129 

Criticism,  A 143 

Criticism,  A,  criticised 262 

Detection  of  Alkaloids 10 

Dysentery,  What  is  the  proper  dose  in    534 

Erysipelas,  Puerperal  Fever  and 641 

■  Ether  and  Chloroform 321 

Femoral  Hernia,  Strangulated,  A  novel 

case  of 257 

Foetus  in  Utero,  Peculiar  Death  of 207 

Foreign  Body  in  the  Air  passages 81 

Halminth,  Observations  on  the  Deve- 
lopment of  a  New  Species  of 449 

Hernia.  A  Remarkable  Case  of 259 

Hernia,  Reducible,  Operations  for  Cure 

of 577 

Hernia,  Strangulated,  Two  Cases  of. . .     266 
Hernia,  Strangulated  Femoral,  A  novel 

case  of 257 

Hip  and  Shoulder  Joints,  Luxations  of    193 
Human  Skin,  The  Vegetable  Parasites 

of  the 385 

Hypertrophy  of  the  Heart  during  C-es- 

tation,  The  normal 327 

Hypnotism 723 

Luxations  of  Hip  and  Shoulder  Joints.     193 

Malpractice,  Suits  for,  Influence  of 747 

Meteorological  Register  17,  88, 148,  209,    271 
338,  408,  453,  538,  690,  651,     762 

Milk  Sickness 5 

New  Methods  of  Resuscitation 84 

Notes  on  some  Cases  of  Heart  Diseases    727 
Observations  on  the  Development  of  a 

New  Species  of  Halminth 449 

Observations  on  Specialities  in  Medi- 
cine          1 

On  Turning  the  Foetus  in  Utero .     705 

Peculiar  Death  of  a  Fostus  in  Utero. . .     207 

Peritonitis,  Cathartics  in 513,    586 

Poisonous  Symptoms  of  Tartar  Emelic    717 
Reducible  Hernia,  Operations  for  the 

Cure  of 577 

Report  of  an  Austrian  Trial  for  Rape. .     722 
Report  to  the  State  Medical  Society  on 

Criminal  Abortions 129 

.  Resuscitation,  New  Methods  of , . . ,      84 

Selections  from  Surgical  Notes 140 

Setting  Aright,  A 392 

Sleep,  Anaesthesia  during 648 

Specialties  in  Medicine,  Observations 

on 1 

Strangulated  Hernia,  Two  Cases  of 266 

Strangulated  Femoral  Hernia,  A  novel 

case  of 257 

Studies  for  the  Elucidation  of  Chronic 

Inflammation  of  the  Uterus 524 

Surgical  Notes,  Selections  from 140 

Tetanus 760 

■J^eatment  of  Chronic  Conjunctivitis. .    269 


Vegetable  Parasites  of  the  Human 
Skin,  The 385 

Bihliographical   Reccn^d. 

Address  to  the  Ohio  College  of  Dental 

Surgeiy 19 

An  Epitome  of  Baithwaite's  Retro- 
spect of  Practical  Medicine  and  Sur- 
gery-   766 

Bane  and  Antidote.  The 19 

Campbell,  Report  on  the  Nervous  Sys- 
tem in  Febrile  Diseases 149 

Carnochan's    Operative    Surgery    and 

Surgical  Pathology 211 

Churchill's    Pulmonary  Phthisis   and 

Tubercular  Diseases 592 

Cleveland  Medical  G-azette 282 

Dalton's  Human  Physiology 281 

Dental  Reporter,  The 19 

Druggist,  The 90 

Durkee's  Gonorrhosa  and  Syphilis 339 

Enteric  Fever,  A  Practical  Treatise  on  409 
Favorite  Prescriptions  of  Living  Amer- 
ican Practitioners 18 

Five  Essays 149 

Flint's  Diseases  of  the  Heart 652 

Fowrie's  Chemistry 595 

Habershon's  Diseases  of  the  Alimenta- 
ry Canal 591 

Hunter's  Treatise  on  the  Venerial  Di- 
sease   90 

Introductory  Lectures  and  Addresses 

on  Medical  Subjects 764 

King's  Microcopists  Companion     .    ...  150 

Knickerbocker  Magazine,  The 18 

Medical  Heroism 272 

Malformations  of  the  Urinary  Bladder  19 

Malgaigne's  Treatise  on  Fractures 89 

National  Qtiarantine  and  Sanitary  Con- 
vention, Proceedings  of 639 

North  American  Medical  Reporter 282 

Parish's  Practical  Pharmacy 594 

Physicians,  Handbook  of  Practice  for 

I860 541 

Practical  Treatise  on  Fractures    and 

dislocations _  751 

Tanner'sDiseases  of  Infancy  and  Child- 
hood   210 

Taylor's  Poisons  in  Relation  to  Medical 

Jurisprudence 596 

Editorial  Department. 

Alcohol,  its  place  and  powers 679 

American   Pharm.    Association,    Pro- 

ceediDgs  of,  for  1859 670 

Announcement,  An 64 

Annual  Dinner  of  N.  Y.  Society  for  the 
Relief  of  Widows  and  Orphans  of  Me- 
dical men 597 

Appointment,  A  good '.'..'.  683 

Artificial  Limbs,  Palmer's .' ."  20 

Association  of  Judge  Mason  with  Mann 

&Co 615 

Blackwood's  Magazine 614 

Catawba  Brandy  as  a  Mediciral  Agent  215 
Cincinnati  Lancet  and  Observer,  Re- 
traction of 92 

Clinical  School  of  the  Medical  Depart- 
ment of  the  University  of  Michigan . .  98 

Coecum,  Diseases  of  the 26 

Communication,  A 665 

Controvers}',  Medical 411 

Correction,  A '*"_"  684 

Discontinuance  of  the  Journal !  Ill ! ! '.  1 !  768 


¥1 


Index    to    Vol   IT. 


Diseases  of  the  Ccecum ..,,..;...  26 

Editorial  Correspondence,  156,  217, 455,  542 

616,  655 

Errata , 615 

Erratum 164 

Eavor,  A 684 

Erench  Pharmaceutical  Preparations. .  288 

Eurniture  Labels,  The  Leaf  sets  of 684 

Indigenous  Plants,  Our 155 

Journal,  A  l^evr 609 

Langenbeck's  Tracheotomy  Hook 97 

Laryngoscope,  The 98 

Meeting  at  Louisville,  The 153 

Medical  Controversy 411 

Medical  Chronicle,  The 163 

Medical  Convention  for  Revising  the 
Pharmacopoeia  of  the  United  States, 

The 99 

Medical  Education  in  Chicago 213 

Medical  G-azette,  The  Cleveland 659 

Medical  Press,  The  New  York 558 

Medical  Students,  The  Pharmaceutical 

Education  of 283 

Medical  Teachers'  Convention,  The  late  151 
Michigan  State  Medical  Society,  Pro- 
ceedings of  the  8th  Annual  Meeting  of  682 

Michigan,  State  University  of —  454 

Our  Indigenous  Plants 155 

Palmer's  Artificial  Limbs 20 

Peninsular  and  Independent    Medical 

Journal,  To  the  Subscribers  to  the  —  683 
Pharmacopoeia   of  the  United  States, 

Medical  Convention  for  Revising  the  99 

Prepayment  of  this  Journal 164 

Professor  Allen— Rush  Med.  College..  343 

Publisher's  Card,  The 26 

Resignation _  164 

Rush  Medical  College— Prof.  Allen 343 

Serapion  Society  of  the  Medical  Depart- 
ment of  the  University  of  Michigan—  669 

Tobacco,  The  Use  and  Abuse  of 678 

Tracheotomy  Hook,  Langenbeck's 97 

University  of  Michigan 754 

University  of  Michigan,  Catalogue  of 

Ofllcers  and  Students  of  the,  for  1859  677 

Validictory- 763,  764 

Woman's  Hospital  Association  of  New 

York 678 

Selected  Articles,  Abstracts,  ^c. 

[Translations  from  Foreign  Journals  for  the  Peninsu- 
lar and  Independent.] 

Auscultation,  the  Employment  of  Water 

in 419 

Health  Ofllcers  in  City  and  Country, 

The  Relative  Number  of 172 

Nitrogenous  Food,  Digestion  of 348 

Osteoplastic  Prolongation  of  the  Bones 

of  the  leg,  Pirogofl''s 413 

Premature  Birth,  Artificially  produced, 

Dr.  Lampe  on _  101 

Premature  Labor,  produced  by  the  Ute- 
rine Douche 344 

Vesico- Vaginal  Eistula,  The  improve- 
ments to  Operations  for 44,  167 

Abortion,  Attempted,  Death  from  En- 
trance of  Air  into  the  Veins 463 

Achillea  Millefolium  in  Uterine  Con- 
gestion    689 

AconitumNapellus 565 

Acute   Otitis 368 

Adhesive  Plaster  in  Maintaining  Ex- 
tension  238,  304 

Adipocere,  Remarkable  Case  of 476 

Albuminous  Anasarca,  Tannin  in  Large 

Doses  in , 433 


Alkaloids,  Solubility  of,  in  Fat  Oils-—  438 

Alum  and  Lavin  in  Condylomata. 367 

Alum  on  Bougies  in  Strictures. 432 

Anaesthesia  During  Sleep 564 

Anaesthesia  by  Chloroform 571 

Antidote  for  Phosphorus 314 

Application  of  Q-lycerine  in  Variola,  On 

the 176 

Arsenic  in  Menorrhagia,    Leucorhcea' 

&c 698 

Arsenic,  Mode  of  Applying  to  Destroy 

Nerve  of  a  Tooth 562 

Artificial  Tympana,  Otorrhcea  and 111 

Ash  Tea  as  a  Remedy  for  the  Bite  of  a 

Rattlesnake 57 

Atropia  in  Epilepsy 179 

Atropia,  Traumatic  Tetanus    success- 
fully treated  by 175 

Bibron's  Antidote  for  the  Bite  of  Poi- 

nous  Reptiles .-  433 

Bismuth  Snuff"  in  Coryza 241 

Blood,  Red  and  Dark 370 

Breath,  Fetid 438 

Carbonate  of  Ammonia  in  the  Bite  of 

Poisonous  Reptiles 54 

Chalybeate  Waters,  The  Eff"ects  of  .  - .  -  367 
Chloride  of  Zinc,  A  new  method  of  ap- 
plying   699 

Chloroform,  Death  from 566 

Chloroform  in  the  Treatment  of  Itch—  490 
Chloroform  in  Lithotomy  and  Amputa- 
tion    472 

Chloroform,  Modus  Operandi  of 366 

Chloroform,  Tests  for  the  purity  of 698 

Clavicles,  Fracture  of  both 561 

Clerical  Quackery 690 

Cod  Liver  Oil  Cakes 53 

Collodeon,  Spina  Bifida  treated  by 490 

Ccecum  and  its  Appendix,  Diseases  of 

the 27 

Compound  Syrup  of  the  Hypophospha- 

tesin  Typhoid  Fever 563 

Compressed     Sponge,     Antidactiscent 

Properties  of 638 

Compressed  Sponge 312 

Condylomata,  Alum  and  Savin  in 367 

Condy's  Fluid  in  Ulcerated  Surfaces.  _.  374 

Consumption,  Dr.  Churchill  on 50 

Copaiba,  Balsam  of,  in  Psoriasis —  239 

Copaiba,  Balsam  of,  Tests  of  its  Genui- 
neness   370 

Croup 368 

Cutaneous  Diseases,  On  the  Use  of  Pot- 
ash in  491 

Cutaneous  Maladies,  White  Lead  Paint 

in 434 

Diarrhoea  of  Children,  Raw  Meat  in  the  428 

Delirium  Tremens,  Lupulin  in  ... 688 

Diabetes,  Treatment  of 432,  478 

Digitaline,  The  Action  and  Uses  of 373 

Diptheria 107 

Diseased  Membranes,  Preservation  of 

Specimens  of 52 

Disinfecting  Agent,  Anew 484 

Emboli 481 

Enema,  Port  Wine 53 

Enteric  Juice 363 

Epilepsy,  Atropia  in 179 

Epilepsy,  Marsh  Salinumin 693 

Erysipelas  of  the  Limbs,  Treatment  of 

by  Elevation 179 

Extracted  Tooth,  Replacement  of  an .  _.  563 
Female  Catheter,  A  novel  Substitute 

for  a 313 

Fetid  Breath - 438 

Fibrin,  The  Physiological  Position  of—  241 

Firing  up  with  Mummies 496 

Fracture-box,  Anew —  560 

Fracture  of  both  Clavicles _—..,..  561 


Index   to    Vol.    II. 


Vll 


Gastric  Juice,  Action  of  the,  on  the  Sto- 
mach and  Diaphragm 470 

G-elseminum  Sempervirens .* 686 

Glycerine,  Application  of,  in  Variola. -  176 

Glycerine  Ointment  for  the  Itch 697 

Golden  Sulphuret  of  Antimony  in  Pneu- 

mionia — 699 

Gout  and  its  Remedy 687 

Gums,  Scurvy  of,  Treated  by  Nitrate  of 

Silve.r 377 

Hemorrhoids,  Treatment  of 482 

Hsemostatic  Efi'ects  of  Perchloride  of 

Iron 433 

Hooping  Cough 374 

Hooping  Cough,  Diluted  Mtric  Acid 

in - 239 

Hunter,  John,  Reinterment  of  the  Re- 
mains of 182 

Hydrocele,  New  Method  of  Treating  . .  177 

Hydrophobia,  A  New  Remedy  for 365 

Hydrophone  — 376 

Hypophosphite  of  Quinia,  Tonic  pro- 
perties of 439 

Ingrowing  Nail,  Perchloride  of  Iron  in  241 

Ingrowing  Toe-Nail,  Treatment  of 688 

Infant  in  Uterus,    Respiratory  move- 
ments detectible  by  Auscultation 314 

Intoxication,  Chronic,  Oxide  of  Zinc  in  689 
Iodide  of  Potash,  The  Use  and  Abuse 

of 358 

Iodide  of  Sodium- 373 

Iodine,  A  New  Vehicle  for 698 

Iron,  Tinct.  Mur.  of,  A  Nasal  Polypus, 

cured  by 562 

Itch,  Chloroformin 490 

Itch,  Glycerine  Oint.  for  the 697 

Jerking  Respiration 363 

Joints,  On  Two  Cases  of  Opening  into  467 

Labor,  Lingering  Uva  Ursi  in 490 

Mad  Dogs,  Remedy  for  the  Bite  of 664 

Management  of  the  Shoulders  in  Exa- 
minations of  the  Chest 109 

Mastic  in  Nocturnal    Incontinence  of 

Urine 432 

Meat,  Raw,  in  the  Diarrhoea  of  Chil- 
dren    428 

Medical    Administration   of   Ozonized 

Oils   -—  435 

Medical  College  at  Bombay,   Students 

rofthe 638 

Melanotic  Cancer,  The  Diagnosis  of 367 

Microscope  before  the  Anatomic  Socie- 
ty of  Paris,  The 573 

Morphia  and  Carbonate  of  Soda  for  Re- 
tention of  Urine 240 

Mortality  from  "Whooping  Cough 434 

Mummies,  Firing  up  with 496 

Nausea  and  Vomiting  during  Pregnan- 
cy   491 

Nervous  Headache,  Treatment  of,  by 

Hydrochlorate  of  Ammonia 572 

Neuralgia 53 

New  Method  of  Treating  Hydrocele.. .  177 
Nocturnal  Incontinence  of  Urine,  Mas- 
tic in 432 

Nursing  Sore  Mouth,  Uterine  Disease, 

The  cause  of 178 

Obstinate  Vomiting 179 

Openings  into  Joints,  Two  Cases  of 467 

Ophthalmia,  Purulent 112 

Opium  in  France,  Preparation  of 435 

Opium,    Purity  of 375 

Oracle,  The,  Fairly  Committed-  - 240 

Organic  Diseases  of  the  Heart,  Chronic  482 

Origin  of  Plants 496 

Otorrhoea  and  Artificial  Tympana 111 

Otorrhoea  of  Young  Children 237 

Otitis,   Acute —  --  368 


Ovarian  Disease 565 

Ozena  178 

Ozonized  Oils,  Medical  Administration 

of -----    435 

Perchloride  of  Iron,  Use  and  Properties 

of 695 

Perchloride  of  Iron,  Hjemostatic  eflects 

of 433 

Phagedenic  Ulcer  Tartrate  of  Iron  and 

Potash  in 177 

Phosphorics,  Poisoning   by,    Antidote 

for  -.u - 314 

Phosphorus,  Poisoning  by,  Treatment 

of 366 

Plants,  Origin  of 496 

Polypus,  Nasal,  Cured  by  Tinct.  Mur. 

of   Iron 562 

Poisonous  Reptiles,  Carb.  Amnion,  in 

the  Bite  of 54 

Pregnancy,  Nausea  and  Vomiting  dur- 

^ing 491 

Prolapsus  Uteri 181 

Psoriasis,  Balsam  of  Copaiba  in 239 

Puerperal   Convulsions   Treated   with 

Nettle 52 

Pulmonary  Phthisis,  Saturnine  Medica- 
tion   in 484 

Quackery,   Clerical 690 

Quinia,  Hypophosphite  of,  Tonic  Pro- 
perties of 439 

Quinic  Ether 696 

Rapidity  of  Thought,  or  Nervous  Ac- 
tion      365 

Rattlesnake,  Bite  of  a,  Ash  Tea  as  a 

Remedy  for  the „      52 

Rectal  Alimentation  Questioned 569 

Red  and  Dark  Blood 370 

Reptiles,  Poisonous,  Bibron's  Antidote 

for  the  Bite  of - 483 

Reptiles,  Poisonous,  Carb.  Ammon.  in 

the  Bite  of 54 

Respiration,  Experiments  on  the  Phe- 
nomena of _ 437 

Respiration,  Saccadee 363 

Respiratory  Movements   of  Infant   in 

Uterus 314 

Retention  of  Urine,  Method  of  Reliev- 
ing     240,    376 

Russia,  Popular  Remedies  of 368 

Saturnine    Medication    in   Pulmonary 

Phthisis 484 

Sarsaparilla,  Therapeutical  Properties 

of 362 

Scarlatina,  Iron  in 178 

Scurvy  of  the  Gums,  Treated  by  Nit. 

of  Silver 377 

Senna  Leaves _.    372 

Sleep,  Aneesthesia  during 564 

Snuff,  Bismuth,  in  Cory za 241 

Sodium,  Iodide  of _.    373 

Solubility  of  Alkaloids  in  Fat  Oils .    438 

Speculum,  The  Uterine 307 

Spina  Bifida,  Treated  by  Collodion 490 

Spinal  Diseases,  Lecture  on 480 

Spina  Bifida,  Treatment  of,  By  Injec- 
tions of  Iodine 567 

Stomatitis  Materni 374 

Stricture,  Alum  on  Bougi  esin 432 

Stricture,  Organic,  of  Urethra,  Jod.  of 

Potass,  in 179 

Suppression  of  Illegal  Practice  in  Paris    241 

Tannin  in  Albumnous  Anasarca 433 

Tetanus  cured 665 

Thymus  Gland,  The   Physiology  and 

Pathology  of 241 

Traumatic  Tetanus  Successfully  Treat- 
ed by  Atropia 175 

Tubercular  Diseases,  Alcoholic  Liquors 


Vlll 


Index   to    VoL   II. 


in 632 

Typhoid  Fever,   Compound  Syrup  of 

the  Hypophosphates  in 563 

Ulcerated  Surfaces,  Condy's  Fluid  m. .  374 
Ulcerations,  &c.,  of  the  Os  and  Cervix 

Uteri 425 

Uva  Ursi  in  Lingering  Labor 490 

Use  and  Abuse  of  Iodide  of  Potash,  On 

the 358 

Uterine  Congestion,  Achillae  Millefo- 
lium in 689 

Uterine  Disease,    The  main  cause  of 

IsTursing  Sore  Mouth — 178 

Uterine  Speculum,  The 307 

Varicose  Veins,  Treatment  by  Blister- 
ing   373 

Variola,  Application  of  Glycerine  in . . .  176 

Vegetable  Parasites  of  the  Human  Skin  180 

Vomiting  during  Pregnancy 178 

Vomiting,   Obstinate ^ 179 

White  Lead  Paint  in  Cutaneous  Mala- 
dies    434 

Whooping  Cough 374 

Whooping  Cough,  Mortality  from 434 

Whooping  Cough,  Diluted  Nitric  Acid 

in 239 

Womb,  Falling  of  the 181 

Pharmaceutical  Department. 

Acid  Nitrate  of  Silver,  The 253 

Administration  of    Medicine  to  Chil- 
dren, The 317 

Aesculin  in  Intermittent  Fever 318 

Alianthus,  Vermifuge,  Properties  of...  444 
Alkahes  in  the  Extraction  of  the  Ac- 
tive Principle  of  Plants 191 

Althea  Paper,  A  New  Test  for  Acids 

and  Alkalies 248 

Ammonia,  Aromatic  Spirits  of 383 

Ammonia,  Carbonate  of,  in  Measles 384 

Ammonia,  Liniment  of 384 

Ammonia,  Muriate  of --  57 

Arnica  Montana 381 

Arsenious  Acid,  Hydrate  of  Mag.  Anti- 
dote for  Poisoning  by 189 

Blue  Mass,  Powdered —  —  318 

Caffein,  Preparation  of 444 

Catawba  Brandy,  B.  S.  Wayne  on 380 

Chalybeates,  New 379 

Chickweed 316 

Chloric  Ether  Commercise 639 

Ohromate  of  Potash  in  Warts 318 

Chromic  Acid  in  SyphiliticVegetations  190 
Chronic  Affections  of  the  Eye,  Treat- 
ment of ---: 254 

Citrate  of  Iron  and  Strychnia -  .  189 

Cod  Liver  Oil,  A  Substitute  for 252 

Cod  Liver  OilJelly--- 57 

Concentrated  Lime  Water .. ..-_.-..---  57b 
Confection  of  Cubebs  and  Copaiba  with 

Nit.  Bismuth l90 

Cornea,  Chronic  Ulceration...: 

Dentriflce,  Sulphur  as  a  -.-..--- 44a 

Detection  of  Pregnancy  by  Ergot -  190 

■  Dulcamara  and  Lolanine,  Therapeutical 

Action  of ^*2 

Dysentery,  The  Use  of  G-lycerine  in ... .  443 
Extractive     Principle    of    Vegetables, 

Combination  of  Iodine  with 440 

Fail,  Never  say. 699 

Febrifuge,  Nux  Vomica  as  a 443 

Fluid  Extract  of  Yarrow 247 

Fusel  Oil,  Purification  of  Spirit  from. .  253 

Ginseng  Excitement,  The 315 

Glycerine  in  Dysentery,  TheUseof...  443 
Goulard's  Cerate  Substituted  by  a  Gly- 

cerole  of  Lead - 247 

Honey  of  Roses 192 


Hydrate  of  Magnesia  an  Antidote  for 

Poisoning  by  Arsenious  Acid 189 

Hydrochloric  Acid,   On    the  External 

Use  of 60 

Hypophosphate  of  Quinia 191 

Indian  Medicine 574 

Indigenous  Plants,  New  Therapeutical 

Uses  for  our « 187 

Infusions,  The  Preservation  of _.  248 

Intermittent  Fever,  Aesculin  in 318 

Intermittent  Fevers,  Tincture  Mur.  of 

Iron  in 690 

Iodide  of  Sodium,  Preparition  and  Uses 

of 509 

Iodide  of  Sodium,  The  Employment  of  249 
Iodine,  Combination  of  with  the  Ex- 
tractive Principle  of  Vegetable 440 

Iodized  Food 254 

Iron,  Reduced  by  Carbon 59 

Iron,  Urine  of 384 

Itch,  Ointments 192 

Jelly,  Cod  Liver  Oil 57 

Koussine 253 

Liniment  of  Ammonia 384 

Liquor    Cinchonas    Hydriodatus,     and 

Liq.  Cinchon.  Hydriodat,  Cum.  Ferro  56 

Measles,  Carbonate  of  Ammonia  in 384 

Mercurial  Ointment _ 61 

Mezereum,  Alcoholic  Extract  of 383 

Muriate  of  Ammonia 57 

Nux  Vomica  as  a  Febrifuge 443 

Ointment,  Mercurial 61 

Pepsin  Wine _ 190 

Powdered  Blue  Mass 318 

Pregnancy,  Detection  of  by  Ergot 190 

Preservation  of  Infusions,  The 248 

Progress  of  Pharmacy 701 

Propylamin - 55 

Purification  of  Spirit  from  Fusel  Oil. .  -  253 

Quinia,  Hypophosphate  of 191 

Revulsive  Treatment  of  Chronic  Affec- 
tions of  the  Eye 254 

Saccharated  Lime  for  Use  in  Medicine .  576 

Samaderine 248 

Scammony  Resin,  New  Process  of  Ob- 
taining   —  188 

Silvering  Animal,  Vegetable  and  Mine- 
ral Substances,  Process  for 441 

Solanine,  Therapeutical  Action  of  Dul- 
camara   and 442 

Spanish   Apple,    The 254 

Sulphur  as  a  Dentriflce 445 

Syphilitic  Vegetations,  Chromic  Acid 

in - 190 

Syrup  of  Coffee  for  Whooping  Cough—  383 

Syrup  of  Tar 639 

Ulmus  Fulva 61 

Vermifuge  Properties  of  the  Chinese 

Alianthus,  The 444 

Warts,  Ohromate  of  Potash  for 318 

Whooping  Cough,  A  New  Mixture  for 

the 445 

Whooping  Cough,  Syrup  of  Coffee  for 

the 383 

Wine  of  Iron 384 

Yarrow,  Fluid  Extract  of 247 

Society  Meetings. 

American  Medical  Association.  63,  113,  704 

American  Pharmaceutical  Assoc.  .  319,  509 

Medical  Teachers,  Convention 183 

Michigan  State  Medical  Society.  ..  640,  704 

Correspondence. 

Chicago  Correspondence 62 

Correspondence,  The  American  Medi- 
cal Association- 165 

News  Items.—  127,  255,  320,  377,  446,  512 


THE 


PENINSDLAR  and  mDEPENDENT 


MEDICAL  JOUMAL. 


Vol.  II.  DETROIT,  APRIL,  1859.  No.  1. 


riginal  C0mm«;nirEti0ns» 


AST.  I.— ObseryatioHs  on  Specialties  in  Medicine. 


By  a. 


Division  of  labor  in  scientific  inquiries,  enriclies  science 
by  large  discoveries  of  facts,  and  consequently  is  by  no 
means  to  be  disregarded  or  contemned.  Particularly  have 
the  series  of  sciences  collateral  to  medicine  been  profited 
by  this  mechanical  system.  This  acknowledged  truth,  and 
lis  analogous  illustrations  in  the  varied  departments  of 
art  and  production,  have  of  later  years  exceedingly  influ- 
enced the  domain  of  practical  medicine.  In  the  cycle  of 
ages  the  medical  world  has  revolved  to  a  condition  of 
affairs  precisely  similar  to  that  of  a  remote  antiquity. 

Time  was  when  each  organ  of  the  human  body  was 
placed  in  the  care  of  a  distinct  medical  custodian,  and  not 
unfrequently  when  the  unhappy  patient  died,  the  doctor 
still  triumphed  ; 

"Still  proved  his  reasoning  best,  and  his  belief, 
Though  propped  on  fancies  wild  as  madmen's  dreams, 
Most  rational," 

Vol.  it. -a. 


2  The  Peninsular  and  Independent. 

because,  sooth  to  say,  the  organ  over  which  he  was  the 
presiding  genius,  had  escaped  destruction  before  death. 

En  passant,  this  reminds  of  a  recent  case  where  a 
modern  specialist  glorifies  and  is  glorified,  because  his  pro- 
bang  did  not  transfix  the  tracheal  parietes,  as  was  sagely 
believed  by  the  patient  (who  died,  however),  and  two 
savans,  of  the  medical  sort,  who  attended  him  in  extremis. 
On  the  contrary,  to  the  utter  discomfiture  of  anti-probang- 
dom,  not  only  did  the  triumphant  probang  not  cause  death, 
but  the  larynx  and  trachea  were  wholly  free  from  disease ! 
Truly,  this  modern  cock  who  came  so  near  being  sacri- 
ficed to  jJEscuLAPius  by  the  Nestor  of  American  Surgery  and 
his  colleague,  may  vigorously  crow  over  the  post-mortem 
developments.  Human  larynxes  and  tracheas  will  bear  a 
deal  of  swabbing  when  wholly  healthy,  and  why  not  allow 
anxious  patients  the  luxury,  if  they  can  afford  it  ? 

The  post -pharyngeal  abscess  with  a  post-mortem  hole 
in  it,  the  emphysema,  et  alii,  are  not  within  the  trachea- 
swabbing  domain  —  why  call  upon  the  king  of  medical 
specialists  to  invade  the  territory  of  his  neighbors  ? 

Medicine  is  spotted  and  covered,  dwarfed  and  pauper- 
ized, by  specialisms.  Comprehensive,  profound,  exact,  en- 
larged and  true  views  of  general  practice  are  too  much  lost 
sight  of  in  the  petty  technicalities,  the  mountebank  ma- 
nipulations, the  legerdemain  tactics,  the  microscopic  little- 
nesses of  throat  men,  skin  men,  womb  men,  eye  and  ear  men, 
et  id  omne  genus — ad  nauseam.  Every  square  inch  of  the 
human  body,  from  head  to  heels,  is  dotted  over  with  medi- 
cal homunculi,  wedded  in  heart  and  soul  to  their  particular 
square  inch,  and  knowing  nothing,  caring  nothing,  for  the 
man  as  a  whole. 

And  this  is  but  the  direct  result  of  pandering  to  a  gross 
popular  error,  which  judges  of  practical  medicine  as  it  does 
of  practical  pin -making —  much  to  be  facilitated  by  division 
of  the  processes.      And  yet,  if  there  is  any  one  truth  estab- 


Observations  on  Specialties  in  Medicine.  8 

lished  by  all  medical  experience  and  all  medical  philosophy, 
these  truths  are  established  beyond  reasonable  cavil. 

There  is  no  man  who  knows  so  little  of  the  correct 
treatment  of  the  human  eye  as  the  professed  oculist.  There 
is,  in  like  manner,  no  man  so  deplorably  ignorant  of  the 
human  ear,  as  the  "aurist/'  There  is  no  no  man  so 
dangerous  to  the  integrity  of  the  human  windpipe  and  its 
appurtenances  as  the  "  throat  man/'  There  is  no  man  so 
prolific  in  mischief  to  the  fairer  portion  of  the  race  as  he 
who  displays,  as  the  peculiar  badges  of  his  ministry,  the 
speculum,  the  parte  caustique,  the  sound,  and  the  multi- 
form pessary. 

And  the  catalogue  might  be  extended  indefinitely.  A 
large  proportion  of  this  unmistakable  quackery  has  grown 
up  insidiously  within  the  very  sheepfold  of  the  Profession. 
The  magnates  have  eaten  of  it  to  their  own  rejoicing  of 
pocket,  and  the  tender  lambs  of  the  flock  nibble  assiduously 
at  the  promising  grain,  being  fully  persuaded  that  they 
shall  thereby  be  enabled  to  wax  fat  and,  in  their  turn,  kick 
lustily  at  all  '^irregulars"  —  outside  the  pale  delicianum 
vitianum. 

Whatever  excuse  might  have  formerly  been  afforded  for 
an  attempt  at  division  of  labor  in  the  practice  of  medicine, 
however  attractive  seems  the  opportunity,  the  great  light, 
which  has  of  late  years  been  thrown  upon  the  intimate 
relation  existing  between  the  most  remote  parts  of  the 
human  body,  now  utterly  dispels  the  illusion.  No  man 
who  understands  the  full  import  of  (;omparatively  recent 
,  discoveries  can  now  fail  to  see  that  the  attempt  to  separate 
treatment  of  any  single  part  of  the  body  from  a  complete 
knowledge  of  the  method  of  treating  the  whole,  however 
diseased,  is  like  a  man's  attempting  to  light  a  single  burner, 
when  the  whole  supply  pipe  is  shut  off  at  the  meter.  It 
may  burn  a  little,  a  timid  flickering  ray  or  two,  enough  to 


4  The  Peninsular  and  Independent. 

show  how  dark  the  surroundings  are,  but  speedily  it  is 
gone — precisely  as  the  traveling  specialists  do,  burning 
out  the  supply  in  their  little  pipes,  and  then,  the  places 
which  have  once  known  them  know  them  no, more  for  ever. 

It  is  to  be  feared  that  much  of  this  tolerance  of  spe- 
cialism has  grown  out  of  sheer  indolence.  Acquaintance 
with  what  inquirers  in  special  dejDartments  of  medical  sci- 
ence have  brought  to  light  is  imperatively  necessary  to  the 
conscientious  medical  practitioner,  and  it  is  quite  a  relief 
to  have  some  prophesiers  of  smooth  things  say  that  it  is 
better  to  devote  attention  to  what  observers  in  one  depart- 
ment only  bring  forward.  But  he  only  is  a  reliable  prac- 
titioner who  has  drawn  from  every  well  at  whose  bottom 
Truth  is  —  who  has  thoroughly  grounded  himself  in  the 
lore  of  experience,  and  the  wisdom  of  research  in  all 
science. 

This  idea  is  not  novel— it  is  as  old  as  Bacon.  "In 
particular  sciences  we  see,  that  if  men  fall  to  subdivide 
their  labors,  as  to  be  an  oculist  in  physic,  or  to  be  perfect 
in  some  one  title  of  the  law  or  the  like,  they  may  prove 
ready  and  subtile,  but  not  deep  or  sufficient,  no,  not  in 
that  subject  which  they  do  particularly  attend,  because  of 
that  consent  which  it  hath  with  the  rest.''  ..."  I  mean 
not  that  use  which  one  science  hath  of  another  for  orna- 
ment or  help  in  practice,  but,  I  mean  it  directly  of  that 
use  by  way  of  supply  of  light  and  information,  which  the 
particLilars  and  instances  of  one  science  do  yield  and  present 
for  the  framing  or  correcting  of  the  axioms  of  another 
science  in  their  very  truth  and  notion!' 

Kefer  now  to  the  flood  of  light  which  is  being  thrown 
upon  the  connection  of  remote  parts  of  the  human  body, 
by  the  ingenious  application  of  the  newly -discovered  laws 
of  nervous  action,  to  the  elucidation  of  previously  occult 
phenomena.  The  physiology  of  metastasis,  now  as  clearly 
discoverable  as  the  physiology  of  digestion.      The  epilepsy 


Waggoner  on  Milk  Sichiess.  5 

supplanting  the  disease  which  long  baffled  the  "  skin  man." 
The  phthisis^  which  rewarded  the  efforts  of  the  "os  uteri 
man."  The  diabetes,  which  puzzled  the  "liver  man/'  and 
so  forth,  and  so  on,  to  the  end  of  the  categories. 

One  blood  percolates  all  capillaries — one  nervous  system 
is  webbed  in  and  over  every  organ,  every  tissue.  Take 
away  every  thing  else,  and  nervous  fibre  and  vesicle  map 
out  the  entire  man.  And  yet,  with  these  all -pervading 
elements,  comes  the  Specialist,  and  rejoices,  like  Marius 
at  Carthage,  "alone  amid  ruins,"  that  he  can  yet  play 
manifold  tunes  upon  his  keyless,  valveless  trumpet.  What 
matter  is  it  if  the  hapless  patient,  like  John  Eandolph, 
dies  so  soon  as  he  is  cured?      Egypt  "still  lives." 


ART,  II.— Milk  Sickness. 


By  F.  R.  Waggoner,  M.  D. 

In  reviewing  the  notices  given  in  the  journals,  of  the 
Transactions  of  the  American  Medical  Association,  I  make 
a  special  note  of  Dr.  Sutton's  Eeport  on  the  Diseases  and 
Topography  of  Kentucky,  and  especially  of  his  malarious 
hypothesis  ol  the  etiology  of  Milk  Sickness. 

I  feel,  in  no  small  degree,  timid,  in  making  an  assault 
on  the  doctrines  promulgated  by  a  grave  member  of  the 
learned  American  Medical  Association.  Notwithstanding, 
however,  his  position  and  senile  dignity,  I  claim  a  voice,  if 
I  am  a  junior  brother— I  claim  it  because  my  knowledge 
has  been  derived  from  personal  observation  and  contact  with 
the  fearful  malady,  though  I  know  not  what  the  learned 
M.  D.'s  advantages  have  been  in  securing  data  to  found  his 
hypothesis  on. 

That  its  etiology  is  not  of  a  miasmatic  origin  is  obvious 
from    many  facts  :    1st,  It  is  strictly   an   endemic  disease  ; 


6  The  Peninsular  and  Independent. 

2d,  It*  is  not  known  in  many  malarious  districts  ;  3d,  The 
victim  of  its  toxical  influence  is  aflected  entirely  different — 
that  is,  the  symptoms  of  malarial  diseases  and  Milk  Sick- 
ness are  in  no  case  the  same.  (I  mean  well  defined  malarial 
fevers. ) 

Who  ever  heard  of  the  entire  Mississippi  Valley  being 
affected  by  ^^  Trembles" — yes,  a  State,  or  even  a  county  or 
community — as  has  been  the  case  so  frequently  with  the 
miasmatic  diseases  ?  I  have  witnessed  seasons  when  scarce 
a  family,  of  however  well  regulated  hygienic  habits,  escaped 
the  malady  in  some  of  its  forms — intermittent,  remittent, 
pernicious,  &c. 

But  on  the  other  hand,  the  disease  in  question  is  sub-^ 
j  acted  to  general  and  fixed  rules,  unalterable  as  the  laws 
of  the  Medes  and  Persians,  that  are  obvious  to  the  most 
casual  observer.  1st.  Persons  are  only  liable  to  the  disease 
who  feed  upon  the  flesh,  milk,  &c.,  of  animals  that  pasture 
in  timbered  land,  as  I  have  stated  in  another  article,  in  the 
January  No.  of  this  journal ;  therefore  we  scarce  ever  see  a 
patient  except  along  water -courses  which  are  bounded  by 
woodland  on  either  side.  So,  we  Suckers  know  too  well 
where  to  look  for  "  Milk  Sickness." 

The  topography  of  this  county  (Shelby),  in  which  I 
reside,  is  such  as  to  demonstrate,  as  clearly  as  any  propo- 
sition in  geometry,  that  it  is  not  of  a  malarial  origin.  The 
county  is  a  large  one,  and  is  traversed  from  northeast  to 
southwest  by  the  Kaskaskia  River,  which  has  a  number  of 
tributaries,  under  the  denomination  of  creeks,  draining  the 
country  for  many  miles  east  and  west  of  the  river.  As  is 
common  in  this  Prairie  State,  the  streams  are  skirted  by 
timber,  extending,  in  some  cases,  back  from  the  stream  two, 
three,  and  even  four  miles  in  places.  The  parent  stream, 
the  Kaskaskia,  makes  it  way  through  a  very  broken  coun- 
try, with  but  little  bottom-land;  the  ridges  and  knolls 
reaching  back  for   some  distance,    from  one   to  two  miles^ 


Waggoner  on  Milk  Sickness.  7 

when  a  tableland  sets  in  that  continues  to  the  prairie.  The 
"river  timber"  is  generally  from  five  to  six  miles  across. 
I  would  add  that  this  broken  region  is  covered  by  a  profuse 
white  oak  growth — now  and  then  a  specimen  of  some  other 
variety  of  the  Quercus,  together  with  an  occasional  hickory 
and  walnut,  the  latter  nearing  the  stream. 

The  tableland  is  studded  by  a  va  iety  of  various  species 
of  the  oak,  hickory,  etc.,  while  nearing  the  prairie  the 
timber  becomes  shrubby,  stinted,  and  inferior.  The  soil, 
generally  speaking,  is  of  a  wet,  heavy  clay  character,  which 
is  noted  for  its  productive  qualities  by  the  farmers.  But 
on  the  other  hand,  the  smaller  streams  are  traced  by  a 
growth  of  a  different  character,  as  the  Gleditschia  triacan- 
thus  in  abundance,  TJlnus,  U.  Americana,  U.  fulva,  Cera- 
sus  Serotina,  Celtis,  Crassifob'a,  etc.,  and  an  undergrowth 
of  hazel,  spicewood,  and  of  such  growths  as  are  generally 
found  in  the  black,  sandy  loam  soil.  I  would  say  here, 
that  the  soil  along  these  minor  water  courses  is  not  to  be 
surpassed  in  fertility  in  the  great  Mississippi  Valley,  while 
the  prairies  adjoining  have  soil   in   no   way   inferior. 

It  is  on  the  course  of  those  creeks  that  Milk  Sick- 
ness makes  its  appearance,  and,  as  it  were,  strikes  its 
victim  down  at  noonday,  and  is  emphatically  the  terror 
of  the  forest,  while  the  inhabitants  of  the  Kaskaskia  re- 
gions, together  with  their  horses,  cattle,  hogs,  &c.,  enjoy 
perfect  freedom  from  the  monster.  This  is  a  fact  well 
known  to  every  citizen  of  a  few  years'  observation  with  us. 

To  remark  more  minutely  upon  our  county  topography. 
The  northwest  corner  of  it  is  drained  by  the  terminus  of 
the  south  fork  of  the  Sangamon  Eiver,  whose  immediate 
source  is  in  the  prairie,  and  winds  its  way  for  some  ten 
or  twelve  miles  through  the  same,  without  scarce  a  bush 
or  shrub  to  mark  its  course,  when  it  enters  a  heavy  and 
thick  forest -growth,  the  same  as  described  as  growing  on 
the  tributaries  of  the  Kaskaskia.      It  is  worthy  of  remark 


8  The  Peninsidar  and  Independent. 

that  on  either  side  of  this  prairie -stream,  the  face  of  the 
country  is  very  flat,  and  boggy  in  places.  In  the  wet  season 
of  the  year  the  entire  face  of  the  country  is  almost  covered 
\>j  the  aqueous  fluid.  The  soil  is  of  the  sandy  loam  also  ; 
very  fertile  and  productive,  if  properly  drained  and  culti- 
vated. This  meadow -land  is  a  favorite  resort  for  cattle, 
from  early  spring  to  late  autumn  ;  and,  strange  to  relate, 
never  a  case  of  Milk  Sickness  occurs  among  them,  though  it 
may  he  readily  inferred,  it  is  the  very  hot -bed  of  malaria. 
But  no  sooner  than  our  stream  reaches  its  sylvan  destina- 
tion than  the  malady  of  which  we  treat  clandestinely  exhi- 
bits its  furor. 

But  to  return  to  our  former  topographical  sketch.  The 
Kaskaskia  and  its  adjacent  country  are,  and  ever  have  been, 
as  prolific  in  miasmatic  diseases  as  any  part  of  the  Great 
West,  and,  too,  in  their  most  hideous  and  malignant  form, 
together  with  the  milder  grades,  as  chills  and  ague,  early 
and  late.  The  Doctor's  fee  is  the  only  dread  for  six  months 
of  the  year  ;  but,  I  repeat,  not  a  case  of  Milk  Sickness  has 
ever  been  known  in  all  this  vast  scope  of  malarious  coun- 
try for  the  M.  D.s  to  try  their  skill  upon,  or  to  alarm  the 
credulous.  It  is  nevertheless  those  smaller  streams  which 
are  subjected  to  malaria,  but  not  to  the  extent  that  the 
Kaskaskia  is.  But  on  these  minor  streams  I  repeat  the 
^^ slows''  reign  supreme.  Can  the  learned  Dr.  Sutton  ex- 
plain this  anomaly  ? 

The  country  intervening  those  creeks  is  prairie,  in  some 
cases  to  the  extent  of  ten  or  fifteen  miles,  very  high  and 
draining.  Though  malaria  frequently  visits  its  tenants. 
Milk  Sickness  is  unknoivn  to  their  prairie  abode. 

As  I  am  very  deficient  in  descriptive  faculties  I  will  dilate 
no  farther  on  the  geography  of  Shelby.  I  shall  not  occupy 
much  of  your  precious   space  with  my  ultima  ratio. 

The  symptoms  of  malarial  diseases  *are  so  varied,  nu- 
merous, and  dissimilar,  that  nearly  every  patient  has  symp- 


Waggoner  07i  3filk  Sickness.  9 

toms  peculiar  to  himself,  thougli  every  case  loudly  proclaims 
to  the  experienced  observer  its  etiology.  The  premonitory 
symptoms  of  Milk  Sickness  differ  most  from  malarial.  The 
symptoms  are  langor^  lassitude,  and  a  peculiar  dullness 
and  stupor,  for  several  days  before  the  onset  of  the  attack 
proper  begins  ;  chilliness,  &c.  are  unknown.  The  "  foetor " 
of  the  exhalations  is  a  striking  diagnostic,  and  is  never 
known  in  any  form  of  the  malarial — in  fact,  every  clinical 
manifestation  points   out  a   malady  of  a  peculiar  etiology. 

I  have  heretofore  ventured  an  opinion  on  its  origin,  and 
I  am  now  no  way  inclined  to  retract,  and  only  ask  the  Pro- 
fession to  indulge  me  in  my  way,  and  look  with  me  for  its 
telluric  source. 

It  has  been  iterated  and  re -iterated  that  the  poison  is 
most  virulent  and  plenty  in  the  fall  season,  after  a  hot, 
dry  summer.  That  this  is  true  I  can  not  add  my  testimony, 
but  am  rather  inclined  to  skepticism.     A  few  facts  in  point. 

The  summer  of  1851  was  extraordinarily  wet,  from  the 
latter  part  of  May  until  late  in  August ;  Milk  Sickness  in 
abundance,  at  least  among  stock.  In  1852,  the  season  was 
very  favorable — but  little  sickness  of  any  kind  ;  not  a  case 
of  Trembles  to  the  best  of  my  knowledge.  In  1853-4, 
very  dry  ;  good  health.  In  1855,  rainy  and  hot ;  cholera 
in  Shelbyville  ;  dysentery,  malarial  fevers,  and  Milk  Sick- 
ness in  great  profusion.  In  1856-7,  drouth,  and  good 
health,  except  on  the  border  country  of  the  Kaskaskia  ; 
malaria  and  dysentery  the  scourge.  In  1858,  very  wet,  with 
a  fearful  outbreaking  of  Milk  Sickness.  I  only  speak  for 
this  county. 

I  readily  concede  the  fact  that  my  observations  have 
been  too  limited  and  circumscribed ;  but  straws  show  which 
way  the  wind  blows. 

Again,  it  has  been  rumored  that  it  disappears  at  the 
approach  of  winter,  or  after  the  vegetation  is  destroyed  by 
autumnal  frosts  and  freezings.      This   may  all  be  true  — 


10  Ihe  Peninsular  and  Independent. 

tliat  is,  primary  Milk  Sickness,  or  the  exciting  cause  ;  but 
that  it  lingers  in  the  system,  fermenting,  hibernating,  or 
incubating  (probably  acts  by  catalysis),  as  the  case  may 
be,  and  manifests  itself  in  the  heart  of  winter,  is  a  fact  now 
proven  indubitably  to  me.  Since  Dec.  1st  I  have  treated 
^NQ  well  defined  and  malignant  cases,  and  have  now  (Feb. 
21st)  a  case  under  treatment,  in  this  town.  The  patient 
is  a  road  hand.  When  and  how  the  poison  was  taken  is 
unknown,  but  in  all  probability  from  beef  consumed  last 
fall,  as  the  landlady  at  his  boarding-house  had  a  severe 
attack  in  October  last,  relapsed  in  December,  but  under 
treatment  as  given  in  my  last  communication  to  you  (viz. 
saline  cathartics,  opiates,  tonics,  and  stimulants)  she  re- 
covered. I  would  remark  my  present  patient  is  convales- 
cing finely. 

Let  me  chronicle,  here,  that  many  cattle  died  of  it  in 
the  month  of  December,  1858,  but  none  since,  as  I  have 
learned. 

These  facts  demonstrate  the  truth  (for  such  it  is)  that 
we  may  look  for  Milk  Sickness  in  winter  as  well  as  in  fall 
practice.  And  now,  Messrs.  Editors,  let  all  who  know  on 
this  subject  speak ;  and  we  will  yet  learn  something  of  its 
latent  etiology. 

Oconee,  Illinois. 


ART.  Ill —Detection  of  Alkaloids. 


By  Henry  Erni,  M.  D. 


MORFHTNE. 

In  my  article  "  upon  the  Employment  of  Strychnine  as  an 
Adulteration  for  Alcoholic  Liquors "  (Dec.  1858)  I  descri- 
bed the  reactions  by  which  strychnine  is  recognized,  and 
pointed  out  the  general  principles  wTiich  have  to  guide  us 


Erni  on  Detection  of  Alkaloids.  11 

in  isolating  any  of  the  alkaloids,  when  mixed  with  food, 
contents  of  stomach,  etc.  (p.  518).  In  referring  back  to 
the  method  devised  by  Stas,  I  propose  to  continue  this 
subject  by  giving  the  chemical  tests  for  tracing  Morphine 
and  its  salts. 

Morphine  occurs  in  small,  colorless  prisms,  or  as  a  crys- 
talline powder.  Cold  water  dissolves  about  1  -  1000th, 
hot  water  nearly  double  the  quantity,  the  solution  showing 
an  alkaline  reaction  with  litmus.  Morphine  is  more  soluble 
in  alcohol,  especially  if  boiling  hot,  taking  up  1  -  40th  of  its 
weight,  the  greater  portion  separating  again  on  cooling.  It 
is  nearly  insoluble  in  ether  ;  concentrated  liquor  of  potasi^a 
or  soda  dissolve  it  largely,  and  without  any  chemical  change. 
(Narcotine  is  insoluble  in  alkaline  lexivias.) 

Morphine  forms  crystallizing  salts  with  acids  which  are 
soluble  in  alcohol  ;  sulphate,  acetate,  and  muriate  of 
Morphine  are  also  soluble  in  water,  and  all  of  them  in 
acidulated  water. 

It  is  recognized  by  the  following  reactions  : 

1.  If  we  bring  some  Morphine  into  concentrated 
nitric  acid,  the  latter  assumes  a  blood  red  color,  turning 
gradually  more  and  more  yellow. 

2.  Morphine  and  its  salts  separate  from  a  solution  of 
iodic-acid  free  iodine,  which  is  either  thrown  down  or 
remains  dissolved,  coloring  the  liquid  yellow  to  brown,  and 
exhibiting  its  peculiar  odor  and  turning  starch -paste  blue. 

3.  A  trace  of  Morphine,  dissolved  in  water  slightly 
acidulated  with  muriatic  acid  (the  solution  must  be  as 
neutral  as  possible),  and  brought  in  contact  with  diluted 
(neutral)  perchloride  of  iron,  causes  a  transient  blue  color, 
passing  into  green  and  brown. 

4.  Perchloride  of  platinum  precipitates  salts  of  Mor- 
phine, orange  -  colored  (no  ammonia  or  alkalies  must  be 
present). 

To  establish  the  presence  of  opium,  it  is  but  necessary 
to  trace  the  meconic  acid,  since  it  is  found  nowhere  else. 


12  The  Peninsular  and  Independent. 

The  substance  to  be  examined  is  treated  with  alcohol 
and  a  few  drops  of  chlorohydric  acid  ;  the  extract  is  evapora- 
ted, and  the  residue  mixed  with  some  water  ;  the  insoluble 
portion  is  now  filtered  ofP,  and  the  filtrate  boiled  with  an 
excess  of  caustic  magnesia  {^Magnesia  usta).  We  again 
throw  the  mixture  upon  a  filter,  the  filtered  liquid  contains 
meconate  of  Magnesia,  which,  when  first  acidulated  with 
chlorohydric  acid,  and  brought  together  with  a  solution  of 
perchloride  of  iron,  produces  an  intense  mahogany-brown 
color. 


•  •  • 


ART.  lY.— Cannabis  Indica. 


By  John  M.  Alden,  M.  D. 


From  hearing,  some  years  since,  favorable  reports  relative 
to  the  use  of  Cannabis  Indica  in  convulsive  and  other  affec- 
tions, I  was  induced  to  employ  it,  and  have  been  highly 
pleased  with  its  eff'ects  in  nervous  sufferings,  annoyances, 
irregularities,  and  also  in  nervous  debility. 

In  hysteria  I  have  found  nothing  better.  I  usually  give 
half- grain  doses  of  the  Extract  every  half  hour,  in  pill  or 
alcoholic  solution.  I  prefer  the  latter  form,  as  the  effect  is 
the  more  immediate.      The  formulae  is  as  follows  : 

Ext.  Cannabis  Indicae,  3j. 
Alcohol,  I  iij. 
M.     Dose,  Half  teaspoonfal  every  half  hour. 

I  have  employed  it  in  many  cases  of  delirium  tremens 
with  the  best  results  :  giving  one  -  grain  dose  every  half  hour ; 
which  should  be  continued  until  sleep  is  induced.  I  have 
often  given  twenty  grains  before  this  was  accomplished. 

I  have  also  used  it  with  marked  success  in  cases  of 
palpitation  of  the  heart,  unconnected  with  any  change  of 
structure,   but   dependent   upon  some   disordered   condition 


Alden  on   Cannabis  Indica.      ^  13 

of  the  stomachj  or  some  other  slight  cause  deranging  the 
equilibrium  of  the  nervous  system.  In  these  cases  I  often 
find  it  necessary  to  continue  its  use  for  some  weeks,  giving 
it  three  or  four  times  a  day  in  grain  doses. 

I  have  often  prescribed  it  to  relieve  spasms  arising  from 
cholera  morbus  ;  and  have  found  it  successful  in  infantile 
convulsions,  independent  of  any  vascular  disturbance,  pain- 
ful dentition,  or  cerebral  implication,  but  v^rhich  are  excited 
and  sustained  by  intestinal  irritation,  caused  by  crude  in- 
gesta  or  vitiated  secretions.  Also,  in  severe  cases  of  burns, 
where  the  pain  was  intense,  the  patient  has  derived  much 
benefit  from  it  in  a  short  time.  Its  effects  being  soothing, 
I  think  it  the  best  remedy  in  all  like  circumstances.  I 
have  met  with  most  success  by  the  use  of  this  remedy  in 
cases  of  nervous  headache,  than  from  all  the  other  reme- 
dies combined,  including  caffein  ;  giving  one  grain  of  the 
Extract  every  three  hours  until  the  patient  is  relieved ;  usu- 
ally continuing  it  several  days,  once  in  six  hours,  which 
continuation  intercepts  a  recurring  paroxysm. 

The  only  bad  effects  which  I  have  ever  experienced  from 
its  use,  during  twelve  years'  experience  with  it,  was  in  two 
instances  where  three -grain  doses  were  administered  in  cases 
of  indigestion  and  constipation.  The  first  case  was  that 
of  Mr.  CooPEK,  /in  the  locality  of  Grand  Kapids,  Mich.; 
he  was  of  ordinary  health,  and  I  had  prescribed  the  Ex- 
tract of  Apocynum  Cannahinum  in  three -grain  doses.  The 
druggist,  by  mistake,  put  up  the  Cannabis  Indica ;  the 
mistake  arising  from  the  fact  that  both  articles  are  im- 
properly denominated  Indian  Hemp.  The  nearest  physician 
being  a  Homoeopathist,  he  was  called  in  at  the  time  Mr. 
C.  was  under  the  influence  of  an  overdose  of  this  elixir  vita?, 
which  afforded  him  a  capital  opportunity  to  portray  the 
dangerous  treatment  of  the  regular  practice.  However, 
when  the  facts  were  known  in  the  case,  both  he  and  the 
patient  were  disposed   to  reverse   their  decision,   and  attri- 


14  The  Peninsular  and  Independent. 

bute  the  phenomena  produced  to  the  true  cause.  The 
symptoms  in  this  case  were  of  a  spasmodic  and  convulsive 
character,  very  nearly  allied  to  those  of  tetanus — cramping 
of  the  voluntary  muscles,  at  times  of  the  whole  body.  The 
exacerbations  of  the  spasms  were  very  short,  and  became  less 
frequent,  and  shortly  disappeared  entirely.  There  was  no 
nausea,  but  a  highly  stimulating  effect  was  produced. 

The  second  case  was  Mrs.  B.,  of  this  city  ;  the  same 
prescription  being  ordered  as  in  the  other  instance,  and  the 
druggist  putting  up  the  Cannabis  Indica  by  mistake. 
About  the  same  phenomena  were  produced  as  in  the  first 
case.  When  I  interrogated  her  in  reference  to  her  feelings, 
she  remarked,  laughing  at  the  same  time,  that  she  never 
was  drunk  in  her  life,  but  from  what  she  had  seen  she 
could  not  describe  her  feelings  better  than  to  say  she  was 
^'  very  drunks  The  neighbors  were  much  alarmed,  as  the 
change  was  sudden,  and  the  patient  convalescing  at  the 
time.  By  the  administration  of  an  anti- spasmodic,  she 
soon  recovered  from  its  effects. 

From  my  own  experience  in  the  use  of  the  Extract 
of  Cannabis  Indica,  I  conclude  its  properties  are  stimulant, 
anodyne,  narcotic,  anti  -  convulsive,  anti  -  spasmodic,  and 
aphrodisiac  —  exhilarating  the  spirits,  increasing  the  appe- 
tite, and  in  large  doses,  occasioning  intoxication ;  when 
administered  properly,  restoring  nervous  composure  and 
quietude,  without  impairing  the  appetite,  checking  secre- 
tions, or  constipating  the  bowels,  hence  its  advantage  over 
opium. 


•  •  > 


ART.  v.— A  Case  of  Brain  Disease  presenting  some  Points  of  Interest. 

By  0.  0.  GiBBS,  M.  D. 

There  are  are  some  brain  affections  that  are  so  obscure  in 
their  systemic  manifestations,  that  a  correct  diagnosis  is  by 


GiBBS's   Case  of  Brain  Disease.  15 

no  means  easy.  Tumors,  cysts,  hydatids,  and  tubercles  of 
the  brain,  atrophy  and  softening  of  that  organ,  present 
^occasionally  illustrative  cases.  There  is  one  source  of  con- 
solation to  the  physician  in  these  obscure  cases,  for  it  is 
often  a  matter  of  but  little  moment  whether  our  diagnosis 
be  correct  or  not,  as  they  tend,  generally,  steadily  to  a 
fatal  termination. 

The  following  case  presents  some  points  of  interest : 
January  10th,    1859,  I  was  called   to  see  Mr.  E.,  aged 
about  55  years.      He  was  a  large,  muscular   man,  in  good 
ilesh,  and,  so  far  as  the  digestive  and  assimulative  organs 
were  concerned,  seemed  in  good  health.      He  had,  for  most 
'of  his  life,   been  a  regular   drinker  of  intoxicating  drinks, 
an    immoderate    chewer    of   tobacco,    and   a    hard    laborer. 
When  the  gold   excitement   in  California  was  at  the   first 
height  of  its  rage,  he  went  there,  and  labored  industriously 
for  about  three  years  in  the  mines.      For  the  last  year  his 
family  had  discovered  something  wrong  with  him.      Always 
seemingly  happy,  joyous,    and   mirthful,   he  first   attracted 
'^.ttention  by  telling  foolish  and   laughably  absurd   stories, 
;always  with    seeming  sincerity  and  unfeigned   truthfulness. 
His  memory,  also,  seemed   greatly  impaired,  as   he  would 
tell  the  same  stories  to  the  same  individuals  repeatedly,  and 
never  show   that  he  did   not  suppose  they  were  each  time 
new   to  them.      About   three  months  ago,  the   integrity  of 
the  will   seemed  greatly  impaired.      When  a  certain   labor 
was  commenced  he  seemed   to  have  no  power  to  stop  the 
muscular  exercise  which  that  labor  called  forth.      If  he  went 
to  the  barn  to  throw  down  a  forkful  of  hay  for  his  horse, 
iie  would  never  stop  pitching  down  hay  until  the  whole  mow 
was  upon  the  fioor,  unless  some  one  stopped  him.      If  sent 
out  to  bring  a  handful  of  wood,  he  would  never  stop  until 
the  pile  was  all  in,  or  the  room  was  full,  until  some  one, 
by  force,  put  his  automatic  motions  to  a  stop.      When  he 
onee  commenced  eating,  it  would  seem  as  though  he  would 
never  stop,  unless  forced  to  do  so. 


16  The  Peninsular  and  Independent. 

For  a  few  weeks  past  the  integrity  of  his  mental  oper- 
ations had  seemed  more  disturbed ;  he  seemed  to  lose  the 
power  of  balancing.  When  he  arose  to  an  erect  position 
he  would  commence  to  go  backwards,  and  would  continue 
to  do  so  until  he  fell,  unless  watched  and  brought  down 
upon  a  seat.  When  sitting  he  would  commence  leaning 
backwards,  and  continue  until  he  tipped  over,  unless  pre- 
vented by  his  attendants.  He  was  disposed  to  sleep  much 
and  soundly.  He  was  uniformly  polite,  cheerful,  sometimes 
witty,  and  never  disconcerted,  or  in  any  way  disturbed  by 
any  mishaps  that  befel  him  in  consequence  of  his  loss  of 
balancing  power. 

The  case  was  diagnosed  as  one  of  softening  of  the  brain, 
more  particularly  of  the  cerebellum,  and  a  fatal  issue  was 
prognosticated. 

Though  there  was  no  pain  in  the  head,  the  temples 
were  cupped,  and  a  seton  was  inserted  in  the  back  of  the 
neck.  At  first  small  doses  of  mercurials  with  antimony 
was  given,  but  subsequently  quinine  with  alcoholic  stimu- 
lants were  substituted.  The  patient  gradually  failed,  and, 
without  marked  symptoms,  died  about  two  months  later. 
No  opportunities  for  post-mortem  could  be  had,  much  to 
our  regret. 

Frewsbury,  Chautauque  Co.,  N.  Y. 


Horton's  Meteorological  Register  for  February.         1 7 


ART.  VI.  —  Meteorological  Register  for  Month  of  February,  1859, 


By  L.  S.  Horton,  House  Physician  to  U.  S.  Marine  Hospital. 


Altitude  of  Barometer  above  the  level  of  the  sea,  597  feet.     Latitude,  42«24'N.;   and 
Longitude,  82''58' W.  of  Greenwich. 


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Vol.  II.  ~  B. 


iibIi0Sira5l]ital  llU0rh 


•  •  • 


FAVORITE    PRESCRIPTIONS    OF  LIVING    AMERICAN    PRACTI- 
TIONERS.    By  Horace  Green,  M.  D. 

A  SMALL  work,  giving,  under  appropriate  heads,  the  selec- 
tions from  Favorite  Prescriptions,  amassed  by  Dr.  Green  in 
his  professional  and  social  intercourse  with  those  Practi- 
tioners who  have  visited  him  during  many  years  past. 
Portions  of  these  have  been  quite  extensively  copied  from 
the  American  Medical  Monthly,  in  which  they  have  ap- 
peared, and  from  them  the  reader  can  gather  an  idea  of 
the  whole.      The  author  says : 

"The  publication  of  these  tried  formulae,  with  appended  observa- 
tions—  which  are  the  contributions  of  many  of  the  distinguished  Prac- 
titioners of  our  country  —  will  not  fail,  it  is  believed,  to  add  to  our 
stock  of  knowledge  in  both  rational  therapeutics  and  practical  medicine. 
To  the  young  and  inexperienced  Practitioner  it  will  afford  material  aid." 

THE   KNICKERBOCKER. 

We  received  from  the  Publishers  the  February  ISTo.  of  this 
^'Century  Plant"  among  the  "mushrooms"  of  popular  pe- 
riodical literature. 

We  particularly  noted  an  article  entitled  "A  Grain  of 
Wheat  in  a  Bushel  of  Chaff,"  in  which  the  writer  offers 
ample  proof  that  the  credit  for  priority  in  discovery  of  the 
pain- conquering  power  of  ether  as  an  anaesthetic,  should 
be  awarded  to  Horace  Wells,  of  Hartford,  Conn.,  instead 
of  to   Dr.    Morton,    of    Boston,   who   has   so    strenuously 


Bibliographical  Record.  19 

tjlaimed  it.  To  not  know  ^^  Knich."  is  to  lose  much  that 
is  pithy,  witty,  and  wise ;  and  if  we  confess  to  past  igno- 
rance, it  is  but  to  assure  ourselves  that  in  future  we  shall 
keep  posted. 

JOURNALS  AND  PAMPHLETS. 

1%6  Dental  Reporter.  An  Independent  Journal.  Devoted  to  Dental 
Progress  and  Improvements.  Edited  by  Jno.  T.  Toland.  Feb- 
ruary, 1859. 

The  No.  before  us  contains  an  extended  Eeport  of  the 
meeting  of  the  Michigan  State  Dental  Association,  and 
from  its  contents  generally  we  should  say  it  is  one  of  th© 
most  valuable   of  the  Dental  journals. 

3efw  Surgical  Treatment  for  Malformations  of  the  Urinary  Bladdei\ 
By  Daniel  Ayres,  M.  D.,   LL.  D.      Brooklyn,   N.  Y. 

Y^  Bane  and  Antidote.      By  B.  Frank  Palmer,   of  Philadelphia. 

The  No.  for  January  has  been  received,  together  with 
^  poem  read  before  the  Society  of  the  Sons  of  New 
England,  in  Pennsylvania.  Mr.  Palmek  seems  to  be  as 
much  of  a  genius  in  the  higher  walks  of  literature  as  he  is 
those  of  art.      Success  to  him  ! 

An  Address  to  the  Graduates  of  the  Ohio  College  of  Dental  Surgery^ 
by  W.  W.  Allport,  D.  D.  S. 

An  exceedingly  well  written  paper,  and  worthy  the 
perusal  of  all  dentists  who  have  not  a  clear  idea  of  what 
the  true  status  of  their  Profession  is. 


^Ht0rial  g^prtmtnt. 


Palmer's  Artificial  Limbs. 

During  our  connection  with  the  Medical  Independent 
we  had  occasion  to  speak  in  terms  of  deserved  praise  of 
Palmer's  artificial  leg ;  and  at  that  time  we  also  were  en- 
abled to  state  that  he  had  just  then  completed  an  inven- 
tion of  an  artificial  arm  which  was  surprisingly  perfect  in 
its  action,  and  also  in  resemblance  to  the  form  and  motion 
of  the  natural  organ. 

We  have  no  disposition  to  consume  either  time  or  space 
in  praising  the  ingenuity  manifested  by  Mr.  Palmer  :  that 
is,  at  this  time,  uncalled  for.  He  is  really  a  public  bene- 
factor, and  the  thousands  who  need  his  aid  are  those,  only, 
who  can  suitably  speak  his  praise.  There  is,  however,  one 
result  of  the  invention  to  which  we  would  especially  allude  : 
it  is  the  influence  that  it  has  exerted  upon  the  place  of 
election  in  amputation  of  the  leg.  Formerly,  if  any  por- 
tion of  the  leg  was  to  be  sacrificed,  the  rule  was  to  make 
the  section  as  close  to  the  knee  joint  as  practicable,  inas- 
much as  the  subcutaneous  position  of  the  tibia  prevented 
the  formation  of  a  flap,  or  cushion,  sufficiently  protective 
to  admit  the  adjustment  of  the  artificial  limb  ;  but,  thanks 
to  the  skill  of  Mr.  Palmer,  that  rule  is  now  expunged, 
and  the  conservative  element  of  Surgery,  which  calls  for 
the  utmost  salvation,  can  be  universally  heeded.  The  rule 
is  now  reversed,  and  the  farthest  point  possible  from  the 
knee  joint   is   the   place   for   the   section.      Thus,   all   the 


Editorial  Department. 


21 


advantages    of  a   natural  joint   at   the   knee   are  saved   to 
the  patient. 

Below  may  be  found  a  detailed  description  of  the  leg, 
illustrated  by  wood  cuts  : 

The  articulations  of  knee,  ankle,  and  toes  consist  of  detached  ball- 
and-socket  joints,  J,  B,  G.  The  knee  and  ankle  are  articulated  bj 
means  of  the  steel  bolts,  E,  E,  combining  with  plates  of  steel  firmly 
riveted  to  the  sides  of  the  leg,  J9,  D.  To 
these  side  plates  are  immovably  fastened 
the  steel  bolts,  E^  E.  The  bolts  take  bear- 
ings in  solid  wood  (properly  bushed)  across 
the  entire  diameter  of  the  htiee  and  anTcle^ 
being  fourfold  more  reliable  and  durable 
than  those  of  the  usual  construction.  All 
the  joints  are  so  constructed  that  no  two 
pieces  of  metal  mom  against  each  other  in 
the  entire  limb.  The  contact  of  all  broad 
surfaces  is  avoided  where  motion  is  re- 
quired, and  thus  friction  is  reduced  to  the 
lowest  degree  possible.  These  joints  often 
perform  many  months  without  need  of  oil, 
or  other  attention,  a  desideratum  fully  ap- 
preciated by  the  wearer. 

The  Tendo  Achillis,  or  heel  tendon,  F, 
perfectly  imitates  the  natural  one.  It  is 
attached  to  the  bridge,  6^,  in  the  thigh,  and 
passing  down  on  the  back  side  of  the  knee 
bolt,  E,  is  firmly  fastened  to  the  heel.  It 
acts  through  the  knee  bolt,  on  a  centre^ 
when  the  weight  is  on  the  leg,  imparting 
security  and  firmness  to  the  knee  and  ankle 
joints,  thus  obviating  all  necesssity  for 
knee-catches.  When  the  knee  bends  in  tak- 
ing a  step,  this  tendon  vibrates  from  the 
knee  bolt  to  the  back  side  of  the  thigh, 
A,  Fig.  2,  next  page.  It  descends  through 
the  leg,  so  as  to  allow  the  foot  to  rise 
above  all  obstructions,  in  flexion,  and  car- 
ries the  foot  down  again,  in  extension  of 
the  leg  for  the  next  step,  so  as  to  take  a  firm  support  on  the  ball  of 
the  foot.  Nature -like  elasticity  is  thus  attained,  and  all  thumping 
sounds  are  avoided. 

Another  tendon,  M,  of  great  strength  and  slight  elasticity,  arrests 
the  motion  of  the  knee,   gently,  in  walking,  thus   preventing  all   dis- 


Fig.  1. 


22 


The  Peninsular  and  Independent. 


agreeable  sound  and  jarring  sensation,  and  giving  requisite  elasticity  to^ 
the  knee. 

A  spring,  lever,  and  tendon,  /,  /,  JT,  combining  with  the  knee 
bolt,  give  instant  extension  to  the  leg  when  it  is  semi -flexed  to  take  a., 
step,  and  admit  of  perfect  flexion  in  sitting. 

A  spring  and  tendons  in  the  foot,  X,  if,  N,  impart  proper  and  re- 
liable action  to  the  ankle  joint  and  toes.  The  sole  of  the  foot  is  made 
soft,  to  insure  lightness  and  elasticity  of  step. 

The  stump  receives  no  weight  on  the  end,  and  is  well  covered  and 
protected,  to  avoid  friction  and  excoriation. 

These  joints,  springs,  and  tendons  are  all  patented,  and  no  modifi- 
cation of  any  part  will  enable  a  person  successfully  to  evade  the  patents^ 
which  contain  about  twenty  distinct  and  combined  claims,  eoverin^ 
nearly  the  entire  mechanism. 


Fig.  2. 


JEditorial  Department, 
Fig.  S  is  a  yiew  of  Palmer's  perfect  model  Artificial  Leg. 


2S 


Fig.  S. 

An  artificial  arm,  that  would  be  something  more  than 
ornamental — that  would  serve  useful  purposes,  and  enable 
the  patient  to  grasp  objects  with  tolerable  precision  has 
long  been  a  desideratum.  That  desired  object  has  at  length 
been  realized.  The  same  genius,  directing  the  same  perse- 
vering effort  which  produced  the  incomparable  leg,  has  now 
achieved  a  still  greater  triumph.  Mechanical  perfection  has 
always  challenged  our  warmest  admiration,  but  when  that 
mechanism  is  made  to  supply  the  place  and  motions  of  a 


24  The,  Peninsular  and  Independent. 

lost  human  hand,  even  though  imperfectly,  admiration 
gives  place  to  enthusiasm,  and,  as  a  surgeon,  we  respect- 
fully and  thankfully  salute  the  genius  that  mitigates  the 
evils  necessarily  caused  by  our  reluctant,  though  limb- sac- 
rificing, catlin. 

That  our  readers  may  justly  comprehend  this  useful 
invention  we  insert  the  following  cuts  and  description  : 

Fig.  1,  represents  an  arm  to  be  applied  above  the  elbow.  The  articu- 
lation A  B,  is  a  ball  and  socket,  connected  by  the  steel  plates  G  c,  and 
turning  upon  the  pinion  D.  The  functions  of  the  bones  in  the  Fore -arm 
(Radius  and  Ulna),  are  imitated  by  the  conical  shaft  E,  which  termi- 
nates in  a  ball  at  the  elbow  and  wrist  J"/.  The  wrist  is  articulated  with 
a  ball  and  socket  firmly  united  by  catgut  tendons  F^  (?,  H^  tensely  drawn 
over  the  convexity  of  the  shaft  E  at  the  elbow.  It  has  every  motion 
of  the  natural  wrist.  The  hand  rotates  on  the  Fore -arm,  being  suscep- 
tible of  pronation  and  supination,  or  any  angle  or  degree  of  flexion  and 
extension  desirable.  The  extensor  tendons  K^  Z,  if,  N,  0,  acting  with  the 
springs  1,  2,  3,  4,  5,  open  the  hand.  The  detached  ball  and  socket 
joints  of  the  thumb  and  fingers  are  indicated  by  the  figures  1,  2,  and 
1,  2,  8. 

The  fingers  are  articulated  on  steel  rods  and  pinions  imitating  the 
bones,  as  seen  in  the  thumb  and  the  first  and  third  fingers.  The  exte- 
rior is  brought  to  a  perfect  imitation  of  the  natural  arm  (as  shown  in 
the  outline,  or  in  Fig.  5),  by  a  soft  elastic  substance,  which  rotates 
around  the  Fore -arm,  preserving  anatomical  symmetry  in  every  position. 
It  is  covered  with  a  delicate  skin. 

Fig.  2,  is  the  same  arm  extended,  with  the  fingers  semi -flexed. 
The  belt  A  attaches  the  arm  to  the  body.  The  small  belt  G  G'2i^  is 
connected  by  a  tendon  to  a  clasp  and  pulley  D^  E.  The  great  muscle 
F  is  the  continuity  of  the  flexor  tendons  G,  H^  /,  /,  K.  These  tendons 
pass  sinuously  over  pulleys  or  fixed  sheaves,  1,  2,  3,  4,  5,  through  the 
hand,  to  the  end  of  the  fingers  and  thumb.  The  principles  of  the  lever 
and  pulley  are  thus  combined,  and  the  maximum  power  retained  at  all 
angles  of  flexion  or  extension.  A  slight  motion  of  the  shoulders,  with 
extension  of  the  Fore -arm,  produces  an  incredible  grasp,  as  seen  in 
Fig.  3. 

An  object  of  any  shape,  such  as  a  pen,  a  fork,  or  an  apple  is  held 
with  facility.  By  a  slight  motion  of  the  shoulders  the  belt  A  B  causes 
the  great  muscle  F,  and  its  tendons,  to  contract  powerfully,  closing  the 
hand.  A  movement  easily  and  naturally  made  actuates  the  tendon  G  6^2 
and  fastens  the  clasp  D  upon  the  muscle  so  as  to  retain  the  grasp  in 
any  position  or  motion  of  the  arm,  when  in  use.  This  is  regarded  as 
invaluable  for  holding  reins  in  driving,  or  carrying  articles  with  safety. 


Editorial  Department. 


25 


26  The  Peninsular  and  Independent, 

An  easy  counter  -  motion  unfastens  the  clasp^  relaxing  the  flexor  muscle 
and  its  tendons,  and  the  extensors  open  the  hand.  This  principle  per- 
forms most  perfectly  in  an  arm  applied  below  the  elbow,  as  in  Fig.  3. 

Fig.  3.  In  this  are  seen  the  belt  A  B  C^  the  great  muscle  F  and 
its  tendons,  the  clasp  and  pulley  i),  E^  as  in  Fig.  2.  A  fixed  eyelet,  j?^2, 
clasps  the  great  muscle  F  and  thus  guides  the  flexor  tendons  of  tho 
fingers.  The  line  1,  shows  the  union  of  the  natural  with  the  artificial 
arm. 

Fig.  4  shows  a  hand  holding  a  fork.  The  tendon  A  A^  pa^ea 
through  the  clasp  B^  and  around  the  pulley  (7,  to  the  side  of  the  clasp  D, 
where  it  fastens  or  unfastens  the  clasp,  by  movements  before  explained. 
The  joints  of  the  fingers  and  thumb  are  flexed  upon  the  fork,  by  powerful 
tension  of  the  great  muscle  and  its  tendons.  The  sinuosity  of  the  tendons 
passing  over  the  pulleys  or  sheaves,  F^  E,  E^  shows  the  new  and  useful 
principle  of  effectually  combining  the  lever  and  pulley  to  gain  the  utmost 
power,  strength,  elasticity  and  adaptaMlity  to  the  various  uses  of  an  ,Ajrti- 
ficial  Arm  and  Hand.     They  are  easily  adjusted  by  the  wearer. 

Q 

Diseases  of  the  Csecnm, 

We  have  repeatedly  been  inquired  of  for  something 
upon  diseases  of  the  cascum.  The  literature  of  this  sub- 
ject is  really  meagre,  and,  as  we  know  of  nothing  recent, 
we  have  reproduced,  from  the  New  York  Journal  of  Med^^ 
icine,  for  July,  1845,  an  article  which  will  amply  repay 
perusal.  It  will  be  found  in  the  department  of  '^Selected 
Articles,  Abstracts,  <&cJ' 

The  Publishers 

Desire  to  call  the  attention  of  the  Profession  in  the 
State  to  their  Catalogue  in  the  Advertising  Department. 
It  has  been  extended  and  revised,  the  prices  being  placed 
at  rates  as  low  as  the  quality  of  goods  offered  can  be  afforded 
in  this  or  any  other  market. 


StlKtjlr  J,rti£hs,  ^bstnds,  ici. 


Cases  IllustratlTe  of  Diseases  of  the  Csecmn  and  its  Appendix. 

By  Edson  Cabr,  M,  D. 

Thb  caecum  has  manifestly  an  individuality  both  of  function  and  dis^- 
ease — having  offices  to  perform  in  some  respects  quite  peculiar  to  itself 
while  it  is  subject  to  frequent  derangements  and  fatal  diseases,  in 
which  no  other  portion  of  the  digestive  apparatus  Is  implicated. 

Wheile  the  former  have  received  far  less  consideration  than  their 
relative  importance  would  seem  to  demand,  the  latter  can  scarcely  be  said 
to  have  a  place  in  our  systematic  practical  works. 

A  Monograph  by  Dr.  John  Buene,  an  article  in  Copeland's  Dic- 
tionary of  Practical  Medicine,  and  the  cases  which  are  detailed  in 
Dupuytren's  Chemical  Lectures,  embrace  nearly  all  that  has  fallen  under 
my  notice  on  this  interesting  class  of  affections,  with  the  exception  of 
single  cases  which  occasionally  appear  scattered  through  our  periodicals. 

If  we  take  but  a  very  superficial  view  of  this  organ,  its  situation 
and  capacity,  its  attachment  to  the  parietes  of  the  abdomen,  so  confining 
it  that  its  relative  position  admits  of  no  change,  and  the  circumstance 
that  its  contents  are  moved  forward  in  opposition  to  the  laws  of  grav- 
itation, it  must  be  evident  that  the  alimentary  substances  were  de- 
signed to  remain  here  longer  than  in  any  other  portion  of  the  alimentary 
canal. 

These  considerations  have  very  naturally  suggested  the  idea  that 
the  caecum  constitutes  a  kind  of  second  stomach. 

Again,  if  we  examine  a  little  more  carefully  into  its  organization, 
we  find  the  caecum  liberally  furnished  with  large  follicular  glands,  evi- 
dently designed  for  the  abundant  secretion  of  important  fluids,  while 
the  entire  organ,  with  its  appendix,  is  more  richly  supplied  with  arte- 
rial blood  than  any  other  portion  of  the  intestinal  canal.  It  appears 
from  the  experiments  Of  Tiedemann  and  Gmelen,  that  these  follicular 
glands  "secrete  an  acid,  albuminous,  and  solvent  fluid,  which  mixes 
with,  and  promotes  the  digestion  of  those  portions  of  aliments  which 
have  withstood  the  action  of  the  stomach  and  small  intestines,  or  hare 
been  insufficiently  changed  by  them."    We   may  also  remark  that  the 


28  The  Peninsular  and  Independent. 

contents  of  the  alimentary  canal  first  acquire  their  peculiar  fecal  odor 
in  the  csecum.  This,  according  to  the  researches  of  the  same  physiolo- 
gists, depends  upon  an  oily  volatile  substance  secreted  by  the  mucous 
follicles.  And  we  think  it  highly  probably  that  the  appendix  performs 
an  important  part  of  this  work,  since,  when  examined  in  its  natural 
condition,  it  is  generally  found  to  contain  a  portion  of  this  material. 
Indeed,  we  think  it  would  be  difficult  to  assign  a  more  probable  func- 
tion to  this  organ ;  inasmuch  as  its  formation  is  such  as  to  preclude 
the  idea  of  the  alimentary  substances  entering  it,  while  the  large  supply 
of  blood  sent  to  it  must  plainly  bespeak  for  it  a  more  important  office 
than  merely  affording  a  convenient  retreat  for  such  unlucky  cherry 
stones  and  the  like,  as  may  chance  to  escape  from  their  destined 
course. 

It  farther  appears  probable  from  the  experiments  of  TiEDiEMANw 
and  Gmelen,  that  the  caecum  performs  the  additional  function  of  secret- 
ing, "chiefly  from  its  numerous  follicles,  an  unctuous  fluid  for  the 
protection  of  the  surfaces  of  the  large  bowels  from  the  irritating  effects 
of  the  fecal  matters  passing  along  them,"  and  that  the  constituents  both  of 
this  and  of  the  other  secretions  poured  out  from  its  surface,  consist  of 
elements  which  require  to  be  eliminated  from  the  blood;  so  that,  in 
addition  to  its  other  functions,  it  is  also  a  depurating  organ. 

We  may  reasonably  infer  from  the  foregoing  considerations  that 
the  caecum  is  an  important  organ,  whose  functions  can  neither  be  sus- 
pended nor  suffer  material  derangement,  without  serious  detriment  to 
the  animal  economy. 

My  own  observations  lead  me  to  apprehend  that  such  disturb- 
ances occur  much  more  frequently  than  it  has  generally  been  supposed. 
Such  suspension  or  modified  function  may  result  from  various  causes, 
as  defective  nervous  stimuli,  the  unnatural  stimulus  of  crude,  undi- 
gested food,  unhealthy  secretions  of  the  prima  via,  or  sympathetic  re- 
lation with  some  other  organ,  in  a  pathological  condition.  The  following 
case  will  perhaps  sufficiently  illustrate  the  most  simple  form  of  such 
derangement : 

Case  I.  Mrs.  B.,  now  thirty -seven  years  of  age,  experienced  slight 
inconvenience  early  in  the  summer  of  1828,  from  dyspeptic  symptoms, 
which  readily  subsided  under  a  regulated  diet.  From  early  childhood 
to  that  period,  she  had  never  suffered  from  any  serious  indisposition. 
She  soon  lost  her  ruddy  complexion,  her  usual  elasticity  and  strength 
began  to  decline,  her  lips  and  tongue  became  pale,  and  a  general  dis- 
inclination to  physical  and  mental  exertion  soon  followed.  But  the 
more  remarkable  circumstances  manifested  in  this  case,  are  a  slight 
uneasiness  seldom  amounting  to  pain,  frequently  felt  in  the  region  of 
the  caecum,  and  ascending  colon,  attended  with  an  evolution  of  gas 
which  escapes   entirely  without  odor,   while   the  fecal  matters,   which 


Selected  Articles^  Abstracts^  dc.  29 

are  quite  natural  in  appearance,  with  the  exception  of  perhaps  being 
slightly  softer  than  common,  are  generally  entirely  wanting  in  fecal 
odor. 

This  state  of  things  has  continued  with  but  short  intervals  of 
interruption  for  more  than  sixteen  years.  During  this  period  she  has 
had  a  good  appetite,  with  no  unnatural  thirst,  and  daily  motions  of 
the  bowels  without  the  use  of  medicine.  This  uterine  functions  have 
been  uniformly  healthy.  She  has  borne  four  children  during  the  time. 
Menstruation  has  never  been  interrupted  except  during  pregnancy  and 
nursing.  It  has  never  varied  materially  in  time,  quantity,  or  quality, 
and  has  never  been  attended  with  pain  or  any  appreciable  constitu- 
tional disturbance.  She  has  never  suffered  from  leucorrhoea,  or  indeed 
from  any  other  indisposition  than  the  above  described. 

Several  intelligent  members  of  the  Profession  have  been  consulted 
in  this  case,  and  the  functions  of  every  organ  in  the  body  have 
been  faithfully  interrogated  and  carefully  watched,  and  yet  no  one 
has  been  able  to  form  a  satisfactory  opinion  as  to  the  cause  of  these 
peculiar  phenomena. 

The  observations  of  Dr.  Copland  upon  the  functional  derangements 
of  the  caecum,  seems  to  throw  some  light  upon  this  and  similar  cases, 
and  make  it  appear  at  least  probable  that  these  peculiarities  depend 
on  such  derangement.  If  the  views  which  are  entertained  in  regard 
to  the  functions  of  the  cascum  be  correct,  there  will  be  no  diflBulty 
in  coming  to  such  conclusion. 

I  might  here  introduce  several  other  cases  which  would  seem  to 
confirm  the  correctness  of  the  views  above  presented,  but  perhaps 
this  may  be  sufficient  to  direct  the  attention  of  other  and  more  com- 
petent inquirers  to  its  investigation. 

I  will,  however,  remark,  that  I  had  an  opportunity,  about  a  year 
since,  of  making  an  examination  of  a  case  in  which  the  leading  symp- 
toms had  for  a  long  time  been  similar  to  the  one  already  described. 
In  this  instance,  death  was  occasioned  by  the  sudden  supervention  of 
acute  gastro  -  enteritis.  The  lower  part  of  the  ilium,  the  caecum,  and 
'a  small  part  of  the  ascending  colon  were  found  very  much  hypertro- 
phied,  the  parietes  of  the  caecum  measuring  over  two  lines  in  thick- 
ness, while  the  cavity  of  the  appendix  was  so  nearly  obliterated  a^ 
barely  to  allow  the  introduction  of  a  small  probe. 

Dr.  Copland  remarks,  that  "when  the  vital  energies  are  weakened 
and  the  alimentary  canal  debilitated,  the  caecum  often  betrays  greater 
disorder  than  any  other  part  of  the  digestive  system.  Its  situation 
and  functions  will  account  for  the  frequency  and  importance  of  its 
diseases.  In  some  cases  the  irritation  produced  by  morbid  or  accu- 
mulated matters  in  it  are  slight,  and  readily  productive  of  suJEcient 
reaction   of   its    muscular   coats   to  propel    them    along  the   colon:    in 


30  The  Peninsular  and  Independent. 

other  instances,  the  efforts  made  to  accomplish  this  end,  owing  to  the 
obstructions  occasioned  by  the  lodgment  of  flatus  about  the  right 
flexure  of  the  colon,  or  by  irregular  spasmodic  contractions  of  this 
bowel,  are  ineffectual,  and  give  rise  to  colicky  pains.  If  the  inter- 
ruption is  removed,  disorder  soon  subsides ;  but  if  it  continues  for 
any  considerable  time,  the  more  violent  forms  of  colic  or  ileus  super- 
vene." 

The  two  following  cases,  while  they  corroborate  the  foregoing  re- 
marks, have  some  points  of  peculiar  interest  as  illustrating  the  fact^ 
that  the  bowels  may  be  freely  evacuated  with  active  cathartic  medi- 
cine, while  substances  remain  impacted  in  the  caacum  undisturbed. 

Case  II.  On  the  7th  Aug.,  1835,  I  visited  Sauger  Brockelbank, 
a  lad  thirteen  years  old,  who  had  complained  for  two  or  three  days 
with  colicky  pains.  He  had  taken  salts,  castor  oil,  and  cathartic  pills, 
which  had  operated  well,  but  without  relieving  the  pain. 

I  learned  that  four  days  previous  to  this  time,  he  had  eaten  freely 
of  choke  cherries  (prunus  virginiana.)  On  examining  the  abdomen,  he 
seized  my  hand  as  it  approached  the  right  iliac  region,  exclaiming  that 
it  was  very  sore.  Careful  examination  discovered  a  distinct  circum- 
scribed fullness  and  hardness  over  the  cascum.  He  complained  of  thirst 
and  headache;  pulse  eighty -four,  and  rather  hard. 

Pres.  V.  s.  I  XV.,  calomel  ten  grs.,  to  follow  in  three  hours,  with 
castor  oil.     Warm  fomentations  to  the  bowels. 

8^^.  His  bowels  have  been  freely  moved  several  times.  Soreness 
over  the  caecum  still  continues;  pulse  ninety -two,  v.  s.  repeated;  cal- 
omel four  grs.,  with  one -eighth  gr.  morphine  to  be  repeated  every  six 
hours.     Blister  to  the  seat  of  the  soreness. 

^th.  Bowels  have  not  been  moved  since  yesterday;  pulse  ninety- 
two;  tongue  slightly  coated  with  white  creamy  covering;  pres.  calomel 
five  grs.,  to  be  followed  with  castor  oil  in  four  hours.  Blister  to  be 
dressed  with  warm  poultice  of  slippery  elm. 

10^^.  Soreness  j-ather  increased ;  bowels  moved,  but  slightly ;  pulse 
ninety -four,  small  and  quick;  pres.  calomel  and  Dover's  powder,  each 
three  grs.  every  four  hours,  and  fomentations  to  the  bowels. 

Wth.  Has  had  two  slight  motions  of  the  bowels — without  faecal 
odor.  Calomel  and  Dover's  powders  continued;  blister  renewed,  and 
to  be  dressed  with  slippery  elm  poultice. 

E'Gening.  His  bowels  have  been  moved  several  times  during  the  day ; 
no  faecal  odor;  complains  of  thirst,  tongue  heavily  coated  but  not 
dark ;  five  grs.  of  Dover's  powder  every  four  hours. 

llth.  Relieved  from  pain  by  Dover's  powder,  but  not  otherwise 
improved;  calomel  and  Dover's  powders  eyery  four  hours,  blister  re- 
newed. 

IZth,  Tongue   more    thickly   coated;   pulse   ninety -six;   small  and 


Selected  Articles^  Abstracts^  cbc.  3l 

quick;  pres.  calomel  five  grs,,  to  be  followed  in  three  hours  with  salts 
and  senna,  and  in  three  hours  the  following  enema  to  be  administered : 
^.  Castor  oil  |  ij.,  spts.  terebinth  |j.,  warm  water  one  pint. 

Evening.  The  bowels  have  moved  freely  several  times  during  the 
day.  The  evacuations  contained  what  the  mother  termed  "a  handful 
of  cherry  stones,  which  had  remained  so  long  that  they  smelt  very 

bad." 

From  this  time  the  soreness  began  to  subside,  and  his  recovery 
was  rapid  and  uninterrupted. 

Can  there  be  any  doubt  that  in  this  case,  the  cherry  stones  were 
lodged  in  the  caecum  during  the  nine  days  which  intervened  between 
the  time  of  eating  and  discharging  them  ? 

Case  III.  At  1  a.  m.,  August  17,  1840,  I  was  called  to  R.  B.  aged 
20.  He  complained  of  excruciating  pain  in  the  abdomen,  with  nausea, 
retching,  anxious  countenance,  features  much  contracted,  pulse  110 
quick,  small  and  tense;  the  whole  abdomen  extremely  painful  to  the 
touch.  He  had  been  troubled  for  several  days  with  diarrhoea,  attended 
with  occasional  griping  pains.  For  the  last  twenty -four  hours,  he 
had  felt  a  dull  aching  pain  in  the  bowels,  which  was  increased 
while  in  the  erect  posture,  and  greatly  aggravated  by  any  slight  jar, 
as  in  walking.  But  the  severe  pain  came  on  suddenly  on  rising  from 
his  bed  just  before  I  was  called,  at  which  time  he  experienced  a  small 
chill.  I  took  from  the  arm  thirty -six  ounces  of  blood,  gave  him  fif- 
teen grains  of  calomel  combined  with  one -half  grain  of  morphine,  and 
hot  fomentations  were  applied  to  the  bowels. 

6  A.  M.  Pain  and  nausea  slightly  relieved,  but  the  soreness 
■of  the  bowels  continued.  Bleeding  repeated  to  twenty  ounces,  which 
occasioned  fainting;  calomel  ten  grs.  and  morphine  one -half  gr. ;  fomen^ 
tations  continued,  and  a  mixture  of  calc.  magnesia  3  ij.,  aromat.  syrup  of 
rhubarb.  |j.;  to  be  given  in  three  hours. 

2  p.  M.  Pulse  127.  Soft  and  compressible  pain  much  relieved. 
By  means  of  a  flexible  tube  passed  into  the  colon,  the  following  enema 
was  administered:  3.  Castor  oil,  |ij. ;  spts.  turpentine,  |  i. ;  warm 
water,  three  pints.  This  passed  off  in  the  course  of  three  hours,  with 
some  faecal  matter. 

9  p.  M.  Pain  much  diminished  and  entirely  confined  to  the  right 
Iliac  region,  where  a  distinct  circumscribed  fullness  and  hardness  was 
perceptible.  Calomel,  three  grs. ;  morphine,  one  -  fourth  gr. ;  to  be  given 
«very  four  hours. 

l^t\  Morning.  Pain,  soreness  and  swelling  over  the  caecum,  con- 
siderably increased ;  pulse  130,  small  and  quick.  An  injection  of  warm 
water  and  castor  oil  produced  a  small  faecal  evacuation,  without  odor. 
Calomel  and  morphine  continued ;  about  four  oz.  of  blood  was  taken 
from  the  region  of  the  caecum  by  cupping  and  fomentations  to  the  seat 
of  pain. 


32  The  Peninsular  and  Independent. 

,  .,.,   2  p.  M.      Pain   somewhat   relieved ;    blister   applied   to   the   seat  of 
pain. 

9  o'clock^  Eveni7ig.  Pain  much  relieved.  Injection  repeated,  but 
with  slight  effect  —  calomel  3  grs.,  Dov.  powder  4  grs.  to  be  given 
every  four  hours.     Blister  to  be  dressed  with  slippery  elm  poultice. 

19^/i,  Morning.  Rested  well;  free  from  pain;  pulse  120,  soft  and 
compressible.  Tongue  slightly  covered  with  moist  white  fur.  Mixture 
of  castor  oil,  |  j.,  and  an  equal  quantity  of  aromatic  syrup  of  rhubarb? 
to  be  given  directly. 

2  p,  M.  Has  had  rather  a  scanty  evacuation,  tinged  with  bile,  with 
slight  faecal  odor;   feels  much  relieved. 

8  d'cloch^  Evening.  Pulse  110,  soft  and  compressible;  bowels  have 
been  freely  evacuated;  f^cal  odor  strongly  marked.  5  grs.  Dov.  pow- 
ders to  be  given  for  the  night. 

20^A,    Morning.     Has    had    a    tolerable    night's   rest;    pulse    100 
bowels  acted  freely ;  complains  of  soreness,  and  some  deep  seated   pains 
in  the  region  of  the  caecum.     Blister  dressed  with  mercurial   ointment. 

Evening.  Pulse  100;  swelling  and  soreness  still  continues;  cam- 
phor and  opium  pill  to  be  given  at  bed  time.  Mercurial  dressing 
continued. 

2l8t.  Still  complains  of  dull,  deep  -  seated  pain  ;  pulse  100;  camphor 
and  opium  pill;   mercurial  dressings  continued. 

Evening.  Pain  continues ;  pulse  more  full  and  hard ;  tongue  more 
coated,  with  edges  very  red ;  colon  distended  with  |  iv.  castor  oil,  in 
five  pints  warm  water.  This  brought  away  an  apple  seed,  with  some 
flakes  of  hardened  faecal  matter  which  appeared  as  if  broken  from  a 
hard  mass.  Pres.  Dov.  powder  and  cal.  aa  5  grs.  to  be  repeated  every 
four  hours. 

22(Z,  Morning.  Has  had  a  quiet  night;  pulse  100;  tongue  looks 
better;  swelling  and  soreness  much  relieved;  skin  has  been  in  a  moist 
state  during  most  of  the  night.  Has  had  a  large  evacuation  of  offen- 
sive faecal  matter,  with  several  hardened  lumps  in  which  were  found  a 
number  of  whole  unripe  blackberries.  On  inquiry,  no  fruit  of  the  kind 
had  been  taken  since  the  Saturday,  a  week  before  his  illness. 

Evening.  Has  had  several  evacuations  during  the  day,  with  frag- 
ments of  hardened  faecal  matter,  containing  numerous  seeds  of  Ji)lack- 
berry. 

From  this  time  he  began  gradually  to  recover,  although  it  was 
several  weeks  before  the  soreness  and  swelling  had  so  far  subsided  as 
to  allow  of  his  returning  to  business. 

He  has  since  had  several  slight  attacks  of  pain  and  soreness  in 
the  region  of  the  caecum,  from  error  in  diet,  which  have  readily 
yielded  to  prompt  treatment. 

We  may  remark  that  in  both  of  these  cases,  during  the  time  in 
which  foreign   substances   remained   impacted   in   the   cascum,  although 


Selected  Articles^  Abstracts,  <&c.  33 

the  bowels  had  been  repeatedly  freely  acted  upon  by  medicine,  there 
was  an  almost  entire  absence  of  faecal  odor  in  the  alvine  discharges. 
I  have  noticed  the  same  circumstance  in  several  other  similar  cases, 
and  recognized  the  re  -  appearance  of  the  odor,  as  one  of  the  earliest 
symptoms  of  anything  like  permanent  relief 

Case  IV.     On  the  evening  of  the  29th  of  August,  1835,  I  visited 

Miss ,  a   young  lady,    sixteen    years   of  age.     She  had  suffered 

from  slight  headache,  for  two  or  three  days.  Four  days  previous, 
while  walking  in  the  garden,  she  had  taken  several  unripe  plums, 
since  which  time  she  has  had  no  motion  of  the  bowels.  I  attributed 
her  headache  to  this  circumstance,  and  directed  castor  oil,  and  aro" 
matic  syrup  of  rhubarb,  of  each  one  ounce. 

30^A.  She  has  had  no  motion  of  the  bowels:  headache  continues; 
Pres.  15  •  Calc.  magnesia  3j. ;  spts.  ammonia  aromat.,  3j. ;  mint  water, 
I  j. ;  to  be  taken  directly,  and  repeated  in  three  hours  if  required. 

E'cening.  The  medicine  has  had  no  effect;  and  the  following  was 
ordered :  calomel,  8  grs. ;  com.  ext.  colocynth,  12  grs.  j  and  should  this 
have  no  effect,  it  may  be  repeated  in  six  hours. 

31s(5.  Her  medicine  has  had  no  effect;  complains  of  pain  in  the 
bowels.  On  examination,  I  discovered  tenderness  and  slight  fullness  in 
the  right  iliac  fossa.  V.  S.  |  xvj.,  fomentations  to  the  abdomen,  and 
an  enema  to  be  administered  directly,  and  should  there  be  no  mo- 
tion of  the  bowels  in  three  hours,  the  following  mixture  to  be  given : 
Castor  oil,  |  j.,  aromatic  syrup  of  rhubarb,  |  ss.,  with  the  addition  of 
two  drops  of  croton  oil. 

From  this  time  to  the  third  of  September,  being  ten  days  from 
the  time  she  had  taken  the  plums,  although  all  ordinary  means  had 
been  resorted  to,  such  as  bleeding,  blistering,  warm  baths,  enemas 
and  active  cathartics,  no  passage  of  the  bowels  had  been  effected. 

At  the  request  of  Dr.  Bristol,  who  was  now  called  in  consulta- 
tion, the  croton  oil,  warm  bath,  and  enema  were  repeated,  but  all  with 
no  effect. 

Sept.  4tth.  The  soreness  and  pain  have  increased  during  the  night ; 
tongue  loaded  with  a  heavy  white  coat ;  pulse  88,  quick  and  small ; 
calomel  and  Dover's  powders,  each  three  grs.  every  three  hours.  About 
noon  she  experienced  a  smart  chill,  which  was  followed  by  severe 
pain  and  exquisite  tenderness,  which  spread  rapidly  over  the  whole 
abdomen. 

Drs.  Cheney  and  Bristol  were  now  called  in  consultation.  The 
stomach  had  become  so  irritable  as  to  reject  everything  taken  into  it, 
and  the  rectum  so  sensitive,  that  enemas  by  an  ordinary  syringe 
could  not  be  retained,  and  it  was  proposed  to  distend  the  colon  freely 
by  means  of  a  long  flexible  tube.  In  attempting  to  pass  this  into 
the  colon,  I  met  with  a  diflficulty  which  I  had  frequently  encountered 
in  similar  attempts. 

Vol.  TT. -C. 


34  The  Peninsular  and  Independent. 

When  the  tube  reaches  the  angle  which  the  intestine  makes,  in 
passing  over  the  psoas  muscle  and  common  iliac  artery,  it  meets  the 
side  of  the  gut,  nearly  at  a  right  angle,  and  after  forcing  the  intes- 
tine before  it  as  far  as  its  loose  folds  at  this  point  will  allow,  the 
tube  is  doubled  upon  itself,  some  two  or  three  inches  from  its  point, 
and  broken.  That  this  is  the  nature  of  the  difficulty,  which  frequently 
occurs  in  passing  a  flexible  tube  into  the  colon,  I  have  satisfied  my- 
self by  laying  open  the  abdomen  of  the  dead  subject,  and  introduc- 
ing it  with  the  intestine  exposed  to  view.  Indeed,  I  think  it  requires 
especial  good  luck,  as  well  as  dexterous  manosuvering,  to  be  able  in 
all  cases  to  pass  an  elastic  gum  tube  into  the  colon,  although,  from 
the  representations  of  Mr.  O'Beirn  and  some  others,  it  seems  quite 
otherwise. 

In  order  to  satisfy  myself  whether  there  was  any  unnatural  ob- 
struction in  this  case,  I  took  a  common  rectum  sound,  and  passed 
it  into  the .  colon  without  diflBculty.  It  now  occurred  to  me  that  a 
flexible  metallic  tube,  made  in  shape  similar  to  the  sound,  might  be 
introduced  without  trouble,  I  accordingly  prepared  one  the  size  of  a 
large  catheter,  with  an  egg-shaped  bulb  upon  the  end,  pierced  with 
several  holes  like  the  tube  of  the  womb -syringe  —  passed  it  into  the 
colon,  attached  it  to  the  tube  of  the  Reed's  double  valve  pump,  and 
gradually  distended  the  colon  with  a  mixture  of  castor  oil  §  iv.,  spts. 
turpentine  |j.,  and  five  pints  warm  water.  This  soon  passed  off,  and 
with  it  a  large  quantity  of  dark  faecal  matter,  containing  several  balls 
of  black,  hardened  faecal  matter,  about  the  size  and,  in  appearance, 
not  unlike  the  black  walnut.  The  evacuations  were  attended  with 
alarming  fainting,  but  were  soon  followed  by  relief  from  all  pain  and 
threatening  symptoms. 

The  three  preceding  cases,  I  apprehend,  furnish  us  with  exam- 
ples of  the  most  common  causes  of  acute  inflammation  of  the  caecum, 
viz. :  foreign  indigestible  substances,  or  hardened  faecal  matter,  impacted 
in  the  caput  coli. 

Mr.  John  Burne,  Physician  to  the  Westminster  Hospital,  in  an 
article  published  in  the  20th  vol.  of  the  Medico -Chirurgical  Transac- 
tions^ has  given  a  history  of  eight  very  interesting  cases  of  this  dis- 
ease. He  tells  us  he  has  seen  no  less  than  twenty  cases,  in  all  of 
which  he  has  not  seen  a  single  example  of  idiopathic  inflammation  of 
the  csecum  from  the  ordinary  general  causes  —  exposure  to  the  vicis- 
situdes of  weather,  &c,  "But  every  instance  has  been  symptomatic 
of  some  mechanical  exciting  cause,  as  the  lodgment  of  undigested  food, 
of  fruit  stones  or  concretions  which  the  structure  of  the  caacum  and 
appendix  favors;  and  hence  the  peculiar  features  of  the  disease."  It 
not  unfrequently  happens  that  after  an  attack  of  acute  inflammation 
of  the  caecum,  induced  by  some  foreign  substance  impacted  in  its 
cavity,  the  natural  powers  of  the  organ  are  but  slowly  regained ;  hence 


Selected  Articles^  Abstracts^  <jbc.  35 

it  is  subject  to  renewed  attacks  from  any  trifling  error  in  the  diet,  or 
slight  exposure  to  cold.  Such  cases  often  become  exceedingly  trouble- 
some and  difficult  to  manage.  The  following  is  an  instance  of  the 
liability  to  a  recurrence  of  this  kind : 

Case  V.  On  the  evening  of  June  13th,  1843,  Miss  E.  J.  W,, 
aged  17,  was  seized  with  pain  in  the  bpwels,.  which  was  attributed 
to  her  having  eaten  freely  of  unripe  gooseberries  during  the  preceding 
afternoon.  I  saw  her  early  on  the  morning  of  the  14th.  Her  coun- 
tenance was  indicative  of  severe  suffering.  She  had  taken  a  full  dose 
of  Gregory's  Mixture  (magnesia,  rhubarb,  and  ginger),  which  was  re- 
jected. The  pain  was  referred  to  the  umbilical  region;  pulse  88,  full 
and  sharp,  Pres.  V.  S.  |  xx.,  calomel  grs.  10,  morphine  grs.  ^,  hot 
fomentations  to  the   abdomen. 

I  saw  her  again  in  three  hours.  Her  medicine  had  been  re- 
tained, although  there  had  been  some  retching.  Pulse  84,  pain  some- 
what abated.  Pres.  Calomel  grs.  5,  morphine  gr.  3^.  Fomentations 
continued. 

3  p.  M.  She  complains  much  less  of  pain.  Skin  moist;  tongue 
slightly  coated  with  moist  white  fur;  pulse  84,  soft.  Pres.  Half  a 
Seidlitz  powder,  to  be  repeated  every  hour,  in  hot  water.  Fomenta- 
tions to  be  continued. 

9  p.  M.  Medicine  has  been  retained,  but  there  has  been  no  mo- 
tion of  the  bowels.  Slight  pain  still  complained  of  in  the  umbilical 
region.  Abdomen  soft;  moderate  pressure  occasions  no  pain  except 
over  the  caecum,  where  there  is  an  evident  fullness,  quite  tender  to 
the  touch.  Pres.  An  enema  of  castor  oil  and  warm  water,  to  be 
administered  directly.  Calomel  and  Dover's  powder,  each  grs.  iij.,  to 
be  given  every  four  hours.     Fomentations  to  be  continued. 

15th.  She  has  passed  a  comfortable  night;  had  a  slight  motion 
of  the  bowels  soon  after  the  enema,  with  some  dark  fsecal  matter. 
The  pain  has  entirely  receded  to  the  right  iliac  foss,  where  it  now  re- 
mains constant  but  not  severe.  Soreness  not  diminished;  the  tongue 
more  thickly  coated,  but  white  and  moist.  Pres.  Blister  over  the 
caecum ;  half  a  Seidlitz  powder  every  hour,  and  an  enema  to  be  re- 
peated every  third  hour,  until  free  evacuations  shall  be  procured. 

Evening.  She  has  had  several  small  evacuations  of  a  greenish 
fluid,  with  no  soHd  faecal  matter.  Pres.  5  grs.  Dover's  powder  to  be 
given  every  three  hours.  Simple  dressing  to  the  blister,  over  which 
is  to  be  laid  a  warm  bran  poultice. 

lUh.  She  has  had  a  quiet  night,  free  from  pain.  Skin  moist. 
Pres.  The  following  enema,  to  be  administered  directly:  Castor  oil 
|ij.,  spirits  turpentine  |ij.,  warm  water  two  pints. 

2  p.  M.  In  the  course  of  the  forenoon,  she  had  several  evacuations 
of  dark  faecal  matter  in  which   there  were   several  hard  masses  con- 


36  The  Peninsular  and  Independent. 

taining  portions   of  several  partially  digested   gooseberries.     Pres.  Half 
a  Seidlitz  powder  every  two  hours. 

Evening.  She  has  had  several  evacuations  of  greenish  faecal  matter 
during  the  afternoon.     Pres.  6  grs.  Dover's  powder. 

l^tli.     Convalescent. 

On  the  8th  of  June,  1844,  a  similar  attack  occurred  after  eating 
unripe,  or  but  partially  ripened,  cherries.  Under  a  similar  course  of 
treatment  she  got  relief  on  the  fourth  day  after  the  attack,  but  the 
soreness  and  tumefaction  subsided  much  more  slowly  than  in  the  first 
instance. 

On  the  14th  of  September  following  she  was  seized  in  the  same 
way  —  but  the  case  proved  much  more  obstinate  than  in  either  of  the 
former  attacks,  yielding  to  the  treatment  on  the  fifteenth  day  after  its 
commencement. 

On  the  3d  of  December,  of  the  same  year,  she  had  a  recurrence 
without  any  known  cause,  except  a  bad  cold,  under  which  she  had 
been  suffering  several  days.  This  lasted  until  the  21st,  or  eighteen 
days  from  its  commencement.  Prom  this  time  until  the  following  spring, 
she  was  constantly  troubled  with  constipation  of  the  bowels,  attended 
with  flatulence,  together  with  more  or  less  tenderness  and  pain  in 
the  caecum  and  ascending  colon.  Her  general  health  suffered  mate- 
rially until  the  23d  of  April,  1845,  when  she  had  another  attack,  at- 
tended with  more  acute  inflammatory  symptoms  than  either  of  the 
former,  involving  the  peritoneum  to  considerable  extent.  This  occur- 
red in  three  or  four  hours  after  eating  boiled  cabbage.  By  the  use 
of  an  emetic  most  of  this  was  thrown  off  from  the  stomach,  in  an 
undigested  state,  together  with  a  quantity  of  green  bile.  The  inflamma- 
tion subsided,  under  active  treatment,  in  the  course  of  six  days,  and 
the  bowels  slowly  regained  their  natural  powers  so  far  as  to  be 
comfortable  under  a  carefully  regulated  diet,  with  the  occasional  use 
of  tonic  laxatives. 

We  occasionally  meet  with  instances  in  which  the  vermiform  ap- 
pendix seems  to  be  the  principal  seat  of  the  primary  disease.  This 
is  generally  occasioned  by  the  accidental  intrusion  of  some  small, 
hard  substance  into  its  cavity,  which  its  free  communication  with  the 
cascum  readily  allows ;  while  there  is  no  way  of  escape  but  by  a 
retrograde  movement.  Whether  this  organ  has  the  power  of  expel- 
ling offending  matter  in  this  way  or  not,  it  is  well  known  that  they 
sometimes  become  impacted  in  this  narrow  tube,  giving  rise  to  irri- 
tation and  inflammation,  which  result  in  perforative  ulceration  of  its 
coats  with  most  disastrous  consequences. 

Mr.  Copland  mentions  having  seen  four  cases  of  this  description, 
where  the  appendix  was  primarily  and  chiefly  affected,  owing  to  hard 
substances  having  escaped  into  it.  All  of  these  cases  terminated  in 
general  peritonitis  and  gangrene  of  the  appendix. 


Selected  Articles^  Abstracts^  <bc,  37 

It  appears  from  his  description  of  this  affection,  that  in  the  cases 
which  he  has  seen,  the  symptoms  from  the  beginning  were  more 
acute  than  in  inflammation  of  the  caecum  itself. 

Two  well  marked  instances  of  this  affection  have  fallen  under  my 
observation,  one  of  which  was  occasioned  by  the  presence  of  two 
biliary  concretions  lodged  in  the  appendix.  The  symptoms  in  these 
cases  were  less  urgent  than  in  those  related  by  him;  although  the 
sequel  was  the  same. 

Case  VI.  This  occurred  in  a  young  man  about  17  years  of  age, 
while  attending  school  at  the  Canandaigua  Academy.  I  first  saw  him 
on  Tuesday,  June  6,  1837.  He  complained  of  sickness  at  the  stomach, 
and  pain  in  the  umbilical  region.  He  attributed  his  illness  to  the 
eating  of  oranges  on  the  previous  evening.  I  gave  him  calomel  and 
rhubarb,  of  each  10  grains  in  powder,  and  directed  hot  fomentations 
*o  the  abdomen. 

I  called  again  in  four  hours.  The  sickness  had  subsided  and  pain 
somewhat  abated;  gave  him  castor  oil  and  aromatic  syrup  rhubarb 
each  1  oz. ;  fomentations  to  be  continued,  and  a  copious  enema  to  be 
administered  in  three  hours. 

1th.  The  bowels  have  been  freely  moved ;  still  complains  of  pain 
about  the  umbilicus.  On  carefully  examining  the  abdomen,  I  discov- 
ered tenderness  on  pressure  deep  in  the  lower  part  of  the  right  iliac 
fossa ;  no  febrile  movement  has  manifested  itself 

I  applied  a  blister  to  the  right  ilio  -  inguinal  region,  and  directed 
calomel  and  Dover's  powders,  each  3  grains,  to  be  repeated  every  four 
hours. 

Evening.  Several  times  during  the  day  he  has  rejected  from  the 
stomach  small  quantities  of  greenish  watery  fluid,  which  has  left  a 
slight  stain  upon  the  tongue.  The  blister  has  filled  well ;  Dover's 
powder  and  calomel  to  be  continued  through  the  night. 

^tJi.  Kested  well  during  the  night;  pulse  76,  soft.  Skin  moist; 
thin  white  coat  upon  the  tongue ;  not  dry ;  no  pain,  but  little  soreness ; 
blister  looks  well.  I  gave  him  ten  grains  of  calomel,  to  be  followed 
in  three  hours  with  a  draught  of  infusion  of  senna  and  Epsom  salt. 

Evening.  His  medicine  has  operated  several  times  during  the  day. 
The  evacuations  contain  a  large  quantity  of  faecal  matter  but  with- 
out faecal  odor.  He  expresses  himself  as  feeling  relieved.  Directed 
Dover's  powder  for  the  night. 

Wi.  Had  a  quiet  night.  No  pain,  but  some  soreness  in  the 
right  iliac  region.  Heavy  white  coat  on  the  tongue ;  pulse  78,  soft, 
and  yielding  readily  to  slight  pressure.  Has  had  a  small  evacuation 
from  the  bowels.  No  faecal  odor;  blister  reapplied,  A  Seidlitz  pow- 
der to  be  given  every  three  hours. 

Evening.  Bowels  have  been  moved  several  times,  evacuations  not 
examined.     Entirely  free  from  pain.     I  spent  more  than  an  hour  with 


38  The  Peninsular  and  Independent. 

him,  in  company  with  some  friends,  who  had  called  on  him.  He  left 
his  bed  and  walked  to  his  chair  without  assistance.  Conversed  freely, 
and  desired  permission  to  ride  to  his  friends'  the  next  day  —  a  distance 
of  10  miles  —  which  I  advised  him  to  defer  for  a  few  days.  Every 
thing  seemed  quite  favorable,  excepting  a  very  heavy,  white,  clammy 
coat  spread  entirely  over  his  tongue.  A  Dover's  powder  was  the 
only  medicine  prescribed  for  the  night. 

\^th.  I  was  called  to  him  very  early  this  morning,  and  found  him 
in  articulo  mortis. 

On  post-mortem  examination,  assisted  by  Dr.  Bristol,  there  was 
found  in  the  pelvis  about  half  a  pint  of  purulejit  matter.  The  verm- 
iform appendix  presented  an  opening  about  one  inch  from  its  attach- 
ment to  the  caecum,  in  which  lay  a  biliary  concretion  about  the  size- 
of  a  common  white  bean,  and  nearly  of  the  same  shape.  On  raising 
the  appendix,  it  separated  from  the  caecum,  and  was  found  in  a  gan- 
grenous state  through  its  whole  extent.  About  half  an  inch  above 
the  ulcerated  opening  already  mentioned,  there  was  an  enlargement  of 
the  appendix  in  which  was  found  another  concretion  of  about  the 
same  size  and  appearance.  On  carefully  cutting  open  the  concretions, 
they  were  found  to  be  composed  of  concentric  layers  of  dense  biliary 
concretion  around  a  common  centre  of  the  same  material.  Marks  of 
recent  inflammation  were  traceable  to  a  great  extent,  over  the  perito- 
neum as  well  as  the  small  intestines. 

The  most  remarkable  feature  in  this  case,  is  the  amount  of  or- 
ganic lesion  of  so  obstructive  a  character,  with  no  more  urgent 
symptoms. 

In  the  other  instance  of  this  description  of  disease  to  which  allu- 
sion has  been  made,  the  symptoms  were  more  nearly  allied  to  those 
of  strangulated  hernia.  The  appendix  was  found  imbedded  in  a  mass 
of  omentum,  greatly  hypertrophied,  and  in  a  state  of  ulceration.  The 
cavity  of  the  appendix  was  nearly  obliterated  by  a  thickened  con- 
dition of  its  mucous  membrane  which  had  assumed  a  kind  of  firm, 
pulpy  consistence.  Portions  of  the  mucous  membrane  of  the  c«cum 
also  presented  a  similar  appearance. 

Affections  of  the  appendix  are  not  generally  distinguishable  from 
those  of  the  caecum  itself,  during  the  life  -  time  of  the  patient.  "We  may 
sometimes  suspect  them  when  the  seat  of  the  affection  is  deep  in  the 
pelvis,  as  this  organ  is  frequently  found  depending  in  this  situation. 
This  was  noticed  as  detailed  in  Case  VI.  The  soreness  was  deep- 
seated  in  the  pelvis,  which  led  to  the  suspicion  that  the  appendix 
was  the  principal  seat  of  the  affection.  Indeed  the  opinion  was  ex- 
pressed before  the  post-mortem  examination.  But  the  situation  of 
appendix  varies  so  much  in  different  individuals,  that  even  this  sign 
can  lead  to  nothing  more  than  a  mere  suspicion;  nevertheless,  this 
fact  is   often  very  important  in  its  practical  results. 


Selected  Articles^  Abstracts^  dtc.  3d 

In  the  dissections  which  I  have  made,  I  have  not  discovered  much 
uniformity  either  in  the  size  or  shape  of  the  appendix,  or  of  its  place 
of  origin,  nor  of  the  direction  which  it  takes  on  leaving  the  caecum. 
Among  my  dried  preparations,  I  have  one  colon  of  common  size,  in 
which  the  appendix  measures  six  and  a  half  inches  in  length,  and  nearly 
half  an  inch  in  diameter ;  passing  off  in  nearly  a  straight  line  from  the 
most  depending  point  of  the  caput  cseci,  the  extremity  of  the  appendix 
resting  on  the  floor  of  the  pelvis.  I  have  another  colon  of  equal  size, 
in  which  the  appendix  is  less  than  two  inches  in  length,  and  no  thicker 
than  a  crow's  quill.  This  has  its  origin  just  at  the  margin  of  the  ilio- 
caecal  valve,  is  coiled  upon  itself,  and  firmly  bound  to  the  caecum  by  a 
fold  of  peritoneum.  In  another  specimen,  the  appendix  measures  four 
inches  in  length;  has  its  origin  within  half  an  inch  of  the  termination 
of  the  ileon,  and  makes  a  turn  round  this  intestine,  firmly  embracing 
it.  I  have  preserved  nine  preparations  of  the  caecum  and  appendix,  all 
of  which  vary  materially  in  their  form  and  construction,  so  that  no 
general  description  will  answer  to  any  two  of  them. 

Dr.  BuKNE  observes,  that  "The  conformation  and  situation  vary 
much  in  different  individuals  —  a  fact  not  noticed  by  anatomists,  but 
which  I  have  found  to  influence  the  phenomena  and  nature  of  its  dis- 
eases very  considerably.  The  conformation  of  the  appendix  is  generally 
described  as  flexuous;  and  its  situation  as  depending  into  the  pelvis; 
but  by  some  the  situation  is  not  noticed,  further  than  that  the  appen- 
dix arises  from  the  caecum,  and  is  bound  down  to  it  on  the  right  by 
a  fold  of  peritoneum,  the  meso  -  appendix ;  whereas  the  appendix  is 
more  frequently  situated  on  the  outer  edge  of  the  psoas  magnus,  on 
the  fascia  iliaca,  snugly  curled  up  beneath  the  caecum,  and  concealed 
by  it  —  a  fact  which  I  have  verified  by  many  dissections,  and  one  of 
great  importance  to  the  pathologist,  as  will  be  seen.  In  the  event  of  a 
perforative  ulceration  of  the  appendix,  and  a  consequent  peritonitis  or 
faecal  absess,  the  parts  involved  will  differ  entirely,  according  to  the 
situation  of  appendix.  If  it  should  happen  to  depend  into  the  pelvis, 
then  the  pelvic  viscera  will  be  implicated;  if  it  should  happen  to  be 
situated  on  the  iliac  fascia,  and  underneath  the  caecum,  then  the  belly 
of  the  iliacus  internus  and  the  neighboring  adipose  cellular  tissue  will 
be  involved,  and  the  course  of  the  abscess  be  determined  accordingly : 
so  important  is  the  relative  anatomy  of  even  inconsiderable  organs  to 
to  the  physician." 

The  foregoing  cases  are  selected  from  eighteen  well  marked  instances 
of  this  class  of  affections  which  have  occurred  under  my  own  observa- 
tion during  the  last  fourteen  years.  I  met  with  several  other  examples 
of  this  disease  during  the  earlier  years  of  my  practice,  of  which  no 
notes  were  made  at  the  time.  I  have  also  occasionally  seen  cases  in 
consultation  with  neighboring  physicians,  so  that  abundant  evidence  is 
afforded  of  their  frequent  occurrence,  at  least  in  this  section  of  the 
country. 


40  The  Peninsular  and  Independent. 

They  are  spoken  of  by  some  medical  writers  as  being  obscure  in  their 
origin,  and  often  difficult  of  detection.  Professor  Albers,  of  the  Uni- 
versity of  Bonn,  makes  the  following  remark,  "That  the  diagnosis  of 
the  diseases  of  the  caecum  is  attended  with  no  inconsiderable  difficulty 
appears  from  the  well  known  circumstance,  that  very  often  they  have 
never  been  suspected  to  exist  during  the  life  of  the  patient,  and  have 
been  discovered  only  on  dissection." 

Dr.  BuRNE  remarks,  that  "A  practitioner  who  witnesses  one  of  these 
cases  for  the  first  time,  is  satisfied  it  is  not  a  common  inflammation  of 
the  bowels,  although  he  does  not  know  its  exact  nature  —  he  says  the 
case  is  a  curious  one  —  he  can  not  make  it  out." 

DupuYTREN,  in  speaking  of  the  importance  of  a  correct  diagnosis  in 
these  affections,  says,  "I  have  seen  this  inflammation  give  rise  to  the 
belief  of  the  existence  of  internal  strangulation,  hepatitis,  and  even 
peritonitis."  That  these  affections  are  sometimes  mistaken  for  common 
inflammation  of  the  bowels,  or  "Bilious  Colic,"  I  am  fully  aware,  hav- 
ing been  consulted  in  four  well  marked  cases,  the  true  nature  of  which 
had  been  entirely  misapprehended.  One  of  these  terminated  in  the  usual 
way  by  resolution  —  the  other  three  were  allowed  to  pass  on  to  suppu- 
ration, one  of  which  terminated  fatally,  the  abscess  bursting  into  the 
peritoneum.  The  other  two  cases  opened  externally,  a  little  above  the 
crural  arch,  one  of  which  formed  ill-  conditioned  sinuses  which  remained 
open  more  than  a  year  —  and  finally  recovered. 

The  causes  of  failure  in  diagnosis  are  probably  owing  in  part  to 
the  mildness  of  the  earlier  symptoms,  which  attract  but  little  atten- 
tion from  the  patient  or  physician ;  but  principally  to  the  fact,  that 
the  pain  attending  them  is  generally  described  by  the  patient  as  a 
colic,  and  is  frequently  referred  to  the  umbilical  region,  or  to  the  abdo- 
men generally.  Indeed  it  is  very  rare  that  the  patient  directs  attention 
to  the  seat  of  the  disease. 

It  is  only  by  a  careful  examination  that  the  nature  and  seat  of 
the  difficulty  are  detected.  By  gentle  pressure  or  percussion  over  the 
surface  of  the  abdomen,  as  you  approach  the  right  iliac  region,  the 
patient  shrinks  from  you,  or  perhaps  instantly  seizes  your  hand,  and 
betrays  surprise  at  the  discovery  of  such  exquisite  tenderness. 

Hence  the  importance  of  carefully  examining  every  part  of  the 
abdomen,  in  these,  as  well  as  in  all  other  affections  of  the  abdominal 
viscera. 

If  we  take  into  consideration  the  situation  of  the  caecum,  fixed 
as  it  is  in  the  parietes  of  the  abdomen,  admitting  of  no  considera- 
ble variation  in  its  relative  position  with  regard  to  the  other  viscera, 
it  must  be  evident,  that  with  such  an  examination  the  disease  under 
consideration  would  seldom  escape  early  detection. 

The  progress  of  the  phenomena  as  developed  in  these  affections, 
is   thus   described  by    M.    Dupuytren:      "After  some   error  in   diet,   a 


Selected  Articles^  Abstracts^  <kc.  41 

constipation  or  diarrhoea,  of  longer  or  shorter  duration,  more  or  less 
habitual  colic ;  sometimes  without  any  of  these  causes,  the  patient 
suffers  from  violent  colic  and  pain  in  the  bowels,  with  a  tendency 
to  concentration  in  the  right  iliac  fossa ;  it  may  also  extend  towards 
the  large  intestine,  or  over  the  whole  abdomen.  This  colic  is  gen- 
erally accompanied  by  constipation,  and  sometimes  vomiting;  such  are 
the  symptoms  by  which  we  may  predict  th6  occurrence  of  the  tumor. 
They  are  of  very  various  duration;  sometimes  lasting  for  a  month  or 
more,  sometimes  for  a  few   days  only." 

Dr.  Hays,  Editor  of  the  American  Journal  of  the  Medical  Sciences 
(see  Medical  Essays,  vol.  1,  page  81,  published  by  Lea  &  Blanch- 
ARD,  1841),  says:  "The  disease  usually  announces  itself  by  certain  ^r«- 
cursory  symptoms,  as  colic,  with  alternate  constipation  and  diarrhoea, 
occurring  at  longer  or  shorter  intervals,  and  continuing  for  a  greater 
or  less  period.  After  a  while  the  attacks  of  colic  become  more  severe, 
and  appear  to  centre  in  the  right  iliac  fossa;  they  may  also  radiate  in 
the  direction  of  the  great  intestine,  or  spread  over  the  whole  cavity 
of  the  abdomen.  These  pains  are  usually  attended  with  obstinate 
constipation,  and  sometimes  with  such  violent  vomitings  as  to  simulate 
an  internal  strangulation.  In  some  cases  the  disease  has  its  origin, 
is  attended  with  less  violent  symptoms,  and  commences  with  pain  in 
the  right  iliac  fossa.  If  this  region  be  examined,  it  will  be  found 
more  tender  to  the  touch,  more  resisting,  and  sometimes  to  project 
more  than  in  the  natural  state.  It  is  frequently  possible,  by  press- 
ing upon  the  abdominal  parietes,  to  distinguish  a  circumscribed  tumor 
of  variable  size,  of  considerable  firmness,  more  sensible  to  the  touch 
than  any  other  part  of  the  abdomen,  and  appearing  to  rest  upon  the 
csecum ;  the  remainder  of  the  abdomen  is  soft  and  indolent.  The 
patient  continues  at  the  same  time  to  complain  of  colic  and  consti- 
pation." 

Dr.  BuRNE,  in  the  papers  to  which  we  have  already  alluded,  gives 
the  following  graphic  description  of  these  affections:  "In  all  the  ex- 
amples of  inflammation  of  the  caecum,  which  I  have  witnessed,  the 
development  of  the  symptoms  has  been  in  the  following  order:  The 
first  sign  is  a  sense  of  uneasiness,  which  soon  amounts  to  an  aching 
pain,  deep  -  seated  in  the  right  ilio  -  inguinal  region,  arising  unexpect- 
edly while  the  person  was  in  health,  and  not  preceded  by  rigor  or 
exposure.  This  pain  increases  progressively  for  twelve  or  twenty -four 
hours,  retains  its  character,  is  fixed  and  constant,  never  even  remit- 
ting. Then  supervene  gradually  tenderness,  fullness,  and  tension  of 
the  whole  ilio  -  inguinal  region;  the  bowels  are  constipated  and  do  not 
reply  to  medicine,  and  the  patient  grows  sick  and  vomits.  Some 
febrile  movement  now  begins  to  manifest  itself;  the  tongue  becomes 
white  and  furred;  the  urine  scanty;  the  appetite  is  gone;  the  pulse 
is  frequent,   tight,  and  sharp,    with   increased   volume,    but  the  stroke 


^2  The  Peninsular  and  Independent, 

though  sharp,  is  not  strong,  nor  is  its  impression  on  the  finger  de- 
cided—it is  a  pulse  of  irritation  and  inflammation  combined;  the 
patient  lies  on  the  back  quite  still,  slightly  inclined  to  the  side  affected, 
and  the  case  presents   a  serious  aspect." 

The  above  is  certainly  a  faithful  delineation  of  most  of  the  symp- 
toms which  are  usually  manifested  in  these  cases,  but  these  phenomena 
are  most  invariably  preceded  by  a  series  of  '^precursory  symptomSy'^ 
as  noticed  by  Dr.  Hays. 

By  referring  to  the  cases  detailed  by  Dr.  Burne,  it  appears  that 
no  one  of  them  came  under  his  observation  earlier  than  the  fifth  day 
after  the  attack ;  a  circumstance  which  fully  explains  the  cause  of  his 
having  failed  to  notice  the  symptoms^  which  usually  precede  what 
may  be  considered  as  signs,  peculiar  to  these  affections. 

Instead,  therefore,  of  waiting  for  the  development  of  local  signs, 
these  symptoms  should  at  once  awaken  our  suspicions,  and  if  we  are 
led  by  them  to  a  careful  examination  of  the  abdomen,  we  may,  even 
before  the  attention  of  the  patient  has  been  directed  to  the  part,  dis- 
cover a  circumscribed  fullness,  well  defined,  and  quite  tender  to  the 
touch,  situated  over  the  caecum.  It  is  during  the  prevalence  of  these 
earlier  symptoms,  that  a  well  directed  treatment  will  often  prove  most 
successful. 

The  course  of  practice  which  I  have  found  most  "successful  in  these 
cases,  previous  to  the  development  of  inflammatory  action,  is  a  free  use 
of  calomel  and  opium,  together  with  warm  fomentations  to  the  abdo- 
men. "When  the  system  is  fully  under  the  influence  of  opium  —  pain 
and  spasmodic  action  having  subsided  —  an  enema  of  castor  oil  and 
spirits  of  turpentine,  in  a  suflScient  quantity  of  warm  water  to  freely 
distend  the  colon,  will  generally  succeed  in  removing  the  offending  mat- 
ters. By  thus  removing  the  cause  of  the  diflSculty,  we  may  often  avoid 
the  more  serious  character  of  these  complaints.  If,  however,  this 
course  proves  unsuccessful,  and  inflammatory  action  supervene,  it  must 
promptly  but  cautiously  be  met;  and  here  I  can  not  do  better  than  to 
commend  as  worthy  of  special  attention,  the  following  judicious  obser- 
vations of  Dr.  James  Johnson.  "As  the  inflammation  is  the  result 
of  a  mechanical  source  of  irritation,  or,  perhaps,  obstruction,  it  is 
obvious  that  depletion  must  not  be  carried  to  so  gTeat  an  extent  as  in 
idopathic  enteritis.  Another  consideration  which  should  moderate  the 
employment  of  depletory  measures,  especially  of  local  or  general  blood- 
letting, is  the  reflection  that  the  patient  may  have  to  go  through  an 
iliac  abscess,  and  that  his  powers  should  be  husbanded  for  its  support. 
The  depletion,  then,  should  be  cautious ;  enemata,  and  such  purga- 
tives as  the  stomach  will  bear  well,  should  be  administered;  light 
poultices  and  fomentations  are  to  be  applied;  and  about  the  fifth  or 
sixth  day  the  bowels  may  begin  to  act,  and  the  symptoms  to  sub- 
side     Should  they   not   subside,    the  physician   or   surgeon   must  anx-. 


Selected  Articles^  Abstracts^  d;c.  45 

iously  watch  for  the  first  appearance  of  an  emphysematous  tumor, 
and  make  an  early  incision  into  it;  foetid  gas  escapes,  and  the  cel- 
lular tissue  is  more  or  less  sloughy,  or  actually  sloughing.  The 
patient  must  now,  of  course,  be  supported,  and  even  stimulated,  to 
the  necessity  pitch." 

There  seems  to  be  some  difference  of  opinion  among  practitioners, 
as  to  the  propriety  of  opening  these  abscesses  after  suppuration  has 
taken  place.  M.  Dupuytren  and  Dance  recommend  leaving  them  to 
the  efforts  of  nature,  allowing  the  matter  either  to  make  its  own 
way  to  the  surface,  or  to  escape  through  some  of  the  natural  passages ; 
while  on  the  other  hand,  Drs.  Hargkave  and  Kennedy,  of  Dublin; 
Drs.  Johnson  and  Copland,  of  London ;  and  Dr.  Hays,  of  Philadelphia, 
advise  a  free  opening  for  the  exit  of  purulent  matter,  as  soon  as  a 
tendency  to  the  surface  is  evident.  There  can  be  no  doubt  that  the 
latter  course  will  be  sustained,  when  experience  shall  have  decided 
their  relative  advantages. 

We  occasionally,  in  these  cases,  meet  with  an  exceedingly  irrita- 
ble condition  of  the  rectum.  Under  these  circumstances,  an  enema, 
by  a  common  syringe,  will  not  be  retained  in  sufficient  quantity  to 
be  of  much  advantage.  We  may  then  resort  to  the  use  of  an  elastic 
tube,  passed  high  up  into  the  colon,  as  recommended  by  Dr.  O'Beirn. 

I  have  during  the  last  two  years  made  use  of  the  tube  described 
in  connection  with  Case  IV.,  which  I  have  found  in  some  respects 
preferable  to  the  common  elastic  tube.  Its  advantages  consist  in  its 
being  of  sufficient  firmness  to  retain  whatever  shape  or  course  we 
may  choose  to  give  it,  previous  to  its  introduction,  while  the  bulb  at 
its  extremity  is  not  liable  to  be  obstructed  in  its  passage  by  the  loose 
folds  of  the  mucous  membrane;  we  consequently  avoid  all  danger  of 
breaking  the  tube,  or  of  injuring  the  coats  of  the  intestine. 

In  detailing  the  foregoing  cases,  I  have  appended  occasional  remarks ; 
not,  however,  for  the  purpose  of  offering  to  the  Profession  anything 
new,  but  rather  with  the  intention  of  directing  the  attention  of  the 
readers  of  your  Journal  to  a  class  of  affections  which  are  scarcely 
noticed  in  the  systematic  works  which  constitute  the  libraries  of  most 
country  practitioners ;  and  also  of  inviting  their  attention  to  the  articles 
from  which  I  have  drawn  so  largely  in  preparing  this  paper. 

[New  York  Journal  of  Medicine,  July,  1845. 


44  The  Peninsular  and  Independent. 


Hie  Improvements  made  to  the  Operation  for  Yesico  •  Taginal  Fistula  by  American 

Surgery. 

Translated  by  O.  D.  Palmer,  M.  D.,  from  the  Gazette  Hebdomadaire. 

•  FIRST  ARTICLE. 

In  the  course  of  the  month  of  November  past,  a  young  American  Sur- 
geon, Dr.  BozEMAN,  came  to  Paris,  and  had  a  run  through  our  hospitals. 
He  demonstrated  to  us,  both  theoretically  and  practically,  the  process 
which  he  put  in  use,  in  the  treatment  of  Yesico- Vaginal  Fistula  —  a 
process  which  has  acquired  for  him  in  the  United  States,  and  even 
in  Europe,  a  just  portion  of  celebrity.  Dr.  Roberts,  having  at  that 
time  under  his  care  in  the  "Hotel  Dieu,"  a  patient  twice  already 
operated  upon  without  success,  he  united  with  me  in  praying  Dr. 
BozEMAN  to  make  still  a  trial.  The  process  was  here  submitted  to 
a  severe  test,  for  the  case  was  but  little  favorable.  The  result  was 
altogether  satisfactory. 

Assisting  at  this  operation,  we  have  been  able  to  follow  atten- 
tively the  phases.  Two  things  particularly  struck  us :  the  great  facility 
of  Dr.  BozEMAN,  and  the  perfection  of  the  manual  operation  in  itself 
The  foreign  press,  besides,  informing  us  daily  of  the  numerous  successes 
obtained  by  this  method,  we  have  believed  it  utile  to  expose  to  light 
a  surgical  progress  that  does  the  greatest  honor  to  American  practice. 

But  in  taking  cognizance  of  the  subject,  and  in  consulting  the  pub- 
lished works,  we  saw  immediately  that  Dr.  Bozeman  had  been  preceded 
in  this  path  by  a  certain  number  of  his  countrymen,  and  we  encounter 
as  we  make  way,  questions  of  priority,  discussed,  unhappily,  with  acri- 
mony to  be  regretted.     From  thence  our  plan  changed. 

It  consorts  with  our  personal  inclinations,  and  with  the  usages  of 
this  journal,  not  to  recoil  from  the  exigencies  of  an  impartial  criti- 
cism, supported  by  history.  To  render  unto  each  whatsoever  pertains 
to  him,  seems  to  us  a  duty  altogether  imperious,  and,  besides,  much 
more  profitable  to  science  than  is  generally  supposed.  We  resolved, 
therefore,  to  throw  a  comprehensive  glance  over  the  whole  of  that  part 
of  American  surgery,  appertaining  to  Vesica -Vaginal  Fistula. 

It  is  in  1839,  that,  with  common  accord,  the  first  success,  if  not 
obtained,  was  at  least  published  to  the  United  States  by  Dr.  Hayward, 
of  Boston.  It  is,  then,  with  the  works  of  this  surgeon  that  we  will 
prosecute  our  inquiries  up  to  the  present  day,  in  the  meantime  attach- 
ing ourselves  less  rigorously  to  dates,  than  to  scrutiny  of  the  ideas 
that  have  been  exposed  to  light;  historical  criticism  having  for  its 
object,  above  all,  the  exposition  of  principles.  This  review  is  not, 
perhaps,  altogether  inoportune.  We  are,  in  fact,  suflBciently  inclined  to 
believe,  in  France,  that  no  where  can  we  be  equaled  in  surgery.  It 
would  be  dangerous,  as  well  as  unjust,  to  perpetuate  this  vain  -  glorious 
illusion,  for   we    strive   so   much   the   more   to  maintain   the  first  rank 


Selected  Articles^  Abstracts,  c^c.  45 

when  we  see  ourselves  threatened  with  being  surpassed ;  and  it  is  not  less 
important  to  our  dignity,  than  to  the  interests  of  humanity,  to  recog- 
nize the  progress  we  have  not  known  to  realize. 

I  come  to  the  subject. 

Dr.  Hayward,  of  Boston,  has  made  two  publications  on  VesicO' 
Vaginal  Fistula,  the  one  in  1839,  the  other  in  1851.  Each  contains 
important  ideas.     I  undertake,  then,  the  examination  of  the  cases. 

The  first  publication,  I  have  said,  dates  from  1839.  The  preced- 
ing year,  the  American  Journal  had  published  the  translation  of  two 
articles  from  Dieffenbach,  inserted  in  the  Berlin  MediciniscTie  Zeitung^ 
in  June  and  July,  1836.  Hayward  had  read  these  articles,  for  he 
cites  their  author,  and  quotes  from  the  Berlin  surgeon  favorable  modi' 
fications.  After  some  generalities,  he  gives  the  following  case,  of  which 
I  make  a  summary  analysis : 

Case.  A  woman,  aged  thirty -four  years,  experienced,  at  nineteen, 
a  laceration  of  the  Vesica -Vaginal  cloison,  in  consequence  of  a  labor 
of  three  days  duration.  Eleven  times  since  that  accident,  she  became 
pregnant,  but  never  was  delivered  at  term.  Cauterizations,  the  wearing 
a  sound,  were  employed  without  success.  The  opening  was  situated  a 
little  to  the  left  of  the  median  line,  at  an  inch  and  a  quarter  from  the 
meatus  urinarius.  It  scarcely  admitted  the  point  of  the  finger.  Its 
borders  were  in  a  manner  cartilaginous. 

The  operation  was  performed  the  10th  May,  1839,  in  presence  of 
many  distinguished  associates.  Put  in  position,  the  parts  were  well 
dilated,  a  large  bougie  was  introduced  into  the  bladder  as  far  as  the 
fistula.  By  the  assistance  of  this  instrument,  the  walls  of  the  bladder 
were  brought  downwards  and  forwards,  so  that  the  opening  became 
very  accessible  to  the  view;  an  assistant  maintained  the  bougie;  a 
rapid  incision  about  the  fistula,  one  line  from  its  borders ;  ablation  of 
the  whole  circumference.  The  walls  of  the  vagina  were  then  sepa- 
rated, from  the  paries  of  the  bladder,  by  dissecting  around  the  whole 
circle  of  the  opening,  to  the  extent  of  about  three  lines.  This  was 
done  in  order,  at  the  same  time,  to  augment  the  chances  of  union  ly 
opposing  a  larger  surface,  and  to  avoid  the  passage  of  the  ligatures 
through  the  coats  of  the  Madder.  A  needle,  introduced  a  third  of  an 
inch  from  the  scarified  i  border  through  the  walls  of  the  vagina,  and 
subjacent  cellular  membranes,  was  pushed  on  through  the  other  lip, 
so  as  to  pass  out  about  the  same  distance.  Before  withdrawing  it,  two 
other  needles  were  passed  in  the  same  manner,  and  as  they  were  suffix 
cient  to  close  the  orifice,  they  were  drawn  out  and  firmly  knotted, 
The  ends  were  cut,  leaving  them  about  three  inches  long.  There  was 
no  difficulty  in  applying  the  sutures  with  the  hand,  for  the  fistulous 
opening  had  been  depressed  in  such  a  manner  as  to  be  very  well  exposed 
to  view.  A  short  silver  catheter,  made  expressly,  was  placed  in  the 
bladder,  the  patient  was  returned  to  her  bed,  and  placed  on  her  right 
side,  so  as  to  prevent  the  contact  of  the  urine  to  the  wound. 


46  Ihe  Peninsular  and  Independent, 

"With  the  exception  of  the  same  smartings,  and  same  annoyance 
from  the  catheter,  which  otherwise  performed  very  well,  the  effects  of 
the  operation  were  very  mild.     Regimen:  arrowroot,  milk,  gum -water. 

The  catheter  was  taken  away  the  next  morning,  cleaned,  and  re- 
placed ;  light  pains,  always  referred  to  the  instrument ;  a  little  sleep,  no 
fever;  position  and  regimen,  ut  supra. 

During  five  days  all  went  well.     The  catheter  was  cleaned  every  day. 

Examination — with  a  speculum.  The  ligatures  held  firmly.  The 
wound  appeared  healed  in  all  its  extent ;  no  infiltration  into  the  vagina. 
The  vesico  retained  the  urine,  which  flowed  through  the  catheter  imme- 
diately this  was  introduced.  The  ligatures  were  taken  away,  which 
was  made  difficult  by  fear  of  rupturing  the  cicatrix,  if  the  bladder  was 
depressed  as  during  the  operation.  A  small  catheter  was  replaced,  and 
the  position  in  bed  preserved.  An  instrument  of  a  smaller  volume  re- 
lieved the  patient  much  during  two  days;  it  was  then  suppressed 
entirely.  The  patient  was  taught  to  sound  herself  every  three  hours, 
but  two  nights  later  she  slept  during  seven  hours,  notwithstanding 
which  she  experienced,  on  awaking,  no  inconvenience.  Twice,  also,  at 
this  epoch,  she  voided  her  urine  by  the  simple  contractions  of  the  blad- 
der, which  had  thus  recuperated  its  functions.  The  catheter,  however, 
was  still  introduced,  but  at  longer  intervals. 

Seventeen  days  after  the  operation,  a  new  examination.  The 
wound  was  entirely  healed  and  appeared,  solid.  The  patient  was  en- 
gaged to  sound  herself  two  or  three  times  per  day  for  several  weeks. 
The  next  day  she  returned  home  by  water,  a  distance  of  200  miles. 

"We  have  reported  the  first  case  of  Dr.  Hayward,  because  it 
contains  the  essential '  points  of  his  process.  We  have  seen  that  not 
only  his  operation  was  crowned  with  success,  but  also  that  the  con- 
sequences were  extremely  benign.  The  author  attributes  the  want  of 
grave  symptoms  to  the  absence  of  all  traction  experienced  on  the 
borders  of  fistula,  and  also  to  the  fact  that  the  bladder  was  not  in- 
cluded in  the  parts  through  which  the  needles  were  introduced. 

But  there  are,  in  this  process,  principles  involved  too  important 
to  permit  a  simple  mention  of  the  case  to  suffice,  particularly  if  we 
are  willing  to  consider  the  epoch  when  this  note  was  published  (1839). 
The  manual  operation  for  Vesico -Vaginal  Fistula,  had  been  then  much 
less  studied  than  in  our  days;  important  works  which  we  now  pos- 
sess, had  not  yet  been  published,  or  were  not  sufficiently  dissemin- 
ated. This  is  why  Dr.  Hayward  ought  to  be  considered  a  real  pioneer 
inovateur)  and  a    successful  pioneer. 

It  may  be  permitted  me  to  examine  separately  the  culminating 
points  of  his   operation. 

1st.  Coaptation  of  Large  Bleeding  or  Scarified  Surfaces.  This 
idea  pertains  to  Dieffenbach.  After  having  paired  perpendicularly 
the  borders   of  the  fistula,  to  the   extent  of  about  a  line,  he  proposed 


Selected  Articles^  Abstracts^  etc,  47 

and  executed  the  separation  of  the  mucous  membrane  of  the  vagina 
from  that  of  the  bladder,  to  the  extent  of  two  lines.  He  succeeded, 
by  this  means,  in  closing,  by  two  operations,  a  large  fistula,  in  a 
woman  of  twenty-eight  years.  He  says,  expressly,  that  this  dissecting 
asunder  has  for  its  object  the  obtaining  of  a  broad  surface  of  re-union. 
Dr.  Hayward  has  been  one  of  the  first  to  comprehend  all  the  import 
of  this   precept. 

2d.  Passage  of  the  Ligatures  exclusively  in  the  Vesica -Vaginal 
Cloison  without  wounding  the  Membranes  of  the  Bladder.  —  This  im- 
portant rule  has  been  closely  adhered  to  by  Dr.  Hayward,  who  at- 
tributes to  this  circumstance,  in  a  great  measure,  the  escape  from 
untoward  symptoms  in  the  operation.  It  is  an  incontestible  fact,  that 
in  the  ordinary  process  each  end  of  the  ligature  penetrating  the'  mem- 
branes of  the  bladder  create  thereby  a  passage  for  the  slow  infiltra- 
tion of  the  urine  into  the  lax  cellular  tissue,  as  is  well  known. 
Moreover,  there  has  been  frequently  observed  the  formation  of  small 
fistulas  produced  entirely  by  the  ligatures,  the  passage  of  which  they 
follow.  Finally,  these  same  ligatures  may  be  considered  as  a  cause 
of  inflammation,  and  inflammation  being  the  principal  cause  of  the 
want  of  success  of  sutures,  all  conspire  to  prove  the  value  of  a  pro- 
cess which  does  not  implicate  the  coats  of  the  bladder. 

3d.  Depressing  the  Vesico -Vaginal  Cloison,  in  order  to  render 
the  Fistula  accessille  to  mew  and  to  Instruments.  —  One  of  the  cir- 
cumstances which  has  most  retarded  the  progress  of  the  operation 
which  occupies  us,  is  the  difficulty  of  handling  instruments  at  the 
bottom  of  a  narrow  cavity,  and  of  being  able  to  scarify  and  stitch 
an  opening  scarcely  visible.  This  objection  disheartened  J.  L.  Petit. 
It  is  found  under  various  forms,  in  many  works  on  this  matter. 
Even  Lallemand,  himself  a  surgeon  so  skilled,  recoiled  before  this 
means,  and  it  is  from  these  obstacles  that  cauterization  owes  the  pri- 
vilege of  being  extolled  and  re -invented  constantly.  We  must  all 
admit  that  the  difficulty  is  great.  Dr.  Hayward  has  triumphed  over  it 
by   a  very   simple  process,   and  from  his  first   trial   in   1829. 

The  patient  being  placed  on  the  border  of  a  table,  in  an  oper- 
ating position,  and  the  parts  well  separated,  a  large  bougie  was  in- 
troduced into  the  urethra,  and  pushed  back  to  the  fistula.  By  this 
means  he  was  enabled  to  bring  the  bladder  down,  and  forwards,  in 
such  a  manner  as  to  expose  to  view,  with  facility,  the  opening. 
The  instrument  was  confided  to  an  assistant.  We  may  recall  to  mind 
that  the  fistula  in  the  present  case  was  situated  but  15  or  16  lines 
from  the  meatus  urinarius,  and  it  is  easy  to  comprehend  the  me- 
chanism of  the  manoeuvre.  The  instrument  introduced  by  the  urethra, 
acts  as  a  fixed  lever,  by  raising  towards  the  abdomen  the  external 
part;  the  vesical  portion,  together  with  the  superior  walls  of  the 
vagina,   are  depressed. 


48  The  Peninsular  and  Independent. 

In  resuming,  the  first  communication  of  Br.  Hayward  brought 
to   light,   in   1839,    two   important   precepts: 

1st.  The  opposition  of  large  bleeding  surfaces; 
2d.  The  position  of  the  ligature  outside  the  walls  of  the  bladder. 
In  1851,  Dr.  Hayward  published  a  second  memoir  on  the  Vesico- 
vaginal Fistula,  inserted  in  the  Boston  Medical  and  Surgical  Journal 
(April,  1851).  Before  passing  to  the  analysis  of  this  interesting  work,  we 
ought  to  consecrate  some  moments  to  two  other  celebrated  American  sur- 
geons ;  these  also  have  studied  the  same  subject.  I  wish  to  speak  of  Drs. 
Mettauer  and  Pancoast.  Unfortunately,  it  has  been  impossible  for  me  to 
consult  their  original  works ;  very  short  extracts  have  come  to  my  knowl- 
edge only,  and  I  have  a  long  time  since  learned  to  suspect  simple  citations, 
and  even  succinct  analyses. 

According  to  Dr.  Bozeman,  Dr.  Mettauer,  otherwise  known  by  numer- 
ous works  on  reparative  surgery,  had  attempted  the  operation  for  Vesico 
Vaginal  Fistula,  as  early  as  1830. 

Process  of  Mettauer. —  It  consists  in  scarifying  the  borders  of  the 
opening,  then  to  hold  them  in  contact  by  the  interrupted  suture,  made  with 
threads  of  lead.  These  threads  traverse  the  whole  Vesico -Vaginal  cloison, 
at  the  distance  of  an  inch  from  the  prepared  borders,  then,  when  they 
have  been  placed  in  sufficient  quantity,  the  ends  of  each  pair  are  twisted 
together  till  they  produce  an  exact  coaptation  of  the  lips.  They  are  then 
cut  on  the  outside  of  the  vulva.  On  the  third  day  this  leaden  wire  is 
tightened  by  a  new  torsion,  and  taken  away  finally  on  the  tenth  day. 

Dr.  Mettauer  has  often  employed  since,  the  same  mode,  without  much 
modification,  and  he  has  much  success. 

The  first  publication  of  this  surgeon  was  made  in  1847,  in  the  Vir- 
ginia Medical  and  Surgical  Journal,  which  it  has  been  impossible  for  me 
to  procure.  The  priority  of  printing,  then,  remains  to  Hayward,  who, 
besides,  proceeded  altogether  in  a  different  manner. 

I  have  been  equally  unable  to  consult  the  cases  of  Dr.  Pancoast, 
inserted  in  the  Medical  Examiner,  May,  1847.  By  good  fortune,  Dr.  Sims 
has  given  copious  extracts  from  them. 

Process  of  Br.  Pancoast,  of  Philadelphia. —  The  particular  character 
of  the  operation  is  in  re -uniting  solidly  the  borders  of  the  abnormal  open- 
ing, on  the  principle  of  the  tenant  and  mortise.  There  are  thus  placed  in 
contact  four  bleeding  surfaces,  which  augments  the  chances  of  union  by  the 
first  intention.  The  borders  should  have  a  considerable  thickness ;  when 
they  are  not  in  this  condition,  they  should  be  made  thicker  by  the  repeated 
application  of  the  nitrate  of  silver,  or,  better,  the  actual  cautery  {fer  rouge). 
The  parts  being  as  well  dilated  as  possible,  with  the  speculum  of  Char- 
RiERE,  the  mobile  valve  of  which  has  been  removed  in  the  same  time  that 
an  assistant  raises  the  vestibula  toward  the  pubis,  the  introduction  of  the 
operation  consists  in  splitting  the  posterior  lip  to  the  depth  of  half  an 
inch.     The  opposite  lip  is  then  paired  in  shape  of  a  wedge,  at  first  revers- 


Selected  Articles^  Abstracts^  c&c.  4,9 

ing  it  as  much  as  possible  with  an  obtuse  hook,  in  order  to  refresh  the 
mucous  membrane  of  the  bladder,  with  the  curved  scissors  and  scalpel ;  then 
in  abrading  in  turn  the  membranes  of  the  vagina  in  the  whole  lip  to  the 
extent  of  three -fourths  of  an  inch.  This  is  a  very  difficult  part,  but  a  very 
important  part,  of  the  operation.  The  hemmorrhage  arrested,  it  remains 
to  insert  the  bleeding  cuneiform  tenant,  into  which  the  anterior  lip  has 
been  converted,  into  the  groove  or  mortise  formed  by  the  posterior  lip,  and 
to  hold  the  parts  in  contact.  This  is  arrived  at  by  means  of  a  particular 
suture,  useful  in  many  plastic  operations,  and  described  by  the  author,  in 
the  American  Journal  tor  October,  1842. 

When  the  suture  is  knotted,  the  tenant  is  included  in  the  mortise ;  the 
ligatures  are  left  two  weeks  or  more,  till  they  become  lax :  elastic  catheter 
left  in  bladder  to  prevent  it  from  becoming  distended.  To  moderate  the 
inflammation  a  bladder  of  cold  water  is  applied  to  the  vulva  during  thirty- 
six  hours.  The  second  or  third  day  frequent  vaginal  injections  of  a  solu- 
tion of  sulphate  of  zinc,  to  augment  the  tone  of  the  parts.  On  the  fourth 
or  fifth,  a  pencil  dipped  in  a  solution  of  nit.  argt.  may  be  passed  over  the 
line  of  union.  We  may  count  on  an  immediate  union,  to  a  great  extent ; 
where  it  is  wanting,  the  secondary  re -union  is  provoked  by  the  solid 
nitrate  of  silver,  which  developes  a  crop  of  granulations  on  the  budding 
surface,  still  held  in  contact  by  the  plastic  suture. 

Dr.  Pancoast  has  cured,  by  his  process,  two  patients.  One  case  con- 
sisted in  a  complete  destruction  of  one  segment  of  the  urethra ;  the  other 
presented,  in  the  fundus  of  the  bladder,  an  elongated  opening,  more  than 
sufficient  to  admit  the  point  of  the  finger. 

We  again  recognize  the  principle  of  coaptation  of  excoriated  surfaces, 
carried  to  its  last  limits  by  Dr.  Pancoast  in  a  veritable  suture  by  scTiindy- 
lese.  We  very  well  comprehend  the  efficacy  of  the  operation,  which 
unfortunately,  would  seem  to  possess  extreme  difficulties  of  execution,  and 
which,  besides,  is  not  applicable  to  all  cases. 

I  have  knowledge  of  an  operation  very  analogous,  practiced  recently  by 
my  excellent  colleague,  Lenoir,  with  success.  It  was  a  fistula,  the  poste- 
rior borders  of  which  was  formed  by  the  os  uteri.  Two  operations  with 
ordinary  sutures  had  already  miscarried.  Dr.  Lenoir  formed  the  idea  of 
splitting  transversely  the  anterior  lip  of  the  neck,  in  such  a  manner  as  to 
form  a  profound  groove,  in  which  he  enclosed  the  anterior  lip  of  the  fistula. 
A  cure  was  effected.  It  is  a  case  which  would  merit  the  honor  of  a  detailed 
publication. 

I  still  remark,  in  the  consecutive  treament  instituted  by  Dr.  Pancoast, 
the  astringent  injections,  the  cauterization  with  nitrate  of  silver  to  the 
growing  cicatrix,  and  finally,  the  protracted  sojourn  of  the  sutures. 

This  process,  I  have  no  doubt,  might  be  useful  still,  in  certain  cases. 

Ar.  VERNEUIL. 


Vol.  it.  -  D. 


50  The  Peninsular  and  Independent. 


Dr.  Churchill  on  Consumption.  * 


As  the  medical  world  is  now  all  agog  in  discussing  the  value  of  the 
Rypophosphites  as  a  remedy  in  Phthisis,  it  may  be  interesting  to 
know  what  are  the  views  of  Dr.  Churchill  in  relation  to  the  me- 
dicine as  a  therapeutic  agent.  Most  persons  have  frequently  heard 
of  Dr.  Churchill,  though  but  few  have  heard  from  him.  The  fol- 
lowing letter,  which  we  get  from  the  Trihune^  was  addressed  to  Mr. 
J.   Winchester,  of  this  city: 

"Paris,   Dec.    17,   1858. 

My  Dear  Sir:  —  *  *  *  *  i  very  much  regret  my  utter  inability 
to  send  you  a  copy  of  my  work  on  Phthisis.  The  whole  edition 
was  sold  off  in  less  than  six  months,  and  it  has  now  been  out  of 
print  since  February  last.  *  *  *  I  am  now  engaged  upon  a  second 
edition,  which  has  been  delayed  with  the  hope  of  my  being  able  to 
settle  the  question  of  the  existence  or  non-existence,  in  the  human 
economy,  of  phosphorus  in  an  oxydizable  condition.  The  chemical 
proof  of  its  existence  in  such  a  state  I  now  confidently  hope  I  shall 
shortly  be  able  to   lay  before  the  profession  and  the  chemical  world. 

Your  reply  to  Mr.  Guilford's  claim  of  priority  is  perfectly  to 
the  point.  The  same  pretension  has  been  raised  here  by  two  differ- 
ent parties,  and  also  by  one  or  two  in  England;  but,  in  reality,  the 
use  of  phosphoric  acid,  in  Phthisis,  dates  as  far  back  as  1789,  when 
it  was  employed  in  Germany  by  J.  B.  Lentin.  Since  then,  the  phos- 
phates, especially  the  phosphate  of  lime,  have  been  used  by  many 
practitioners,  and  among  others  by  Dr.  Stone  of  New  Orleans.  That 
all  the  cases  in  which  they  are  stated  to  have  proved  beneficial  are 
to  be  rejected,  or  attributed  to  error  of  diagnosis,  I  am  not  at  all 
prepared  to  assert;  but  think  they  are  to  be  accounted  for  in  one 
of  the   two  following  ways: 

Any  mode  of  treatment  which  is  combined  with  rest,  and  im- 
proved diet  and  living,  may  prove  beneficial  by  stopping  or  dimin- 
ishing the  amount  of  waste  of  the  oxydizable  phosphorus.  The  phos- 
phates may,  therefore,  have  occasionally  appeared  to  be  of  use,  just 
as  may  have   change   of  climate,    homoeopathy,    or  anything  else. 

Phosphoric  acid,  as  shown  by  Weigel  and  King,  and  later  by 
DellA  Judda,  frequently  contains  phosphorous  acid,  an  oxydizable  com- 
pound, and  as  such  could  have,  in  accordance  with  my  hypothesis, 
a  curative  effect,    owing  to   its  very   impurity. 

My  views,  with  regard  to  Phthisis,  may  be  summed  up  in  very 
few  words,   and  are  as   follows: 

Phthisis    is    a    diathesis   or   general    disease,    depending   upon   the 


*¥vom  American  Druggists'  Circular,  March,  1850. 


Selected  Articles^  Abstracts^  etc,  61 

want  or  undue  waste  of  thes  oxydizable  phosphorus  normally  existing 
in  the  animal  economy.  Hence  it  follows  that  the  remedy  consists 
in  supplying  the  deficient  element  by  the  administration  of  any  pre- 
paration of  phosphorus  which  is  at  once  assimilable  and  oxydizable. 
Now,  phosphorus  itself  possesses  the  latter  quality,  and  has  occasionally 
been  used  with  success;  but  is  has  not  the  first,  and  is  so  dangerous 
a  substance,  that  it  has  fallen  into  complete  disuse.  Phosphoric  acid 
is  assimilable,   but  not  oxydizable. 

The  Rypop'hosp)hites  combine  both  qualities  in  the  highest  degree, 
being  perfectly  soluble,  and  nearly  as  oxydizable  as  phosphorus  itself; 
for  which  latter  reason  I  originally  preferred  them  to  the  pliosphites, 
which  are  less  so. 

As  to  the  cause  of  Consumption,  my  hypothesis  leads  also  to 
one  or  two  other  consequences  of  the  highest  importance  in  practice, 
viz.  ^  Although  the  hypophosphites  are  the  specific  remedy  of  the 
diathesis,  they  can  not  cure,  by  their  own  direct  action^  the  local 
diseases  which  the  diathesis  may  have  produced  in  the  lungs  or  else- 
where, previous  to  the  employment  of  the  remedy.  To  expect  the 
contrary  would  be  just  as  reasonable  as  to  think  that  the  water 
thrown  upon  a  burning  building  can  do  the  work  of  the  mason  or 
the  carpenter. 

The  repair  of  such  local  disorder  is  brought  about  by  the  special 
energy  of  the  parts  affected,  and  will  take  place  in  all  cases  in  which 
the  destruction  of  the  parts  involved  has  not  gone  beyond  a  certain 
extent.  The  degree  of  the  disease  I  hold  to  be  of  less  moment  than 
the  extent^  and  incline  to  go  so  far  as  to  look  upon  Phthisis  in  the 
third  stage  as  of  a  more  favorable  prognosis  than  in  the  second,  all 
other  circumstances  teing  equal.  The  prognosis  of  each  individual  case 
will,  therefore,  depend  upon  two  points  — the  extent  of  the  existing 
lesion,   and  upon   the  presence  or  absence  of  complieation. 

Another  consequence,  which  is,  if  possible,  of  still  greater  im- 
portance than  the   cure  of  the   disease,   is  the  following: 

If  consumption  depends  upon  the  waste  of  the  oxydizable  phos- 
phorus, it  follows  that  the  hypophosphites  not  only  have  a  remedial, 
but  a  preservative  power.  In  fact,  they  are  a  complete  proi^hylactic, 
Such,  I  am  confident,  will  prove  to  be  the  case;  and  the  time  will 
come,  I  hope,  when  Phthisis  and  Tuberculosis,  instead  of  occupying 
the  first  place  in  the  causes  of  mortality,  will,  like  small-pox  at  the 
present  day,    form   a  comparatively   insignificant  item. 

My  reason  for  this  confidence  is  not  derived  from  my  assurance  of 
the  correctness  of  my  general  theory,  but  from  the  invarialle  efficacy 
with  which  I  have  found  them  act  in  all  incipient  cases,  even  of  the 
acute  kind  commonly  called  galloping  consumption. 

I  am  anxious  that  all  these  assertions  should  be  verified  by  the 
medical  profession  throughout  the  world.     With   them,  and  them  only. 


52  The  Peninsular  and  Independent, 

does  it  rest  to  establish  or  to  deny  their  validity.  Unfortunately,  the 
past  history  of  our  art  shows  that  every  discovery  in  therapeutics  has 
been  met  with  a  storm  of  prejudice  and  opposition  such  as  finds  no 
parallel  except  in  the  records  of  religious  dissension.  I  might  have 
much  to  relate  on  that  head  in  my  own  case,  but  prefer  leaving  such 
matters  in  the  obscurity  to  which  posterity  is  sure  to  consign  them. 

If,  as  you  say,  the  people  of  the  United  States  take  an  interest  in 
my  discovery,  the  only  way  in  which  I  should  wish  them  to  show  it 
would  be  by  inducing  the  Medical  Profession  among  you  to  give  my 
treatment  a  fair  and  complete  trial,  which,  I  conceive,  can  only  be  done 
upon  the  following  conditions: 

1.  That  no  case  shall  be  considered  to  have  any  bearing  at  all 
upon  the  question  at  issue,  unless  it  be  expressly  shown  that  all  the 
conditions  which  I  have  laid  down  as  necessary  have  been  complied 
with. 

2.  That  in  each  case  not  only  the  degree,  but  also  the  extent,  of 
the  tubercular  deposit  pre  -  existing  to  the  treatment  shall  be  recorded* 
together  with  the  symptoms  upon  which  this  diagnosis  is  founded. 

3.  That  the  treatment  used  shall  be  the  Hypophosphites  as  I  have 
employed  them.  I  do  not  consider  myself  in  anywise  responsible  for 
the  ill  success  of  every  crude  formula  which  may  be  imagined  by  other 
practitioners. 

As  soon  as  my  new  edition  is  through  the  press,  I  shall  have 
much  pleasure  in  forwarding  you  a  copy  of  it,  and,  meanwhile,  I 
remain  Your  very  obedient  servant, 

J.  F.  CHURCHILL, 
17  Boulevard  de  la  Madelaine. 
J.  Winchester,  Esq. 

ASH  TEA  AS  A  EEMEDY  FOR  THE  BITE  OF  A  RATTLESNAKE. 

A  correspondent  of  the  Nashville  Journal  of  Medicine  and  Surgery 
affirms  that  a  tea  prepared  from  the  bark  of  the  ash  is  a  reliable  rem- 
edy for  the  bite  of  a  rattlesnake.  He  does  not  give  the  variety  of  the 
ash  tree  used,  nor  very  definite  directions  as  to  its  preparation.  His 
treatment,  however,  is  the  administration  of  "about  one  pint  of  ash 
tea,  prepared  by  taking  a  handful  of  the  inner  bark  of  the  ash,  adding 
one  quart  of  water,  and  boiling  down  to  a  pint."  About  half  a  gill  is 
to  be  taken  every  twenty  minutes. 


PUERPERAL  CONVULSIONS  TREATED  WITH  THE  NETTLE. 

Dr.  Wm.  Hauser,  of  Jeflferson  County,  Ga.,  mentions  in  the  Ogle-^ 
thorpe  Medical  and  Surgical  Journal,  a  case  of  convulsions  a  short  time 
prior  to  labor,  in  which  he  employed  the  cow  nettle  (the  urtica  dioica),, 


Selected  Articles^  Abstracts^  dc.  63 

in  the  form  of  infusion.  For  this  purpose  he  employed  the  balls  of 
this  plant,  just  then  maturing,  and  it  seems  with  complete  success,  the 
relief  being  almost  immediate.  The  convulsions  were  very  severe,  the 
xjhild,  which  was  delivered  a  few  hours  after,  being  badly  crushed.  He 
had  previously  employed  anodynes,  antispasmodics,  bleeding,  &c.  It  is 
to  be  hoped  that  the  call  w^hich  he  makes  upon  the  profession  to  an- 
alyse the  plant  and  ascertain  its  therapeutic  value  will  not  remain  un- 
answered. 


COD  -  LIVER  OIL  CAKES. 

We  have  examined  a  specimen  of  gingerbread  made  by  Messrs. 
Newberry  —  each  cake  containing  a  spoonful  of  Cod -Liver  Oil.  The 
gingerbread  is  extremely  light  and  pleasant,  the  flavor  of  the  oil  being 
<;ompletely  covered.  This  seems  likely  to  prove  a  very  useful  mode  of 
administering  Cod -Liver  Oil  to  children,  and  to  others  who  are  nause- 
ated by  the  offensive  odor  and  flavor  of  the  oil  as  generally  taken. — 
Medical  Times. 


PRESERVATION  OF  SPECIMENS  OF  DISEASED  MEMBRANES. 

Dr.  Arnold,  of  Savannah,  has  pursued  the  following  plan  with  suc- 
cess during  three  years.  The  specimen  is  well  washed,  and  one  side 
is  sprinkled  with  arsenic,  but  not  too  thickly.  It  is  then  spread  on 
a  pane  of  glass,  and  its  free  surface  is  thickly  powdered  with  arsenic, 
which  is  revived  when  absorbed — the  specimen  being  kept  in  the 
shade.  When  dry  it  is  covered  with  a  coat  of  white  varnish,  and 
when   this  has   dried,   by  another  pane   of  glass. 

PORT  WINE  ENEMATA. 

Dr.  H.  L.  Williams  recommends  an  enemata  of  port  wine  as  a  sub- 
stitute for  transfusion  of  blood  in  cases  of  post-partum  hemorrhage, 
and  records  {British  Med,  Jour.^  Sept.  4,  1858)  a  case  in  which  he 
successfully  resorted  to  it.  The  patient  was  in  the  most  alarming 
state  of  prostration,  pulseless  at  the  wrist,  with  cold  extremities,  &c. 
Dr.  W.  commenced  by  administering  four  ounces  of  port  wine  with 
twenty  drops  of  tincture  of  opium.  The  patient  speedily  manifested 
«igns  of  improvement.  In  half  an  hour  he  repeated  the  enemata  with 
marked  advantage,   and  the  patient  was  soon   out  of  danger. 

NEURALGIA. 

Dr.  ALEXAJiTDER  WooD  Operated  at  the  Infirmary  before  the  mem- 
bers of  the  British  Association,  at  the  late  meeting  in  Edinburgh, 
«on  two   patients  for  neuralgia,  according  to  a  plan  proposed  by  him. 


54  The  PeninsulaT  and  Independent. 

This  consists  in  injecting  under  the  skin,  at  the  most  painful  part 
of  the  nerve,  a  few  drops  of  Battley's  solution.  The  patients  ex- 
pressed themselves  relieved,  and  Dr.  Wood  speaks  of  the  process  as 
the  most  certain  and  effective  means  of  curing  all  forms  of  neuralgia. 

TiEMANN  has  produced  one  of  the  most  beautiful  specimens  of  skill, 
in  point  of  delicate  workmanship.  It  is  a  small  syringe,  with  steel 
points,  1%  inches  long,  and  only  %  a  line,  or  the  24th  of  an  inch  in 
diameter.  These  points  are  of  cast  steel,  and  an  orifice  is  drilled 
through  the  whole  length,  the  ©nd  is  sharpened,  and  the  whole  is 
especially  adapted  to  carry  out  Dr.  Wood's  process  of  injecting  ano- 
dynes or  haemostatics. 


CARBON"ATE  OF  AMMONIA  IN  THE  BITES  OF  POISONOUS  REPTILES. 

Dr.  A.  S.  Payne,  of  Paris,  Fouquier  Co.,  Ya.,  from  long  experience 
in  the  treatment  of  poisoning  by  snake  bites,  spider-bites,  etc.,  has  come 
to  the  following  conclusions: 

"1st.  That  hartshorn  is  the  natural  remedy  or  antidote  for  the 
cure  of  all  bites  of  poisonous  reptiles  or  stings  of  insects  which  exert 
a  rapid  and  depressing  influence  upon  the  heart's  action. 

"2d.  That,  in  my  opinion,  second  to  the  hartshorn,  in  remedial 
virtues,  stands  an  etherealized  solution  of  iodine. 

"3d.  That  the  biniodide  of  mercury  has  proven  itself  next  most 
valuable. 

"In  the  fourth  place  of  value  I  place  various  plants  indigenous  ta 
the  United  States  of  America." 

[  Virginia  Med.  Jour,  and  Am.  Jour.  Phar 


lljarmarewtital  f^prtnunt* 


Propylamin. 

This  organic  alkaloid  having  recently  come  into  use  in  Philadel- 
phia, in  testing  its  asserted  powers,  as  a  specific  in  Kheumatism, 
Prof.  Procter  gives  a  formula  for  its  preparation.  Though  it  can 
be  prepared  artificially,  and  is  found  naturally  combined  with  an  acid 
in  several  plants,  yet  he  recommends,  as  a  most  convenient  source^ 
herring  pickle — the  process   as  follows: 

Propylamin  is  prepared  by  taking  any  convenient  quantity  of  herring 
pickle,  obtained  from  the  dealers  in  salt  fish ;  this  is  put  in  a  retort  or 
tight  still,  with  sufficient  potash  to  render  the  liquid  strongly  alkaline,  and 
the  liquid  heated.  A  well  refrigerated  receiver,  containing  some  distilled 
water,  being  attached,  heat  is  applied  as  long  as  the  distillate  has  the  odor 
of  herrings.  This  is  then  saturated  with  hydrochloric  acid,  evaporated 
carefully  to  dryness,  and  the  dry  crystalline  mass  exhausted  with  absolute 
alcohol,  which  dissolves  the  propylamin  salt  and  leaves  the  muriate  of 
ammonia.  From  the  former,  the  pure  propylamin  may  be  obtained  in 
solution  by  means  of  hydrate  of  lime,  using  strong  precautions  to  refri- 
gerate and  condense  the  vapors,  which  are  actively  disengaged  almost 
without  heating. 

The  author  further  states  that  Propylamin  is  a  colorless,  trans- 
parent liquid,  with  a  strong  pungent  odor  that  reminds  one  of  am- 
monia,  and   quotes  Dr.  Awenarius   of  St.   Petersburg,   as   follows: 

Propylamin,  as  obtained  from  the  pickle  of  herrings,  codliver  oil, 
ergot,  human  urine,  etc.,  appears,  according  to  the  author,  to  possess  the 
power  of  a  true  specific  for  the  various  affections  of  rheumatic  origin.  The 
diagnosis  of  these  diseases  being  often  very  obscure,  one  can  succeed  by 
the  use  of  propylamin  in  bringing  to  light  in  a  few  days  the  true  nature  of 
the  malady.  The  author  has  treated,  by  means  of  this  remedy,  250 
patients  in  the  hospital  of  Kaulinkin,  at  St.  Petersburg,  between  March, 
1854,  and  June,  1856;  and  besides,  it  has  been  employed  in  outside 
practice  in  a  considerable  number  of  acute  and  chronic  cases  of  rheuma- 
tism. In  acute  cases  the  pain  and  fever  always  disappear  the  next  day. 
The  remedy  was  prescribed  in  the  following  manner,  viz. : 

I^.    Propylamin       ....     gtt.  xxv. 
Distilled  water      .         .         .         f-  1  vj.     Mix. 
and  when  necessary,  add 

Oleo  saccharum  of  peppermint      3  ij. 
Dose.     A  tablespoonful  every  two  hours. 


56  The  Peninsular  and  Independent. 

It  is  necessary  to  carefully  ascertain  if  the  medicine  is  fresh  and 
pure. 

Although  this  remedy  has  not  found  its  way  into  commerce,  it  is  to  be 
presumed  it  will  soon  be  readily  obtainable. 


Liquor  Cinchonse  Hydriodatus,  and  Liquor  Cinchonse  Hydriodatus  cum  Ferro. 

The  editors  of  the  Semi  -  Monthly  Medical  News  speak  favorably  of 
two  new  pharmaceutical  preparations  under  the  above  titles,  from  their 
own  experience,  in  common  with  that  of  several  Physicians  of  their  city, 
(Louisville,  Ky.)  They  were  introduced  by  Mr.  J.  C.  Christopher,  in  an 
article  upon  "Secondary  Syphilis,"  stating  that  in  cases  of  this  disease 
which  resist  the  ordinary  means  of  treatment,  with  the  use  of  these  prepa- 
rations all  the  virtues  of  Iodine  are  obtained,  without  its  irritating  effects. 
He  affirms  that  it  has,  in  his  hands,  effected  cures  in  cases  of  constitutional 
syphilis  which  had  failed  to  be  relieved  by  other  forms  of  Iodine,  and  that 
in  other  hands  it  had  proved  valuable  in  the  treatment  of  scrofula,  anemia, 
and  furunculoid  tendencies,  especially  of  epidemic  form. 

In  a  late  number  of  the  "iV^wJS,"  we  find  two  formulae,  proposed  by 
T.  E.  Jenkins,  Chemist,  of  Louisville,  which  we  give  below. 

Liquor  GinchoncB  Hydriodatus. 

Cinchon.    cort.    (Calisaya)           ....  1.2288  grs. 

Iodine  (in  fine  powder)             ......  1536     " 

Water  (distilled) 128    oz. 

Sulphuretted  hydrogen            ....          .  q.  s. 

Convert  the  iodine  into  hydriodic  acid  by  passing  a  current  of  washed 
sulphuretted  hydrogen  gas  into  sixteen  ounces  of  water,  through  which 
the  iodine,  in  powder,  is  gradually  mixed;  after  the  whole  of  the  iodine 
has  been  converted  into  hydriodic  acid,  and  the  watery  solution  has  become 
white,  filter  the  solution  and  heat  the  filtered  liquor  until  the  excess  of 
sulphuretted  hydrogen  is  entirely  driven  off",  the  resulting  liquid,  which 
should  be  colorless  and  transparent,  is  a  solution  of  hydriodic  acid. 

With  one -half  this  solution  of  hydriodic  acid,  and  as  much  water  as 
may  be  necessary,  thorougly  moisten  the  cinchona  bark,  in  moderately  fine 
powder ;  allow  the  mixture  to  stand  for  twenty  -  four  hours ;  then  transfer 
the  mixture  to  a  percolator,  and,  by  the  process  of  displacement,  exhaust 
tlie  bark  with  a  mixture  of  the  remaining  half  of  the  solution  of  the 
hydriodic  acid  and  the  water.  The  last  portion  should  be  displaced  by 
pure  water.  If  the  resulting  fluid  measure  over  128  fluid  ounces,  it  should 
be  reduced  to  that  quantity  by  gentle  evaporation ;  if  less,  the  percolation 
may  be  continued  with  water  until  the  proper  measure  be  obtained. 

Each  teaspoonful  of  this  preparation  contains  the  active  principles  of 
12  grains  of  the  best  variety  of  Peruvian  bark  and  1%  grains  of  iodine  in 
the  form  of  hydriodic  acid,  all  in  perfect  solution,  and  entirely  compatible 
with  ferruginous  compounds. 


Liquor  Cinchonce  Hydriodatus  cum  Ferro. 

Liquor  cinchonas  hydriodatus  may  be  mixed  with  solutions  of  salts  of 
iron  without  producing  the  ordinary  effects  of  incompatibility  which  follow 
the  admixture  of  ferruginous  compounds  with  the  officinal  preparations 


Pharmaceutical  Department.  •        57 

of  bark.      The  following  formula  will  yield  a  handsome  and  stable  combi- 
nation of  liquor  cinchonse  hydriodatus  with  iron.     Take  of 

Cinchona  bark  (Calisaya)           ....  1.2288  grs. 

Iodine 1536     " 

Water 128    oz. 

Sulphuretted  hydrogen q.  s. 

Iron  wire ,     .         .  q.  s. 

Convert  512  grains  of  the  iodine  into  hydriodic  acid,  and  with  it 
exhaust,  by  percolation,  the  bark,  precisely  as  in  the  process  for  making 
"Liquor  Cinchonae  Hydriodatus."  While  the  exhaustion  of  the  bark  is 
going  on,  combine  the  remainder  of  the  iodine  (1024  grs.),  with  the  iron 
to  form  a  solution  of  iodide  of  iron,  as  described  under  the  head  of  iodide 
of  iron,  in  the  United  States  Pharmacopoeia ;  when  the  whole  of  the  liquid 
has  passed  from  the  bark,  filter  into  it  the  solution  of  iodide  of  iron,  and 
reduce  the  resulting  liquid  to  128  fluid  ounces. 

This  preparation  contains  in  each  teaspoonful  the  active  principles  of 
12  grs.  of  Peruvian  bark,  3^  gr.  of  iodine  in  the  form  of  hydriodic  acid, 
and  1  1-5  grs.  iodide  of  iron. 

In  both  the  Liquor  CAnchonce,  Hydriodatus  and  the  Liquor  CinchoncB 
Hydriodatus  cum  Ferro^  the  hydriodic  acid  is  combined,  and  forms  hydrio- 
dates  with  the  bases  in  the  bark. 


Cod  Liver  Oil  Jelly. 

Mr.  T.  E.  Jenkins  proposes  the  following : 

^.  Gelatin  (pure  and  white)     .         .         .         .         .         .        |    1 

Water        .         . 

Syrup  (aa)   .         .         .         .         .         .         .         .         .        |    8 

Cod  Liver  Oil     . 1 16 

Oil  Lemon 1  drop,  or  q.  s. 

Dissolve  the  gelatin  in  the  water  by  the  aid  of  a  gentle  heat,  add  the 
syrup,  and  then  incorporate  the  pil  by  thoroughly  beating  the  ingredients 
together,  lastly  add  the  oil  of  lemons  or  some  other  aromatic  essence  to 
suit  the  taste,  and  mix  well  together.  When  the  mixture  is  nearly  cold 
pour  it  into  wide  mouth  bottles.  Dose  from  one  to  two  tablespoonfuls 
three  times  a  day,  after  meals. 

[Semi  -  Monthly  Medical  Neios. 


Muriate  of  Ammonia. 

Quite  recently  this  substance  has  excited  some  interest  in  the  Medical 
world,  on  account  of  its  asserted  curative  power  over  several  forms  of 
Neuralgia;  and  we  present  to  our  readers  some  abstracts  from  a  paper 
upon  the  therapeutical  uses  of  Muriate  of  Ammonia,  written  by  Dr.  M. 
J.  Rae,  for  the  London  Lancet  (Feb.  1859).     He  says: 

I  have  prescribed  it  pretty  extensively,  in  various  diseases,  for  the 
last  eight  years  in  private  and  for  the  last  four  years  in  dispensary 
practice,  and  with  satisfactory  results.  The  hydrochlorate  of  ammonia, 
besides  being  liquifacient  and  resolvent,  as  mentioned  by  Sundelin, 
WiBMER,  and  others,  appears  also  to  possess  considerable  neurotic  action, 
as  is  shown  by  its  curative  power  in  neuralgia  and  other  nervous  dis- 
orders.    Its   remedial  influence   is   often  so  rapidly  manifested   in    these 


58  The  Peninsular  and  Independent, 

aflfections  as  to  preclude  the  idea  of  the  eflfect  being  owing  to  any  al- 
terative or  resolvent  action;  it  seems  more  rational  to  refer  it  to  a  di- 
rect or  peculiar  influence  of  the  salt  on  the  nerves  or  their  centres. 

I  have  used  the  salt  with  marked  success  in  goitre,  and  am  not 
aware  of  its  ever  having  been  tried  before  in  the  treatment  of  that  de- 
formity. In  several  cases  where  the  local  application  of  the  muriate 
was  conjoined  with  its  internal  administration,  the  tumors — some  of 
which  were  very  large — rapidly  diminished  in  size,  and  were  soon  re- 
duced to  the  normal  condition.  It  cured  the  whole  of  the  cases  (ten 
in  number)  in  which  it  was  tried,  the  period  of  cure  extending  from  a 
fortnight  to  two  months.  The  subjects  of  rteatment  were  mostly  fac- 
tory girls,  of  ages  varying  from  fourteen  to  twenty.  To  test  the  pow- 
ers of  the  muriate  fairly,  it  was  given  alone  in  mucilage,  or  infusion  of 
quassia,  and  combined  with  soap  liniment  for  external  use. 

As  goitre,  from  some  unknown  cause,  prevailed  here  last  year  to  a 
considerable  extent,  opportunities  were  thus  afforded  of  contrasting  the 
curative  power  of  the  muriate  with  iodine  in  this  affection.  Cases 
were  selected  where  the  tumors  were  nearly  all  of  equal  size  and 
duration,  and  where  the  age,  temperament,  general  health,  and  sanitary 
condition  of  the  individuals  corresponded  as  nearly  as  possible ;  and  in 
the  cases  treated  with  the  muriate,  which  was  used  both  internally  and 
locally,  the  tumors  generally  yielded  as  readil}'-,  and  sometimes  more 
quickly,  than  in  those  subjected  to  the  trial  with  iodine  similarly  em- 
ployed, and  apparently  quite  as  permanently.  The  muriate  appears  to 
be  a  safe  and  efficient  substitute  for  iodine  in  the  cure  of  bronchocele, 
and  worthy  of  further  trial.  The  hydrochlorate  of  ammonia  is  also  a 
valuable  remedy  in  hooping-cough.  I  was  first  led  to  make  trial  of  it 
in  the  treatment  of  pertussis,  from  a  belief  that  if  the  disorder  was  de- 
pendent— as  it  is  considered  to  be  by  some  pathologists — on  an  enlarged 
or  morbid  condition  of  the  lymphatic  glands,  or  that  the  exciting  cause 
of  the  paroxysm  was  owing,  as  is  very  probable,  to  the  presence  of 
irritating  glairy  mucus  in  the  bronchial  passages,  the  muriate,  on  ac- 
count of  its  alterative  power  in  glandular  enlargements  and  diseased 
mucoMS  structures,  and  its  effect  in  promoting  the  healthy  secretion  of 
the  mucous  membrane  in  cases  of  bronchitis,  accompanied  with  the 
discharge  of  tenacious,  glairy  mucous,  ought  to  prove  an  excellent  rem- 
edy in  the  treatment  of  that  often  troublesome  affection.  The  result 
was  most  satisfactory.  It  was  tried  in  thirty -seven  cases,  ten  of  which 
were  private  patients,  and  the  rest  home  patients  at  the  dispensary, 
which  were,  for  most  part,  under  the  charge  of  Mr.  Langsfoed,  house- 
surgeon  to  the  institution,  to  whom  I  am  indebted  for  the  efficient 
carrying  out  of  the  treatment,  and  for  a  report  of  the  cases.  Of  the 
number,  two  died — two  were  doubtful  cases,  the  patients  having  been 
removed  from  town  before  the  cure  was  completed.  In  the  thirty -three 
remaining  cases,  the  majority  of  which  were  of  more  than  ordinary  se- 
verity, the  average  period  of  cure  w^as  about  twenty  days.  But,  in 
most  instances,  where  the  patient  was  at  all  favorably  placed,  and  came 
early  under  treatment,  the  disorder  yielded  in  from  nine  to  fifteen 
days. 

The  remedial  influence  of  the  muriate  in  the  disorder  is  immediate 
and  decided.  Under  its  use  the  expectoration  soon  loses  its  irritating 
glairy  character,  becoming  bland  and  less  tenacious,  and  the  par- 
oxysms are  rendered  milder,  less  frequent,  and  of  shorter  duration  ;^  in 
fact,  by  its  influence  the  little  patient  seems  to  be  carried  more  easily, 
quickly,  if  not  at  the  same  time  more  safely,  through  the  attack  than 
by  the  agency  of   any  other  remedy  with  which  I  am  acquainted.      In 


Pharmaceutical  Departmeyit.  59 

most  cases  the  muriate  was  given  in  mucilage,  or  with  liquorice  water, 
combined  with  an  aromatic,  and  in  doses  of  one  to  five  grains,  accord- 
ing to  the  ages  of  the  child,  and  repeated  every  four  or  six  hours. 

When  pneumonic  or  bronchial  complications  existed,  or  were  threaten- 
ed, antimonial  or  ippecacuanha,  with  morphia  or  hyoscyamus,  were  added 
to  the  ordinary  mixture.  The  only  inconvenience  observed  to  result  from 
the  use  of  the  muriate  was  the  occasional  supervention  of  a  slight  mucous 
diarrhoea,  which  was  easily  checked,  and  did  not  interfere  with  the 
treatment. 

I  can  confirm  the  favorable  opinion  of  other  observers  as  to  the  efficacy 
of  the  muriate  in  enlarged  lymphatic  glands,  and  in  indolent  bubo,  and 
can  confidently  recommend  it  in  scofulous  ulceration  of  the  lymphatic 
glands.  There  are  few  more  intractable  cases  to  be  met  with  in  dis- 
pensary practice  than  those  of  extensive  ulceration  of  the  cervical  lym- 
phatic glands,  which  frequently  occur  in  weak,  under -fed,  and  badly- 
lodged  children.  In  several  aggravated  cases  of  this  sort  which  have  come 
under  my  own  observation,  some  of  which  presented  a  chain  of  foul,  ragged 
ulceration  extending  from  ear  to  ear,  the  muriate  acted  with  great  rapidity; 
and  in  some  instances,  where  iodine,  syrup  of  iodide  of  iron,  and  other 
medicines,  had  no  effect,  the  ulcerations  quickly  healed  under  its 
employment. 

It  is  also  a  very  excellent  remedy  in  many  forms  of  cutaneous  affections, 
more  especially  in  the  scaly  variety.  I  have  seen  cases  of  psoriasis  in- 
veterata  which  had  resisted  the  long  continued  use  of  arsenic,  iodine,  and 
other  remedies,  quickly  yield  to  its  influence.  It  seemed  to  me  to  have 
the  most  decided  eflfects  in  those  cases  of  psoriasis  occurring  in  patients  of 
dissipated  habits,  or  when  complicated  with  enlarged  liver.  It  is  also  very 
useful  in  eczema  and  syphilitic  squamae.  Drs.  Watson,  Ebden,  and  others, 
recommend  the  muriate  in  tic  and  facial  neuralgia,  and  it  certainly  possesses 
very  considerable  curative  power  over  these  painful  affections,  and  parti- 
cularly over  that  form  of  neuralgia  mentioned  by  Dr.  Watson,  which  is 
confined  chiefly  to  the  lower  part  of  the  face,  and  in  a  very  troublesome 
variety  affecting  one  or  other  side  of  the  neck,  and  probably  connected 
with  a  morbid  condition  of  the  cervical  lymphatic  glands. 

The  muriate,  like  other  remedies  in  neuralgia,  does  not  succeed  in  every 
case ;  but  in  those  cases  in  which  it  proves  successful,  the  beneficial  effect 
generally  follows  soon  after  its  administration.  In  my  hands  the  best  re- 
sults were  obtained  with  it  in  neuralgia  when  it  was  given  in  the  ordinary 
dose,  and  repeated  every  half  hour  or  hour. 

Never  having  occasion  to  prescribe  the  salt  in  the  large  doses  recom- 
mended by  some  authorities,  I  have  not  observed  any  irritant  or  injurious 
effects  on  the  stomach,  intestines,  or  other  organs,  to  follow  its  employment. 
When  given  to  adults,  in  from  five  grain  to  scruple  doses,  in  mucilage  or 
bitter  infusion,  with  aromatics  and  anodynes,  it  may  be  continued  for  a 
considerable  time  without  producing  any  unpleasant  results.  The  or- 
dinary dose  to  adults  was  from  five  to  ten  grains  three  or  four  times  daily. 
It  was  seldom  necessary  to  increase  the  dose  beyond  the  latter  quantity. 


Iron  reduced  by  Carbon ; 

A  new  preparation,  introduced  by  a  German  Pharmacien  —  M.  A. 
Henry,  of  Giromans  (Upper  Rhine).  It  consists  of  an  intimate  mixture 
of  metallic  iron  and  carbon,  obtained  by  calcining  the  pyrolignite  of 
iron.  It  is  in  the  form  of  a  light,  porous,  impalpable,  non  -  pyrophoric 
carbon,  of  which  the  composition  is  uniform  when  the  operation  has 
been  properly  conducted. 


60  The  Peninsular  and  Independent. 

The  great  tenuity  and  slight  density  of  this  carboferric  powder 
renders  easy  its  suspension  in  liquids,  to  the  bottom  of  which  it" does  not 
precipitate  like  iron  reduced  by  hydrogen.  The  presence  of  a  notable 
quantity  of  charcoal  has  the  advantage  of  rendering  the  product  more 
spongy,  more  absorbent,  of  facilitating  thus  the  contact  of  the  ferrugineus 
particles  with  the  liquids  of  the  stomach,  and  of  preventing  by  a  special 
action,  analogous  to  that  of  the  charcoal  of  Belloc,  the  eructations  of  the 
stomach  produced  by  preparations  of  iron. 

The  clinical  trials  made  by  Dr.  Benoit,  cantonal-physician  at  Giro- 
mans,  goes  to  confirm  the  efficacy  of  this  new  product,  which  M.  Henry 
had  rationally  foreseen  from  its  chemical  composition.  The  following  are 
the  conclusions  to  which  this  operator  has  been  led. 

Iron  reduced  by  carbon,  in  the  dose  of  1%  to  2  grains,  three  times  a 
day,  has  all  the  efficacy  of  the  best  preparations  of  iron.  Perfectly 
suspended  it  has  never  caused  constipation  nor  dyspeptic  exacerbations 
which  so  often  follow  the  use  of  the  soluble  preparations  of  iron,  and  it 
possesses,  nevertheless,  an  activity  much  greater  than  the  insoluble  pre- 
parations, which  are  frequently  resorted  to  at  first.  The  mean  duration  of 
43  cases  of  chlorosis  was  two  days  and  the  mean  quantity  of  the  medicine 
administered  was  11  grammes  168  grains.  The  efficacy  of  this  product, 
its  easy  preparation,  and  moderate  price,  recommends  it  to  practitioners, 
especially  in  medicines  for  the  poor. 

\Am.  Journal  Phar.  from.  Gaz.  Med.  de  Strassbourg. 


ON  THE  EXTERNAL  USE  OP  HYDROCHLORIC  ACID. 

In  the  course  of  some  investigations  made  with  reference  to  the 
physiology  and  pathology  of  the  skin,  Prof.  Kletpinsky  found  that, 
among  all  the  agents  subjected  to  the  test,  none  was  as  efficient  in  ex- 
citing the  respiratory  function  of  the  skin,  accelerating  the  capillary 
circulation,  and  influencing  the  action  of  the  lymphatic  and  glandular 
system,  as  hydrochloric  acid.  Skin  moistened  with  hydrochloric  acid 
expired,  under  the  same  circumstances,  twenty -seven  to  thirty  per 
cent,  more  of  carbonic  acid,  and,  what  is  very  remarkable,  seven  to 
twelve  per  cent,  less  of  water,  than  an  equal  space  of  skin  not  subjected 
to  the  influence  of  the  acid.  This  fact  induced  the  author  to  apply  the 
acid  in  a  great  number  and  variety  of  cases,  in  order  to  test  its  thera- 
peutical efficacy.     He  obtained  the  following  results: 

1.  Hydrochloric  acid  restores  and  stimulates  the  circulation  if  peri- 
odically interrupted  or  stagnating;  it  thus  cures  frost-bite  and  chilblain, 
and  is  an  efficient  prophylactic  against  these  complaints. 

2.  The  acid  diminishes  the  troublesome  perspiration  of  the  hands 
and  feet,  and  cures  it  in  some  cases  completely,  if  the  application  is  con- 
tinued long  enough. 

3.  It  is  an  efficient  remedy  in  a  great  variety  of  cutaneous  diseases, 
particularly  in  follicular  acne ;  by  rendering  the  metamorphosis  of  tissues 
more  active,  it  destroys,  if  steadily  used,  many  maculae  and  exudative 
patches  of  the  skin. 

4.  It  does  not  injure  the  integrity  of  the  epidermis,  if  properly  ap- 
plied, but  diminishes  its  roughness  and  callosities ;  like  a  true  cosmetic, 
it   renders   the   skin   pliable   and   soft,  increasing   at  the   same  time  its 
density,  and  making  it  consequently,  more  resistant  to  obnoxious  influ- 
ences. 

The  hydrochloric  acid,  which  must  be  free  from  admixture  of  iron 
or  chlorine,  is   best  applied  in   as   concentrated  a   condition   as  can  be 


Pharmaceutical  Department.  61 

borne,  without  its  giving  rise  to  burning;  commonly,  a  more  conceur 
trated  acid  can  soon  be  made  use  of,  even  if  it  was  inapplicable  at  the 
beginning  of  the  treatment.  The  skin  is  moistened  with  the  acid, 
(which  was  used  by  the  author  in  many  cases  even  in  its  fuming  state,) 
and  is  washed  off  after  a  quarter  of  a  minute,  at  first  with  water  and 
then  with  soap.  It  is  easily  understood,  that  the  hands  bear  most  easily 
the  concentrated  acid,  the  feet  (especially  the  toes)  less,  the  forehead  the 
least ;  on  all  sensative  places  of  the  skin  the  acid  must  be  applied  more 
diluted  and  for  a  shorter  time.  It  is  an  excellent  plan  to  mix  the  hy= 
drochloric  acid  with  glycerin,  the  therapeutical  action  of  which  on  the 
skin  is  hardly  enough  appreciated,  and  which  in  this  case  renders  a 
longer  application  of  the  acid,  even  to  a  sensative  skin,  practicable. 

[Osterreichische  Zeitschrift  fiir  Praktische  Heilkunde,  No.  xii.,  from  North  Amer^ 
tcan  Medico  -  Chirurgical  Review. 


MERCURIAL  OINTMENT. 

M.  CoLDEFUER,  a  chcmist  of  Geneva,  describes  a  new  method  of  mak- 
ing mercurial  ointment,  discovered  by  him  accidentally  during  the  progress 
of  some  investigations  upon  ozone.  It  seems  that  tallow  becomes  ozonized 
in  the  presence  of  an  atmosphere  of  that  gas,  and  when  in  that  condition, 
by  simply  mechanical  action,  rapidly  absorbs  mercury.  The  process  for 
preparing  the  ointment  is  as  follows :  put  into  a  large  porcelain  capsule 
sixteen  ounces  of  lard,  perforated  with  holes,  so  as  to  increase  the  extent 
of  surface,  and  place  half  an  ounce  of  phosphorus  in  a  vessel  suspended 
on  a  thread  above  the  lard ;  cover  the  whole  with  a  glass  receiver,  and 
at  the  end  of  a  fortnight  ozonization  is  complete.  This  lard  so  prepared 
is  introduced  into  a  wide -mouthed  bottle,  and  melted  on  a  sand  bath  at 
a  temperature  of  194*^  F.  Four  ounces  of  mercury  are  now  gently  heated 
and  rapidly  poured  into  the  lard ;  the  vessel  is  then  briskly  agitated  for 
some  minutes,  and  the  operation  is  terminated  by  quickly  plunging  the 
vessel  in    cold  water. 

[New   Orleans  Medical  and  Surgical  Journa   May,  1858. 


ULMUS  FULVA. 

The  Ulmus  fuha  is  found  very  generally  throughout  the  middle  and 
south  of  Lower  Peninsula.  Hundreds  of  tons  of  the  valuable  inner 
bark  of  this  tree  are  collected  and  sent  east  every  year  from  our  State. 

The  following  is  a  statement  of  the  manner  of  curing,  etc.,  this 
bark,  as  related  by  a  person  who  makes  it  a  livelihood:  The  Indian 
name  in  Michigan  is  Sharscope ;  time  to  commence  collecting  is  15th 
of  May,  continuing  about  six  weeks.  Best  way  to  dry  the  bark  is  to 
nail  up  the  large  pieces  in  a  room  heated  by  a  stove,  or  else  in  the 
direct  sun -light.  Must  be  kept  from  rains  and  dew.  Requires  about 
three  days  to  thoroughly  dry,  in  favorable  circumstances.  The  larger 
trees  afford  the  most  brittle  and  thick  white  bark,  which,  if  white,  brings 
the  highest  price,  but  which  is  not  best  for  medicinal  use,  as  the  tough, 
stringy,  thin  bark  affords  the  best  and  most  mucilage.  About  half  the 
weight  of  the  green  bark  is  wasted  in  drying.  The  Indians  are  usually 
paid  one  cent  per  pound  for  collecting  the  green  bark,  and  the  price  of  the 
bark  when  brought  into  market  varies  from  five  to  ten  dollars  per  cwt. 
In  grinding  the  tough  bark,  it  yields  two -thirds  of  its  weight  of  super- 
fine flour,  and  the  balance  is  coarse  ligneous  powder,  suitable  for 
cataplasms. 

I  believe  that  considerable  slippery  elm  bark  is  exported.        F.  S. 


62  Ihe  Peninsular  and  Independent, 


CHICAGO  COERESPONBENCE. 


A  NEW  Medical  College  has  just  been  established  here.  The  Trustees 
of  Lind  University,  being  desirous  of  founding  a  Medical  Department 
in  their  institution,  proposed  such  advantageous  terms  as  enabled  several 
medical  gentlemen  of  this  city  to  organize  at  once  the  institution. 
These  gentlemen  had  long  been  desirous  of  improving  the  means  of 
Mea-i  Jt.  Education,  and  they  seized  upon  this  opportunity  to  establish 
a  school  upon  a  new  basis,  and,  as  they  believe,  upon  a  plan  far  supe- 
rior to  that  of  most  of  the  older  colleges.  The  faculty  consists  of 
Profs.  Davis,  F.  Andrews,  Johnson,  Byford,  Rutter  (Emeritus), 
IsHAM,  HoLLiSTER,  and  Mahla.     Two  chairs  are  yet  unfilled. 

Profs.  Davis,  Johnson  and  Byford,  lately  occupied  chairs  in  Rush 
Medical  College.  Prof  Andrews  formerly  held  a  chair  in  Michigan 
University.  Prof.  Rutter  (Emeritus),  is  the  gentleman  mentioned  so 
favorably  in  Meigs'  writings. 

As  intimated  above,  the  plan  of  the  College  is  different  from  that 
of  most  others  now  existing  in  our  country.  In  the  first  place,  the 
students  are  to  be  divided  into  Junior  and  Senior  classes.  The  Junior 
class  will  listen  to  lectures  upon  the  elementary  branches  only;  such 
as  Anatomy,  Physiology,  etc.  They  will  have  only  four  lectures  each 
day,  and  be  subjected  to  daily  examinations  on  the  previous  day's 
topics;  in  these  respects  adopting  the  excellent  practice  of  the  Univer- 
sity of  Michigan.  At  the  close  of  the  session,  the  Juniors  will  be  ex- 
amined upon  their  Junior  studies,  and,  if  found  worthy,  passed  to  Senior 
grade. 

At  the  same  time  that  the  Juniors  are  listening  to  lectures  upon  the 
elementary  department,  the  Seniors  will  be  attending  lectures  upon  the 
practical  branches;  such  as  Practice,  Surgery,  Obstetrics,  etc.,  the  num- 
ber of  Professors  being  so  increased  above  the  usual  number  as  to  en- 
able them  to  carry  on  both  classes  simultaneously. 

The  following  scheme  represents  the  curriculum  of  study : 
Junior  Lectures.  Senior  Lectures. 

Descriptive  Anatomy.  Theory  and  Practice,   and  Clinical 

Physiology.  Medicine. 

Pathology  and  Public  Hygiene.  Surgery  and  Surgery  Clinic. 

Materia  Medica  and  Therapeutics.        Obstetrics. 

Inorganic  Chemistry.  Surgical  Anatomy  and  operation  of 

Practical  Anatomy.  Surgery   (shown    on    dead  sub- 

jects). 

Medical  Jurisprudence  is  not  definitely  provided  for  yet,  but  will 
probably  be  assigned  to  some  legal   gentleman. 

The  Chairs  will  be  filled  as  follows: 
Practice^  by  Prof  Davis.  Physiology^  by  Prof  Johnson. 


Pharmaceutical  Department.  63 

Surgery^  by  Prof.  Andrews.  Pathology  (not  filled). 

Surgical  Anatomy^  by  Prof.  Isham.      Descriptive  Anatomy,  by  Prof  Hol- 

OdstetricSj  by  Profs.  Rutter  (Emer-         lister. 

itus),  and  Byford.  Materia  Medica  (not  filled). 

Chemistry,  by  Prof  Mahla.  Practical  Anatomy  (not  filled). 

The  vacant  Chairs  will  be  provided  for  shortly. 

It  is  proposed  to  make  the  course  some  four  weeks  longer  than  that 
of  the  old  college,  bringing  up  the  standard  in  that  respect  to  a  level 
with  the  best  Philadelphia  schools.  It  is  believed  that  the  division  into 
Junior  and  Senior  courses  will  give  opportunity  for  greater  thoroughness, 
and  enable  the  Faculty  to  stop  lazy  and  stupid  men  for  the  most  part  at 
the  beginning  of  the  Senior  course,  thus  avoiding  the  inconvenience  and 
mortification  suffered  by  the  poor  fellows  who  otherwise  would  only 
learn  their  fate  by  a  rejection  at  the  very  end  of  a  three  years' 
course.  It  enables  each  man  also  to  concentrate  his  attention  upon 
fewer  studies  at  a  time. 

Rush  Medical  College  proposes  to  fill  up  its  vacated  Chairs,  and  go 
on  as  usual.  Prof  Brainard  has  purchased  the  Medical  Journal  from 
Prof  Davis,  with  the  view  of  retaining  it  as  the  organ  of  the  old 
school. 

The  health  of  the  city  is  much  as  usual,  but  the  type  of  the  dis- 
eases is  not  as  sthenic  as  it  was  six  months  ago. 

Several  of  our  physicians  are  starting  for  Pike's  Peak. 

There  is  a  movement  to  put  the  City  Hospital  in  operation.  The 
Homoeopaths  don't  show  themselves  this  time  in  the  matter. 

A  new  medical  society  has  been  formed,  called  the  Academy  of 
Medicine,  mostly  of  members  from  the  old  organization.  X. 


-^~^•- 


AMERICAX  MEDICAL  ASSOCIATION. 


The  twelfth  annual  meeting  of  this  Association  will  be 
held  in  Louisville,  Kentucky,  on  Monday,  May  3d,  1859. 
The  secretaries  of  all  societies  and  other  bodies  entitled  to 
representation  in  the  Association,  are  requested  to  forward 
to  the  Secretary,  S.  M.  Bemiss,  at  Louisville,  correct  lists 
of  their  delegations  so  soon  as  they  may  be  appointed. 
The  Convention  of  Teachers^  invoked  by  a  resolution  of 
the  National  Association,  for  the  purpose  of  a  general  con- 
ference upon  the  best  means  of  elevating  the  standard  of 


64  The  Peninsular  and  Independent. 

Medical  Education  in  this  country,  will  meet  in  the   same 
city  on  Monday,  the  2d  of  April. 

Medical  journals  throughout  the  United  States  are  re- 
quested to  insert  the  above. 

S.  M.  BEMISS,  M.  D. 
Secretary  American  Medical  Association. 


£^^  It  may  be  proper  to  announce  that  one  of  our 
number,  Prof.  Palmer,  is  about  to  embark  for  Europe  to 
spend  some  eight  months,  on  a  tour  principally  for  profes- 
sional observation,  and  that  we  expect  from  him  regular 
contributions  during  his  absence.  He  hopes  to  visit  many 
of  the  places  most  interesting  to  Medical  men,  both  on  the 
Continent  and  in  G-reat  Britain,  and,  as  he  may  find  time, 
will  furnish  our  readers  with  some  of  the  results  of  his  ob- 
servations of  men  and  things. 

Our  promises  of  contributions  from  various  sources  are 
encouraging,  and  on  the  whole  our  literary  resources  have 
never  appeared  so  abundant  as  at  present. 

Arrangements  have  been  made  for  supplying  brief  ab- 
stracts from  the  whole  range  of  our  Periodical  Literature, 
and  efforts  will  not  be  wantino;  to  render  the  Jouimal  more 
interesting  in  the  future  than  during  the  past. 

Eds. 


THE 


PENINSULAR  and  INDEPENDENT 


MEDICAL  JOURNAL. 


Vol.  II.  DETROIT,  MAY,  1859.  N^o.  2. 


Original  C0mmiittirati0n5. 


ART.  YII.— Address  to  the  Graduating  Class  of  UniYersity  of  Michigan.* 

By  Richard  Inglis,  M.  D. 

In  Ancient  Greece,  the  students  of  Medicine  in  the  temple 
of  the  Asclepiades  advanced  by  gradations  similar  to  other 
associations^  whether  of  Religion,  Art,  Philosophy,  or  Poli- 
tics. They  were  required  to  pass  the  mysteries  of  the 
orders,  and  receive  the  degrees  indicative  of  the  different 
stages  of  progress — the  preparatory,  the  theoretical  or  study 
of  abstract  principles,  the  practical,  and,  lastly,  of  ability 
to  practice  and  teach.  Apart  from  these  mysteries  and 
religious  ceremonies,  the  course  of  instruction  in  those  an- 
cient schools  seems  to  have  differed  but  little  from  the 
most  approved  systems  of  the  present  day.  The  ceremony 
of  the  first  degree,  called  Purification,  was  performed  upon 
those  students  who  had  fitted  themselves  to  enter  upon  the 


*  Published  by  request  of  the  Graduating  Class. 
Vol  II.-E. 


66  The,  Peninsular  ayid  Independent. 

study  of  Medicine.  They  were  required  to  possess  a  natu- 
ral disposition  and  a  favorable  position  for  study,  early 
tuition,  and  love  of  labor.  The  next  degree  was  Illumi- 
nation ;  and  the  duties  which  preceded  this  ceremony  corres- 
pond with  the  practice  in  our  own  colleges  of  listening  to 
the  prelections  of  Professors,  in  connection  with  the  study 
of  authors.  The  next  grade  was  Inspection,  and  corres- 
ponds with  our  system  of  requiring  the  students  to  become 
familiar  with  the  treatment  of  diseases  under  the  in- 
struction of  preceptors,  and  in  a  clinical  course.  The 
next  ceremony  was  Coronation,  which  took  place  at  the 
completion  of  the  term  of  study,  and  was  an  evidence  of 
the  recipient's  fitness  for  assuming  the  duties  of  his  pro- 
fession, and  corresponds  with  the  present  ceremony  of 
Graduation.  Indeed,  the  practice  of  placing  a  wreath,  cap,  or 
crown,  upon  the  heads  of  those  who  were  admitted  into  full 
fellowship  at  those  ancient  schools,  was  continued  down  to 
the  period  of  the  middle  ages.  In  some  of  the  Universities 
of  Europe,  the  occasion  of  conferring  degrees  is  still  called 
croivning  or  capping  day,  from  the  practice  of  jjlacing  a 
cap  ujDon  the  head  of  the  graduate.  This  may  also  ex- 
plain the  fact,  that  while  the  statues  of  the  ancients  usu- 
ally represent  the  head  uncovered,  the  head  of  Hippoc- 
rates is   seen  covered  with   a   crown. 

Gentlemen  Graduates,  on  this,  the  day  of  your  Cor- 
ronation,  I  congratulate  you  upon  the  honorable  distinc- 
tions conferred  upon  you.  May  the  laurels  with  which 
you  have  to-day  been  crowned  never  fade,  but  prove  to 
be  the  adorning  of  real  merit,  of  genuine  acquirements, 
and  earnest  devotion  of  mind  and  heart  to  a  noble,  use- 
ful, and  heaven-honored  aim!  May  the  wreaths  which  now 
encircle  your  heads  be  ever  fresh ;  acquiring  new  beauty, 
as  you  wear  them  well,  and  new  splendor,  as  you  prove 
by  your  lives  that  they  were  not  misplaced  ;  may  their 
beauty  be   but  changed   to   brilliancy  as   you  pursue  the 


Address  to  Medical  Graduates  of  the  University.  67 

journey  of  life,  and  the  adorning  become  more  dazzling  as 
your  learning  and  usefulness  steadily  increase,  and  your 
aims   daily   become   more  exalted. 

You  bave  to-day  emerged  from  the  outer  temple  of 
^scuLAPius,  and  gladly  I  meet  you  on  the  threshold  of 
the  inner  court,  to  bid  you  welcome  as  priests  of  that 
temple  over  whose  portals  is  inscribed,  "Fok  the  Heal- 
ing OF  THE  Sick."  Welcome  to  share  the  toil  and  labor, 
the  self-denial  and  hardships  of  our  vocation  !  Welcome 
to  days  and  nights  of  anxious  regard  for  the  welfare  of 
your  race,  and  of  labor  and  study  for  the  advancement  of 
your  Profession !  But  welcome,  also,  to  the  honor  and 
privileges,  the  pleasures  and  recompenses,  of  a  useful,  re- 
spected, and  honorable  calling. 

Gentlemen,  the  position  you  have  taken  to-day  is  one 
of  high  honor,  is  fraught  with  most  important  results,  and 
demands  of  you  the  most  careful  guardianship,  as  it  has 
reference  to  responsibilities  and  engagements  affecting  the 
welfare  of  your  fellow -men.  Your  title  is  no  empty 
bauble ;  these  are  not  tinsel  crowns  that  have  been  placed 
on  your  heads.  You  have  earned  the  honors  conferred  on 
you  by  years  of  earnest  study  and  hard  head-work.  And 
now,  I  know,  that  with  glad  hearts  and  good  hopes — with 
the  fire  and  energy  of  youth  in  your  veins — with  the  honor 
of  your  Profession  on  your  shoulders,  and  devotion  to  the 
welfare  of  your  race  in  your  hearts — with  the  hopes  of  pa- 
rents and  friends,  the  earnest  well-wishes  of  your  Profess- 
ors, and  the  prayers  of  Christians  in  your  behalf,  to  en- 
courage you, — you  stand  ready  for  the  work  and  the  battle 
of  actual  life.  Kemember  that  the  Michigan  University 
has,  this  day,  trusted  you  as  standard-bearers  of  her  honor, 
and  she  expects  every  man  so  honored  to  do  his  duty. 
Emulate  the  zeal,  cultivate  the  virtues,  and  endeavor  to 
^void  the  errors,  of  the  great  and  good  men  who  have 
'adorned  our  Profession^  both  in  ancient  and  modern  times, 


ft8  The  Peninsular  and  Independent. 

— men  who  never  forgot  the  great  aim  of  their  lives,  de- 
votion to  the  cause  of  suffering  humanity,  and  who,  with 
a  rare  unselfishness,  heaped  up  stores  of  experience  and 
observation,  not  to  make  a  miser's  hoard  for  self- gratifi- 
cation, but  to  furnish  their  followers  with  ever-enlarging 
supplies  of  useful   knowledge. 

The  origin  of  Medical  Practice,  or  the  use  of  remedial 
agents,  may  be  sufficiently  accounted  for  by  the  prompt- 
ings of  human  sagacity,  seeking  relief  from  present  suffer- 
ing. It  is  reasonable  to  suppose  that,  in  some  form  or 
other,  the  practice  of  Medicine,  or  the  application  of 
knowledge  to  the  relief  of  abnormal  conditions  of  the  hu- 
man system,  was  attempted  during  the  earliest  period  of 
the  world.  Says  Le  Clerc  :  "  Le  premier  homme  a  et6 
en  un  certain   sens  le  premier  Medecin." 

When   Man's    nature    was    changed    from    the    Divine 
image  in  which  he  was  created,  the  sentence  was  passed  upon 
him,  "  Dying,  thou    shalt  die'' ;    but    though    now   subject 
to.    pain    and     sickness,    he    was    still    permitted    by    his 
benevolent  Creator  to    use  the  powers  of  his  mind  for  the 
alleviation  of  his  suffering.     He  would,  naturally,  seek  for 
the  balm  that  would  heal,  as  well  as   for   the   fruit  which 
would  nourish,  his  frail  body,  and,  although  fallen  from  the 
high  estate  in  which  he  was  created,    we  can  not  imagine 
him  to  be  fallen  so  low  as  to  keep,  as  a  secret  in  his  own 
bosom,  any  discovery   which   he   made  fraught  with   bless- 
ing to  the  afflicted.      No,  this  is  a  depth  of  baseness  and 
inhumanity  reserved  for  a  later  day  1     Every  new  discovery 
"would  be  carefully  handed  down  to  succeeding  generations, 
until,  when  men  had  "increased  exceedingly  on  the  earth,** 
and  the    different    avocations    of  life   were   instituted,   the 
knowledge   of   remedies  and    their  application,  became  the 
office  of  particular  individuals;  and  so,   a  class  of  Physi- 
cians arose. 

However  it  may  have  been   among  the    antediluvians. 


Address  to  Medical  Graduates  of  the  University.  69 

we  have  ample  evidence  of  the  existence  of  this  class, 
at  an  early  period  of  the  world's  present  history.  Proba- 
bly amongst  the  Egyptians  the  earliest  progress  was  made, 
in  this  as  in  other  branches  of  learning.  The  Egyptian 
physicians  were  an  order  of  Priests.  The  people  were 
Buperstitious,  and  it  was  natural  that  they  should  look  to 
the  ministers  of  religion  for  relief  from  diseases  which 
they  believed  to  be  the  direct  manifestation  of  the  dis- 
pleasure of  their  gods.  Amongst  the  Jews,  also,  we  have 
evidence  that,  at  an  early  period  of  their  national  exist*. 
«nce,  the  office  of  physician  was  established.  In  the 
lapocryphal  book  of  Ecclesiasticus  (supposed  to  have  been 
written  by  King  Solomon)  is  to  be  found  the  passage, 
*^  Honor  a  physician  with  the  honor  due  unto  him,  for 
the  Lord  hath  created  him,  for  of  the  Most  High  cometh 
'healing,  and  he   shall    receive   honor  of  the  king.'' 

But  it  is  to  Greece  that  we  must  look  for  the  origin  of 
the  rational  and  scientific  practice  of  Medicine,  and  for 
the  line  in  which  we  trace  our  descent.  Amongst  the 
O-reeks,  instruction  on  the  subject  of  Medicine  was  com- 
municated in  the  schools  of  Philosophy  and  the  Gym- 
nasia, as  well  as  in  the  temples  of  ^sculapius.  A 
knowledge  of  medicine  was  a  necessary  part  of  every  true 
scholar's  education.  The  writings  of  Plato  and  Aristotle 
abound  with  allusions  to  our  art,  and,  although  not 
practitioners,  they  were  well  versed  in  its  principles.  But 
as  Dr.  Watson  remarks,  "The  temples  of  ^sculapius 
were  the  first  great  foundations  of  medical  knowledge 
amongst  the  Greeks."  In  them  were  found  a  sacred 
'Order  of  men,  whose  whole  lives  were  devoted  to  the 
practice  and  teaching  of  the  healing  art.  Those  temples, 
apart  from  the  sacred  rites  and  religious  honors  paid  to 
s^scuLAPius,  Hygeia,  and  other  divinities,  resembled,  in 
-many  respects,  the  hospitals  of  the  present  day.  They 
were  very  numerous  throughout  the  Grecian  States.     They 


70  The  Peninsular  and  Independent. 

were  the  residences  of  the  Asclepiades,  or  Priest  Physi- 
cians, where  they  reared  their  families  and  trained  their 
sons,  and  were  resorted  to  by  the  afflicted  and  suf- 
fering for  relief  Along  the  walls  were  suspended  votive 
tablets,  recording  the  history  and  treatment  of  particular 
cases  of  disease.  The  situations  chosen  for  them  were 
well  adapted  to  promote  the  health  of  the  sick.  Says 
Dr.  Watson:  "They  usually  occupied  some  elevated  or 
retired  and  healthy  locality,  removed  from  the  city,  sur- 
rounded by  shady  groves,  or  in  the  neighborhood  of 
thermal  springs  or  medicated  waters.  They  were  sacred 
from  intrusion,  and  accessible  to  the  sick  only  after  suit- 
able preparation."  The  priests  received,  as  fees,  the  free- 
will offerings  of  the  sick.  Some  have  supposed  that 
those  physicians  were  restricted  in  the  exercise  of  their 
art  to  the  temples,  but  many  instances  are  on  record 
in  which  they  practiced  abroad.  Thus  the  Lacedemonian 
physicians  were  obliged  to  accompany  the  army.  Xeno- 
PHON  himself,  in  his  expedition  to  Persia,  was  accom- 
panied by  Ctesias  of  Cnidos,  who,  being  taken  pris- 
oner, subsequently  rose  to  great  eminence  as  a  physician 
at   the   Court   of  Persia. 

About  450  years  before  Christ,  was  born  Hippocrates, 
well  styled  Pater  Medicince,  a  son  of  the  Asclepiades, 
Trained  by  his  father  in  the  temple  of  Cos,  he  became 
famous  far  above  all  who  had  preceded  him.  He  form- 
ed a  new  era  in  Medicine.  Separating  it  from  the  re- 
ligious dogmas  and  speculations  of  the  old  schools,  ha 
set  aside  crude  theories  and  ignorant  hypotheses,  and  es- 
tablished incontestably  that  observation  is  the  sole  basis 
of  true  Medicine.  The  rapid  advancement  which  the 
practice  of  Medicine  made  in  his  hands  is  almost  incred- 
ible. He  removed  the  teaching  of  Medicine  from  the 
schools  of  Philosophy,  and  established  it  as  a  distinct 
department   of  practical   knowledge.      Himself    thoroughly 


Address  to  Medical  Graduates  of  the  University.  71 

educated  in  the  science  and  philosophy  of  his  day,  a 
bold  practitioner,  an  elegant  writer,  and  a  correct  observer, 
he  gave  such  an  impulse  to  it  that  he  may  almost  be 
considered  as  the  inventor  of  the  Healing  Art.  He  at- 
tained such  eminence  in  Athens  that  it  was  decreed  that 
he  should  be  honored  with  a  golden  crown,  and  that  all 
the  children  born  at  Cos  (his  native  island),  might  pass 
their  youth  at  Athens,  and  be  treated  as  Athenian  citi- 
zens. 

Gentlemen,  I  have  thus  alluded  to  the  early  history 
of  our  Profession  to  stir  up  your  enthusiasm,  and  remind 
you  of  the  responsibilities  you  have  to-day  assumed  as 
the  successors  of  a  long  line  of  heroic  men,  which  has 
been  perpetuated  from  the  days  of  the  great  Grecian  to 
our  own  times,  as  well  as  to  recall  you  to  a  grateful 
remembrance  of  the  privileges  you  have  enjoyed  in  the 
study  of  your  Profession,  sitting,  as  it  were,  at  the  feet 
of  the  prophets,  and  learning  from  them  the  accumula- 
ted experience  of  the  past,  as  a  guide  to  your  future 
career.  While,  on  behalf  of  the  Fraternity  of  Physicians, 
I  extend  to  you  a  cordial  welcome  as  members  of  that 
body,  permit  me,  at  the  same  time,  to  speak  with  you 
of  some  of  the  duties  and  responsibilities  upon  which  you 
are  about  to  enter.  What  I  may  say,  has  probably  been 
all  told  you  before  ;  but  a  few  words,  spoken  on  this  in- 
teresting occasion,  may  possibly  enforce  on  your  atten- 
tion important  truths,  even  if  they  are  familiar,  and 
clothed  in  homely  garb.  It  is  of  the  utmost  importance 
that  your  first  steps  should  be  taken  in  the  right  direc- 
tion ;  for  a  young  physician,  starting  wrong,  seldom  gets 
right  again. 

First,  Gentlemen,  I  hope  you  will  remember  that  you 
have  but  mastered  the  first  step  in  your  life  -  education. 
If  any  of  you  are  conceited  enough  to  think  that  you 
have  finished  it,  you  will  soon  find  out  your  mistake  ;  or 


72  The  Peninsular  and  Independent. 

it  will  be  the  worse  for  you,  if  your  conceit  hinders  you 
from  discovering  it.  I  suppose  you  will  all  acknowledge 
that  when  you  first  commenced  your  studies,  your  heads 
might  properly  have  been  ticketed  "To  Let/'  Now  some 
of  the  empty  apartments  have  found  good  tenants — I 
trust  permanent  occupants  —  that  will  always  be  ready  to 
pay  you  well  for  the  accommodation.  But  while  you  have 
got  the  basement  respectably  occupied,  if  you  are  wise 
and  prudent  landlords  you  will  just  be  the  more  anxious 
to  fill  the  best  rooms  and  upper  chambers,  with  good 
tenants.  You  have  laid  a  good  foundation,  build  care- 
fully the  superstructure,  and  let  not  that  which  has  cost 
you  so  much  labor  be  covered  up  with  rubbish  or  de- 
stroyed. 

Do  not  imagine  that  the  greatest  object  you  can  now 
accomplish  is  to  get  quickly  into  extensive  practice.  Be 
more  desirous  to  practice  well  than  much.  Let  every  day's 
experience  at  the  bedside  of  the  sick  add  to  your  knowl- 
edge. Learn  to  observe  closely,  to  reason  correctly,  and 
to  prescribe   wisely. 

It  is  of  great  importance  that  you  should  continue 
steadily  to  pursue  the  study  of  the  principles  of  your 
Profession.  If  you  neglect  to  do  so,  you  will  soon  come 
to  practice  as  the  sailor  who  navigates  a  ship,  ignorant  of 
the  laws  of  navigation.  A  physician,  to  do  his  duty, 
can  be  governed  by  no  general  laws.  Every  case  he  is 
called  to  treat  requires  independent  action,  and,  ignorant 
of  the  principles  of  his  Profession,  he  can  only  blunder 
in  the  dark.  Unless  you  maintain  habits  of  study,  you  will 
be  likely  soon  to  forget  what  you  already  know.  Your 
minds  are  now  well  disciplined,  and  it  will  be  easy  for  you 
to  prosecute  the  course  on  which  you  have  entered.  Fol- 
low out,  more  especially,  those  branches  of  learning  which 
bear  more  directly  upon  the  practice  of  Medicine,  but  you 
will  also   derive   great   advantage   and   pleasure  in  combin- 


Address  to  Medical  Graduates  of  the  University.  73 

ing  the  study  of  the  more  exact  sciences  and  general 
literature.  I  doubt  not,  very  many  physicians  would  ac- 
knowledge how  much  they  regret,  after  years  of  practice, 
that  they  did  not  pursue  their  studies  upon  leaving  the 
class-room.  Becoming  absorbed  altogether  in  practice,  and 
striving  to  accumulate  wealth,  they  forgot  much  of  that 
which  they  once  knew,  and  now  realize  that  they  are  mere 
machines,  their  minds  stunted,  and  their  highest  motive  auri 
sacra  fames.  In  such  cases,  the  attempt  to  go  back  and 
start  anew   is   difficult   and   irksome. 

There  is  probably  no  course  of  study  in  any  depart- 
ment of  learning,  either  in  this  country's  or  in  European 
Universities,  so  severe  and  exacting  as  that  prescribed 
for  students  of  Medicine,  in  our  Colleges.  And  say  of 
American  Medical  Colleges  what  they  please,  they  have 
produced  a  class  of  men,  who,  as  a  whole,  have  been 
unsurpassed  in  usefulness,  skill,  and  energy,  by  any,  or 
in  any  country,  in  the  world.  But,  Gentlemen,  I  know  that 
when  you  find  in  the  retirement  of  your  homes,  that  the 
excitement  which  enabled  you  to  apply  yourselves  with 
such  energy  has  passed,  there  will  be  a  tendency  to  ease  and 
indolence.  You  have  climbed  the  first  hill  of  the  moun- 
tain range.  After  struggling  up  its  rugged  sides  manfully 
and  bravely,  will  you  be  content  to  sit  down  on  its  grassy 
table -land  top,  satisfied  with  the  limited,  though  beautiful 
view  ?  Will  you  be  enticed  by  the  sweet  rest,  to  be  con- 
tent to  pluck  the  few  flowers  around  you,  only  to  be  so 
lulled  by  the  repose  as  unconsciously  to  slide  down  again 
to  your  starting  point.?  Kather,  I  pray  you,  look  onwards 
and  upwards.  One  eminence  after  another  rises  before 
you:  climb  steadily  and  hopefully  on;  you  will  be  well 
rewarded  for  your  toil.  Be  not  discouraged  because  you 
can  never  reach  the  highest  peak ;  the  higher  you  climb 
the  more  glorious  the  vision  ;  and  when  you  realise  that 
the   mountain   top  is  infinitely  beyond   your   view,    up   to- 


74  The  Peninsular  and  Independent. 

wards  God,  may  your  aspirations  be  drawn  out  after  a 
participation  in   His  glory ! 

Although  it  is  highly  proper  that  physicians  should 
be  well  remunerated  for  their  services,  yet  if  you 
mean  to  practice  only  for  the  sake  of  making  money, 
you  will  be  slaves,  and  fools  too.  For  if  your  talents 
will  enable  you  to  get  rich  with  23ractice,  and  ^  this  be 
your  only  aim,  you  would  attain  it  more  easily  and  cer- 
tainly in  other  employments.  If  you  practice  with  a 
proper  regard  for  the  welfare  of  your  patients,  with  a 
noble  aim  and  purpose  towards  the  general  good,  with  an 
enjoyment  of  the  luxury  of  mental  cultivation,  and  an 
appreciation  of  the  delights  of  increasing  knowledge,  then 
your   toils   will   be   lightened,  and   the  drudgery    removed. 

I  am  sure  you  will  look  with  abhorrence  upon  the 
mercenary  practice  of  warranting  cures  for  stipulated  sums 
of  money.  It  has  truly  been  said,  by  one  in  ancient 
times,  that  ^^  Medicine  is  the  noblest  of  professions,  but 
the  meanest  of  trades." 

The  position  which  you  occupy  in  society,  will  depend 
very  much  upon  your  own  character.  Mankind  will  natural- 
ly respect  a  physician.  The  office  is  one  calculated  to  call 
forth  their  gratitude,  and  if  a  physician  does  not  stand 
high  in  the  respect  and  esteem  of  those  around  him,  it  is 
his  own  fault.  If  you  lower  yourselves  to  familiarity  with 
the  rude  and  immoral,  do  not  be  surprised  if  you  are 
classed  amongst  them.  Gentlemen,  strive  not  only  to  be 
wise  and  prudent  practitioners,  but  also,  to  take  such  a 
position,  as  will  ensure  the  respect  and  esteem  of  the 
community  around  you.  Kemember  that  if  you  lower  your 
own  reputation,  you  injure  yourself  and  disgrace  your 
Profession.  Be  not  only  competent  physicians,  but  be 
every  inch  gentlemen.  Avoid,  I  pray  you,  as  you  would 
an  enemy,  all  attempts  to  draw  you  into  bar-room  friend- 
ships.     Does   it    not   make  the  ears  of  a  respectable  man 


Address  to  Medical  Graduates  of  the  University.  '75 

tingle  when  he  hears,  as  he  passes  in  the  village,  or  on 
the  corners  of  the  streets  in  the  cities,  recognition  of  the 
Doctor  in   low   and   vulgar  familiarity. 

Be  courteous  to  all  men — rich  and  poor  alike. 

Let  your  learning,  your  integrity,  your  morality,  and  (I 
would  do  violence  to  my  conscience  were  I  to  omit),  your 
Christianity,  mark  you  out,  not  only  as  good  physicians^ 
but  as  honest  men  and  useful  citizens. 

The  success  of  an  army  depends  upon  every  soldier 
acting  as  though  his  country's  honor  depended  upon  his 
undaunted  valor ;  and  so,  Gentlemen,  are  you  required  to 
act  on  behalf  of  your  Profession.  As  we  have  no  legal 
enactments  to  guarantee  our  status,  or  protect  our  inter- 
ests, and  as  all  that  is  necessary  to  constitute  a  Doctor 
ostensibly  is  the  ability  to  procure  a  shingle  with  the 
name  on  it,  it  becomes  more  imperative  on  each  one  of 
us  to  maintain  such  a  position  as  will  elevate  the  Pro- 
fession. You  go  before  the  public  with  credentials,  than 
which  there  are  none  higher  or  more  honorable  in  the 
land  :  see  to  it  that  you  do  not  tarnish  the  fair  fame  of 
Ann  Arbor. 

No  other  Profession  requires  such  a  comprehensive 
mind.  In  other  learned  professions  there  are  fixed  stand- 
ards to  which  appeal  may  be  made,  by  which  the  practitioner 
is  to  be  guided  ;  and  a  knowledge  of  them  may  be  at- 
tained with  certainty,  by  dint  of  arduous  study.  But  in 
Medicine  we  have  no  such  simple  authority.  The  phy- 
sician is  required  to  rest  on  his  own  judgment,  and  to 
bring  all  his  knowledge  to  bear  upon  an  endless  number 
of  points.  You  can  pursue  the  study  of  Medicine  by  con- 
sidering every  disease  separately,  but  in  practice  you  will 
find  the  symptoms  complicated  in  endless  variety,  which 
no  system  can  include,  and  the  greatest  discernment  is 
required   to   enable  you  to  come  to  correct  conclusions. 

Let  me  guard  you,  young  physician,  against  presump- 


7Q  The  Peninsular  and  Independent, 

tion.  Know  that  your  power  is  limited.  Many  have  start- 
ed with  vain -glorious  and  ignorant  ideas  of  their  power- 
In  their  pride  they  have  thought,  that  every  disease  must 
fly  at  their  approach.  If  a  little  experience  does  not 
soon  humble  their  pride — if  such  persons  do  not  speed- 
ily see  their  error — the  consequence  is  likely  to  be  that 
some  time  they  will  turn  a  complete  somersault,  and  be 
loudest  in  proclaiming  the  '^Old  School  Practice,"  as 
they  call  it,  a  "humbug";  still  too  proud,  too  ignorant 
to  know,  that  the  "humbug"  was  in  themselves,  and 
not  in  the  practice.  On  the  other  hand,  let  the  remem- 
brance that  a  higher  power  than  yours  disposes  of  events 
keep  you  from  self-reproach  when  disease  terminates  fa- 
tally. I  have  known  some  excellent  men,  of  over -sensitive 
dispositions,  render  their  lives  miserable,  and  unfit  themselves 
for  practice,  by  unjust  reflections  upon  their  own   acts. 

Need  I  warn  you,  Gentlemen,  to  have  nothing  to  do 
with  Quacks  .^  Avoid  them  as  you  would  a  poisonous 
reptile,  and  be  very  careful  to  give  no  occasion,  to  be 
thought  like  them.  Do  not  even  condescend  to  argue 
with,  or  oppose  them ;  for  in  so  doing  the  slime  may 
stick  to  your  own  fingers.  Have  nothing  at  all  to  do 
with  them  professionally  or  socially,  whatevei  be  their  name 
— whether  followers  of  the  more  crude  systems  which  have 
sprung  up  amongst  ourselves,  or  the  dreamy,  stupid  im- 
postures  of  Europe. 

Kemember  that  the  term  "'Allopathic  Physician"  was 
applied  to  us  by  those  who  wished,  by  so  doing,  to 
bring  us  down  to  their  own  level.  It  is  a  nickname,  a 
slander,  a  falsehood ;  and  he  who  is  content  to  be  so 
called — he  who  does  not  spurn  the  name  as  an  insult 
— deserves  to  be  ranked  with  the  Quacks.  Says  Dr.  Wood, 
in  his  admirable  Address  before  the  Americ&-n  Medical 
Association,  "I  say  again  we  are  not  Allopathists — we 
are  simply  regular  practitioners  of  Medicine,  claiming  to  be 
honest  and  honorable  ;  in  other  words,  to  be  gentlemen." 


Address  to  Medical  Graduates  of  the  University.  77 

There    are    some    features    common    to    all    forms    of 
quackery,    and    they    may    sometimes   be   found    to    char- 
acterize  those  who  do   not   openly  join   the   ranks   of  the 
charlatan.      It   would   be    well    for   the    Profession   if  the 
line   of    demarcation   between    the    regular    physician]  and 
empiric  was  more  marked.     There  are  those  who  nominal- 
ly  belonging   to  us,  are  head  and  shoulders  with  the  em- 
pirics,   and   it   is   a   pity   that   their   feet   are   not  so  also. 
Gentlemen,    let  me  warn  you   against  even  the  appear- 
ance of  evil  in  this  matter.     With  the  class  of  open  quacks, 
be  they  knaves  or  simple  ignoramuses,  you  expect  to  hear 
boasting   and   bragging    to    any    extent ;     the    relation    of 
marvelous    cures,    and    the    infalibility    of    their    systems. 
These  inflated  stories  are  their  stock  in  trade,  and,  however 
disgusting,    from  them  it  is   expected.      But   any  thing  of 
this  character  in  a  physician,  is  disgraceful  and  hurtful. 

I  know.  Gentlemen,  that  now,  with  your   minds  fresh- 
stored  with  proper  ideas  of  practice,  and  with  the  lessons  of 
high-toned  professional  conduct,  which  have  been  impress- 
ed  upon  your   minds  by  your  Professors,    still    ringing   in 
your  ears,  you  scorn  the  very  thought  of  allowing  quacke- 
ry, in  any  shape,  to  influence  you.     You  ask,  "  Am  I  a  dog 
to  do   this   thing  .?"      But   allow   me  to  remind  you,  that 
the  temptation  will  be  great.     The  bold  and  false  language 
in  which  the  empiric  parades  himself  before  the  public,  his 
power  to  cure  diseases,  the  certainty  of  his  remedies,   the 
warranting  of  cures,  has  created  a  public  sentiment  which 
every  physician  finds  difficult  to  strive   against,  and  which 
every  honest   one   must   lament,    even   when   it  results   in 
unwarranted  praise.     For  he  knows  that  those  persons  who 
are  continually  in  the  habit  of  speaking  of  the  Doctor  hav- 
ing cured  diseases,  will  be  just  as  ready  to  say,  if  occasion 
offers,  that  he  killed  his  patient.      He  will  often  feel  that 
the  praise  is  as  loathsome  as  the  blame  is  unjust. 

Gentlemen,  avoid  the  habit  of  asserting  your  power  to 


Y8  The  Peninsular  and  Independent. 

cure    disease.      If   necessary,    give   your   patients,  or   their 
friends,  the  strongest  assurance   of  your  favorable  opinion; 
and  this  is  all  that,  in  any  case,  you  can  do  as  true  men. 
Even  the  mildest  forms  of  disease  will  sometimes  baffle  the 
skill  of  the  physician,  and  fatal  results  will  sometimes  occur 
when  the  closest  observation  failed  to  detect  the  cause,  or 
to  give  warning  of  the  approach  of  death.      Let   no   man, 
however  much  learned,  assume  the  attributes  of  the  Deity, 
and    say    ^^I    can    cure'';    and   let   none  rob  his  Maker  by 
saying  "  I  have  cured."     He  that  indulges  in  such  language 
is  a  quack,  whatever  his  name,  and  wherever  you  find  him. 
A  bragging,  boasting  physician  is  an  absurdity.     No  really 
intelligent  and   honest  man,    a  student  in  any   department 
of  learning,  can  be  a  boaster  ;  for  the  highest  elevation  of 
human  intellect  will  but  serve    to    make    the    discovery   of 
how  little  man  can  know  on  this  side  of  the  grave.     When 
he  has  climbed  the  highest  and  struggled  the  hardest,   he 
will  but  realise  that  he  can  only  pierce  the  outer  crust  of 
knowledge,  and,  instead  of  boasting,   he  will  feel  his   own 
littleness,  and   prostrate   himself  in  humbleness   before  his 

GrOD. 

No,  Gentlemen,  I  am  quite  sure  that,  if  you  continue 
to  advance  in  your  studies  —  if  you  continue  to  be  actua- 
ted by  proper  motives — and  aim,  as  honest  men,  to  do 
all  that  lies  in  your  power  to  relieve  the  suffering,  and 
promote  the  welfare  of  your  patients,  you  will  never  be 
quacks,  hypocrites,  or  braggarts. 

Your  demeanor  towards  the  dupes  of  quackery  must, 
of  course,  be  different  from  that  which  is  necessary  to- 
wards those  wlio  practice  it.  Amongst  the  former  you  will 
sometimes  find  men  whom  you  are  bound  to  respect  and 
esteem.  Is  is  almost  unaccountable  how  some  men,  having 
a  character  for  shrewdness  and  intelligence,  will  allow 
themselves  to  be  imposed  upon  by  the  veriest  quack.  But 
while    you    respect  them,  be  on  your  guard   never   to   be 


Address  to  Medical  Graduates  of  the  University.  10 

betrayed  by  them  professionally.  Do  not  argue  and  debate 
witb  them  ;  let  them  distinctly  understand  that  you  wish 
to  have  nothing  to  do  with  them  professionally,  that  you 
can  not  alternate  with  a  charlatan  as  their  physician.  You 
will  find  that  many  persons  can  not  understand  your  posi- 
tion. They  have  been  led  to  believe  that  the  different 
forms  of  quackery  and  regular  practice,  are  just  different 
systems  of  treatment^ — all  alike  good — sometimes  one  is 
best  and  sometimes  the  other  !  One  pathy  versus  another 
pathy — one  pathy  for  children,  another  pathy  for  adults — 
the  one  if  the  sickness  is  slight,  the  other  if  it  is  severe. 

Now,  Gentlemen,  if  you  are  wise,  and  respect  yourselves 
as  you  ought,  you  will  put  a  stop  to  all  this  nonsense, 
so  far  as  you  are  concerned.  The  fact  is,  that  the  less 
you  have  to  do  with  people,  who  have  once  run  after  ab- 
surdities, the  better.  They  are,  I  was  about  to  say,  like 
a  runaway  horse,  never  to  be  trusted  again ;  but  the  re- 
semblance to  this  animal,  except  in  a  few  cases,  is  not 
striking.  Such  a  horse  has  usually  a  great  deal  of  natural 
spirit,  high  mettle  ;  he  is  a  noble  animal,  but  has  been 
badly  trained  :  while  amongst  the  crowd  of  followers  of  every 
system  of  quackery,  although  you  may  find  good,  honest, 
and  upright  men,  and,  I  am  sorry  to  say,  too  often 
Christian  men,  yet,  I  think  they  are,  usually,  unstable 
and  fickle -minded.  A  fitter  comparison  would  be,  that 
other  member  of  the  equine  race  which  is  for  ever  in- 
clined to  go  backwards,  and  which,  insignificant  though 
it  be,  if  you  are  not  on  your  guard,  will  do  you  an 
injury. 

Whilst  you  refuse  to  argue  with  these  people,  you 
should,  at  the  same  time,  be  always  ready  to  explain 
to  any  one  your  position.  You  should  acquaint  your* 
selves  with  the  different  systems  of  deceit  and  charlatanry, 
to  be  able  to  explain  to  those  seeking  information,  what 
they  really  are.       Some .  men    have   been  enticed  into  a 


80  The  Peninsular  and  Independent, 

belief  of  these  systems  for  a  time,  by  arguments  and 
well -managed  impostures,  who,  when  their  eyes  are  open- 
ed to  see  that  they  have  been  dupes  of  cheats  or  fools, 
learn   to  appreciate   true   science. 

Endeavor,  Gentlemen,  at  all  times,  to  be  not  only 
skillful  in  combating  disease  and  relieving  suffering,  but 
also  to  exert  a  healthful  moral  influence  in  your  prac- 
tice. There  is  a  lamentable  amount  of  moral,  as  well 
as  physical,  degradation  fostered  in  our  communities  by 
the  character  of  the  language  employed,  and  the  schemes  re- 
sorted to,  by  the  charlatan  ;  and  this  is  greatly  aided  by 
the  popular  medical  and  physiological  works  scattered 
broadcast   amongst   the  people. 

Gentlemen,  be  above  resorting  to  any  of  the  practices 
which  savor  of  deceit  or  humbug,  to  obtain  practice.  Do 
not  assume  airs  of  importance  and  greatness,  which,  how- 
ever calculated  to  impress  the  ignorant  for  a  time,  will 
only  cause  you  to  be  laughed  at  by  intelligent  people. 
The  use  of  technical  phrases  and  long -sounding  names, 
in  talking  to  your  patients,  will,  in  the  end,  only  beget 
contempt.  Be  respectful  in  your  deportment,  plain  in 
your  language,  kind  in  your  inquiries,  and  firm  in  your 
requirements  ;  above  all,  do  not  fawn  and  flatter,  to  ob- 
tain practice.  Flunkeyism  is  disgusting  anywhere,  but 
especially  in   a   physician. 

In  your  intercourse  with  your  brethren,  strive  to  be 
ever  honorable.  Professional  and  personal  rancor  amongst 
physicians,  has  done  incalculable  injury  to  the  Profes- 
sion. As  you  regard  your  own  reputation,  as  you  value 
your  own  happiness,  and  as  you  desire  to  uphold  the 
honor  of  your  Profession,  avoid  ungentlemanly  conduct 
towards  your  brethren.  There  is  one  short  injunction  of  the 
inspired  pen  which  should  ever  guide  you — "^e  courte- 
ous." In  a  word.  Gentlemen,  pursue  the  course  which  will 
lead  you  to  honor  and  respect  as  well  as  success. 


Address  to  Medical  Graduates  of  the  University.  81 

I  know  that  I  express  the  sentiinents  of  every  one  in 
this  assembly,  when  I  wish  you,  with  all  my  heart,  God- 
speed !  Speed  then.  Doctors  of  Medicine,  on  your  honora- 
ble but  arduous  career  !  May  you  be  enabled  to  meet 
the  trials  of  life  bravely,  and  its  difficulties  with  undaunt- 
ed hearts,  cheered  by  the  smiles  of  fortune,  an  approving 
conscience,  the  esteem  of  the  good  and  the  gratitude  of 
those  to  whose  welfare  you  devote  yourselves.  Beyond  all 
pecuniary  recompense,  and  in  the  midst  of  services  which 
money  can  never  remunerate,  may  the  blessings  of  him 
who  was  ready  to  perish,  come  upon  you.  At  the  close 
of  a  useful,  beneficent,  and  honored  life,  may  the  loving 
arms  of  the  Gieat  Physician  receive  you.  And  on  that 
coming  Coronation -day  which  will  surpass  all  that  has 
preceded  it  as  Eternity  is  greater  than  Time,  may  you 
receive  crowns  of  rio^hteousness   which   never   shall   fade  ! 


-•♦  •- 


ART.  YIII.— Foreign  Body  in  the  Air  Passages. 


By  W.  H.  Johnson,  M.  D. 


On  the  20th  of  February,  1854,  I  was  called  to  visit  the 
son  of  Mr.  E.  P.  Hall,  aged  about  seven  years.  The  case 
presented  the  following  conditions,  to  wit :  Fever  of  the 
remittent  form,  differing  in  some  respects  from  the  ordin- 
ary type  of  fever  then  prevailing,  as  it  seemed  more  symp- 
tomatic than  endemic.  On  inspecting  the  thorax,  the 
right  side  of  the  chest  was  found  anteriorly  to  be  much 
distended — raised  probably  about  three -fourths  of  an  inch 
above  its  fellow.  Auscultation  detected  a  very  bad  vesic- 
ular murmur  at  each  respiratory  movement,  not  unlike 
the  resonance  heard  in  interlobular  emphysema.  The 
sound,  on  percussion,    was    morbidly   clear,    otherwise   the 

Vol.  11.- F. 


82  Tlie  Peninsular  and  Independent, 

lung  was  apparently  healthy.  The  same  tests  applied  to  the 
left  side  discovered  a  dissimilar  set  of  symptoms,  though 
I  was  unable,  on  percussion,  to  detect  the  least  devia- 
tion from  the  normal  state.  In  aj^plying  the  ear  to  the 
left  side  of  the  chest,  I  found  greatly  diminished  respir- 
atory movement.  But  little  of  the  respiratory  murmur 
was  heard,  yet  the  lung,  on  percussion,  emitted  a  clear 
healthy  sound  throughout  its  whole  extent.  There  was 
no  cough ;  nor  was  there  any  soreness  complained  of  or 
admitted.  This  was  the  state  in  which  I  found  the 
patient.     Now,    What   was   the   matter  ? 

At  the  time,  after  the  most  careful  examination  I 
failed  to  satisfy  my  own  mind  as  to  the  cause  of  this 
unusual  pathological  condition,  and  misdiagnosed  the  case. 
By  an  accident,  I  believed  the  right  lung  had  become 
emphysematous  by  the  infiltration  of  air  in  the  cellular 
texture,  and  that  the  left  had  become  impaired  in  its 
functions  by  the  same  cause  that  affected  the  right, 
though  affected  very  differently.  From  the  slight  mucus 
mZe,  discovered  on  presenting  the  ear  to  the  chest  pos- 
teriorhjj  I  inferred  the  diminished  action  was  due  to  the 
collection  of  mucus  of  extreme  tenacity  about  the  bifur- 
cation  of  the    trachea. 

The  accident  alluded  to,  was  this  :  Two  days  pre- 
vious to  my  visit,  the  boy,  playing  at  school,  alleged 
that  he  had  swallowed  a  pencil,  and  was  seized  with 
spasmodic  periods  of  coughing,  and  went  home.  The 
parents  assured  me  that  the  spasms  occurred  frequently 
for  the  first  four  hours  succeeding  the  accident,  and  were 
very  violent,  nearly  amounting  to  strangulation.  After 
this,  the  violence  of  the  cough  abated,  or  stoj^ped  alto- 
gether ;  and  so  slight  was  the  disturbance,  that  but  little 
attention  was  given  to  the  case  for  forty -eight  hours  af- 
terwards. From  this  circumstance,  the  mitigation  of  all 
the   violent   symptoms,    and   the    quietude    of    more    than 


Johnson  on  Foreign  Body  in  the  Air  Passages.        83 

ordinary  intelligent  parents,  I  was  induced  to  believe  that 
the  pencil,  if  inhaled,  had  never  passed  the  chink  of  the 
glottis,  but  had  secured  a  lodgment  at  the  superior  por- 
tion of  the  trachea,  giving  rise  to  those  violent  spas- 
modic movements,  and  had  been,  by  them,  unobserved  by 
the  parents,  thrown  out,  leaving  the  pathological  condition 
alreadv   described. 

The  patient  was  put  on  a  treatment  of  the  milder 
alternatives  with  diaphoretics,  and  continued  on  the  same, 
with  slight  modifications,  for  about  eight  days.  This 
was  attended  with  an  abatement  of  the  acute  inflam- 
matory action  and  a  diminution  of  fever.  There  was 
still  no  soreness  in  the  least  complained  of.  A  tonic 
course  of  treatment  was  now  substituted,  and  persisted  in 
for  another  eight  days,  as  the  diminished  strength  of  the 
patient  seemed  to  require,  though  there  was  a  slight  exa- 
cerbation of  fever  occurring  every  day. 

In  the  mean  time  my  mind  was  undergoing  a  change 
in  relation  to  the  case,  arising  from  the  persistence  of  the 
fever  and  the  local  difficulty.  It  was  possible  —  yes,  highly 
probable  —  that  a  foreign  substance  had  plugged  up  the 
left  bronchus,  giving  rise  to  all  the  phenomena  there  pres- 
ent. If  a  foreign  substance  was  thus  lodged,  it  must  be 
the  pencil.  On  the  11th  of  March  following,  at  my  request, 
the  patient  was  seen  by  Dr.  W.  B.  Southard,  to  w^hom 
I  had  confided  mv  fears.  He  too,  came  to  the  conclusion 
to  which  I  had  arrived.  The  local  symptoms  were  still 
,  the  same  as  when  I  first  saw  the  patient,  except  the  slight 
respiratory  murmur  and  the  mucus  rdle^  which  had  entirely 
disappeared.  The  patient  was  subsequently  seen  by  Drs. 
Cornell  and  Osburn.  Tracheotomy  was  suggested,  but 
deemed  improper. 

The  tonic  treatment,  with  nutricious  diet,  was  pursued 
up  to  28th  of  March.  From  this  time,  but  little  treat- 
ment was  had.     So  far  there  was  no  especial  change  in  the 


84  The  Peninsular  and  Independent. 

condition  of  the  patient,  except  that  of  gradual  emaciation. 
On  the  22d  of  April,  being  at  play  with  a  little  sister, 
and  having  occasion  to  laugh  heartily,  the  patient  was 
again  seized  with  very  violent  spasmodic  coughing.  By  a 
series  of  well-directed  movements  on  the  part  of  the  mother, 
such  as  shaking  the  boy  violently  with  his  head  in  a  de- 
pending position,  with  many  other  indescribable  manipula- 
tions, a  slate  pencil,  measuring  three -fourths  of  an  inch  in 
length,  and  two  lines  in  diameter,  was  thrown  from  the 
lungs,  after  remaining  in  the  bronchial  tube,  as  described, 
for  sixty-four  days. 

Since  the  expulsion  of  the  pencil,  the  boy's  health  has 
been  steadily  improving.  I  have  constantly  kept  my  eye 
on  the  case,  and  have  quite  recently  examined  the  little 
fellow.  He  is  quite  active,  and  seems  to  develop  physically 
equal  to  other  children  ;  but  I  find  still  upon  him  almost 
precisely  the  same  condition  of  both  lungs  that  I  found  on 
visiting  him  fL\Q  years  ago.  The  right  lung  is  still  per- 
forming rnuch  the  larger  portion  of  respiration,  while  the 
action  of  the  left  remains  very  weak,  and  respiration  by  it 
is  very  feebly  performed.  * 

There  has  not,  at  any  time  since  the  accident,  been  the 
least  soreness  of  either  lung. 

Albion,  March  18th,  1859. 


•  •  • 


ART.  IX,— 5ew  Methocls  of  Resuscitating  Stillborn  Children,  and  of 
Restoring  Persons  apparently  Drowned  or  Dead. 


By  M.  A.  Patterson,  M.  D.,  Tecumseh,  Mich. 

In  corroboration  of  the  views  presented  in  the  sub- 
joined extract,  it  may  be  proper  to  state  that,  for  se- 
veral years,  it  has  been  our  practice  to  treat  cases  of 
stillborn   children    by   directing   an   attendant    to    support 


Patterson-  on  New  3Iethods  of  Resuscitating,  €$:c.       85 

the  head  of  the  child,  with  its  neck,  at  times,  slightly 
inclined  backwards,  while  we  place  our  hands  high  in 
its  armpits  and  close  to  the  chest,  with  the  palms  up- 
ward and  under,  and  the  thumbs  over  its  shoulders ; 
positions  which  enable  us  to  raise  the  arms  of  the  in- 
fant to  the  requisite  height,  and,  at  the  same  time  to 
elevate  its  body  and  lower  limbs  nearly  or  quite  per- 
pendicular. When  this  is  done,  the  arms  of  the  child 
are  brought  rather  quickly  to  its  sides,  and  its  body  as 
quickly  to  a  sitting  posture.  These  motions  are  continued 
with  temporary  suspensions  ;  during  which  the  usual  pre- 
cautions to  remove  mucus  from  the  air  passages,  to  dash 
a  few  drops  of  cold  water  in  its  face,  and  to  stimulate 
the  nostrils  and  chest,  are  attended  to,  until  the  child 
cries,  which,  if  life  is  not  entirely  extinct,  usually  hap- 
pens in  a  few  minutes.  During  the  whole  process  of 
restoration  we  carefully  guard  against  the  loss  of  animal 
heat,  and,  occasionally,  we  have  found  it  necessary  to 
apply   this   method  while   the   child  was   in   a  warm  bath. 

If  the  hands  are  properly  placed,  the  required  motions 
may  be   made  without   the   slightest   injury  to   the   infant. 

The  effect  of  these  motions  upon  the  mechanism  of 
the  child  explains  the  modus  operandi  of  the  process 
without   a   word   of  comment. 

Whoever  has  seen  a  dying  person  "gasping  for  breath" 
will  comprehend  why  we  incline  the  head  gently  backwards. 

Our  friend  Dr.  Baldwin  has  used  this  method  sev- 
eral times,  with  perfect  success  ;  and  we  described  it  to 
Prof.  Palmer,  a  year  or  two  since,  who  promised,  on 
the  first  opportunity,  to  give  it  a  trial.  Whether  he 
has  had  occasion  to  test  its  utility,  we  have  no  present 
means  of  ascertaining,  as  he  is  now  on  his  way  to 
Europe.  Some  misgivings  as  to  its  novelty  prevented  an 
earlier  publication  of  this  "  discovery " -^— if  entitled  to  a 
name,    so   significant   when    truly   applied,    and    so    hack- 


86  The  Peninsular  and  Independent. 

neyed  as  ordinarily  used.  At  all  events,  the  present 
publication  will  serve  to  illustrate  the  correctness  of  Dr. 
Sylvester's  views,  whose  process  in  part,  is  similar  to 
the  "ready  method'"  which  we  have  thus  briefly  de- 
scribed. 

In  a  pamphlet  recently  published,  Dr.  Sylvester  argues  that  the 
postural  method  of  Dr.  Marshall  Hall  for -the  restoration  of  persons 
who  have  been  asphyxiated,  does  not  displace  more  than  a  fraction  of 
a  cubic  inch  of  air  from  the  lungs,  that  the  expansion  of  the  thorax  is 
limited  to  that  which  results  from  from  the  mere  elasticity  of  the  tissues 
compressed  during  the  rotatory  efforts,  and  that  the  contraction  and 
expansion  are  confined  to  one  side  of  the  chest.  He  points  out  other 
objections,  such  as  that  the  contents  of  the  stomach  and  oesophagus  may 
pass  into  the  windpipe,  or  that  the  patient's  face  may  be  bruised  and 
his  neck  twisted  by  the  prolonged  movements,  to  which  may  be  added 
that  ribs  are  sometimes  fractured,  as  we  have  ourselves  witnessed.  The 
author  proposes  to  make  the  first  effort  of  the  asphyxiated  individual 
an  *?ispiratory  one,  by  using  the  arms  as  handles  to  open  and  close 
the  chest. 

To  determine  the  effect  produced  on  the  contents  of  the  thorax,  by 
the  proceeding  advocated  by  Dr  Sylvester,  he  introduced  a  glass  tube 
into  the  trachea  of  a  corpse ;  this  was  connected  by  a  flexible  tube  with 
a  glass  horse-shoe  tube  containing  a  small  quantity  of  colored  fluid, 
which  was  maintained  at  the  same  level  in  both  legs.  "The  height 
of  the  column  having  been  first  carefully  noted,  the  arms  of  the  subject 
were  raised  and  steadily  extended  upwards  by  the  sides  of  the  head,  so 
as  to  draw  up  the  shoulders,  and  put  the  pectorals  on  the  stretch,  ele- 
vate the  ribs,  and  consequently  enlarge  the  cavity  of  the  chest.  The 
result  was,  that  the  fluid  in  the  bent  tube  rapidly  fell,  and  so  consider- 
ably as  to  recede  high  up  in  the  leg  of  the  instrument  nearest  the  body; 
that  is  to  say,  the  tendency  to  a  vacuum  produced  in  the  chest  drew 
the  air  into  the  lungs;  the  shoulders  and  arms  were  next  pressed  down 
upon  the  sides  of  the  chest,  and  immediately  the  fluid  rose  as  much 
above  its  usual  level  in  the  further  leg  of  the  apparatus  as  it  did  in 
the  foregoing  experiment." 

Dr.  Sylvester  has  tested  the  effect  of  the  rotatory  plan  by  the  same 
instrument,  which  demonstrates  that  while  a  small  quantity  of  air  is 
expelled  from  the  thorax  by  compression,  only  so  much  can  be  drawn 
in  as  will  occupy  the  space  created  by  the  elasticity  of  the  ribs.  He 
concludes:  ''1.  That  by  his  mode  of  procedure  the  actual  capacity  of 
the  chest  was  increased,  and  air  drawn  into  the  lungs  by  the  constrained 
action  of  the  muscles  of  respiration  upon  the  movable  walls  of  the 
thorax ;  2.  That  expiration  was  produced  by  pressing  the  arms  and 
shoulders  down  upon  the  sides  of  the  chest." 


Patteeson  on  JSFeio  Methods  of  Resuscitating^  c0c.       87 

The  author  points  out  that  his  method  is  characterized  by  an  actual 
enlargement  of  the  cavity  of  the  chest,  owing  to  elevation  of  the  ribs 
above  their  ordinary  or  natural  level ;  this,  he  maintains,  is  not  eflfected 
by  the  Marshall  Hall  plan. 

Dr.  Sylvester's  suggestion  certainly  is  based  upon  sound  anatomi- 
cal and  physiological  principles ;  we  therefore  hasten  to  lay  it  before  our 
readers,  and  request  them  to  put  it  to  the  test,  without,  at  the  same 
time,  neglecting  such  other  precautions  with  regard  to  the  restoration 
of  warmth  by  friction  and  dry  clothing,  of  drawing  forward  the  tongue 
to  prevent  the  larynx  from  being  closed,  and  the  like,  as  the  author 
very  properly  points  out. 

[British  Medico- Chirtcrgical  Review. 


88 


The  Peninsular  and  Independent. 


ART.  X,  —  Meteorological  Register  for  Month  of  March,  1859. 

By  L.  S.  Horton,  House  Physician  to  U.  S.  Marine  Hospital. 

Altituda  of  Barometer  above  the  level  of  the  sea,  697  feet.     Latitude,  42^24' N.-   and 
Longitude.  82°58'AV.  of  Greenwich. 


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CO-^vO-r^-<*lrti'*Tj<>0»Ou:) 


CslCOCOOO'^CDiOOO: 

CO  co_coj:m  CO  CO  -^  CO ^ 

C^  Tti  '^  Tt<  O  i^  CO  C<1  ^^ 

■^  -rtl  •<*  -"i^  CO  TH  TtH_CO  co_ 

fM  CM  CD  O  C<I  00  t-  ^  1^ 

CO  CO  CO  CO  CO  CO  Tt<  CO  gsl 

"uTTciT^fN  ?N  CO  00  00  r-i 
COCOCOCOCOtJHCOCOCO 


(MOCO-^C<1C0  1^CO(M'>1C<I 
COCOCOCOCOOQC<JCOCOCOCO 


COCOOO'^iOCOOOTt^t^-^b- 
COrtlrtl-^COCOO^tiCOCOCO 


CO  -M  O  C-1  O  C^l  (M  »>!  CO  ■>*  CO 

CO  CO  CO  CO  CO  (M  CO  CO  CO  CO  co 

O  O  t—  t^  CO  Ci  Ci  CO  lO  -"^"^ 

cocococococmC'ItHcococo 


■1  <M  >0  lO  C<1  CO  O  t^ 
lOOiO-^-^cDlOCOCO 


l^COOOr^(M(MiOCOCOI^-H 
(MCOCOCOCOCOCOCOCOCOCO 


OOOi-HCOCO-*C55-^^>— I 

coThiTtt'<*-<*TtiTj<coco 


00  o  oq  to  >o  lO  00  o  o  (M  ^ 

OOSt^t^OOOOt^QOOiOOOO 


'NOiOOiOOOtOC^l 
O'-tOOOOOOOOOCO 


CDO-lr-iOC<lCOCD(MOOObcD 
coco:DcOTiHcocDto-^cOTtt 

lO  00  'tl  CO  uO  -^  CO  00  to  CO  b-. 

cocococococ<icccocococo 

"Cll^)  tO  -^  00  to  (M  -t-  'c^o'^ 
00CiC5t--^00CD<NO(MI>» 


o^cooooooooooooooocooo 

C<1  -M  C<J^  G<l  (M  C^  CI  (M  'M  (M 

to  "O'tO  1— 'to  OO  ^  to  O  fM  Ol 

Oo:)t^t^c:t^i--.i^OOOt^ 


OiCSlOOOJCiOOOOOOOO 

OiOO^OO-t^OCS-^" 
O'-HOt^OCiOOOOO 


OOOOOOOOOOOOCOOOOOOOOO 
(MG<l<MC<ie^'Mg^(MC<lC<ie<» 

<:500O.-<OOtOO(MC<l-* 
0000OC0-*05C0Tt<O<MC0 


OiOOOOOOOOOOOOOOCiOOOO 
<M  (M  C^l  C<l  (M  (M  ^  Cvl  CM  -M  C-l 


CTiCTSOiOOOiOOOOOOOO 


OOOOOiOOOOOOOOOOOOOOOO 


o  >o  >o  O  00  'M  o  o  o  o  r^ 
OC5500t^OOOOt^OOOOOOO 


'+toooooo^::50i0>o 

CSOOt-i—tOOt—OS 


cooooiOicoajcoioooqto 


GiOOOOOOCCOOOOnOOiOOOO 


OOCiGiOO<3iO^COP^OO 
Oq'MfM'MtMCSICq'MfM 


OOOOCOOOOOQOOOCOOCQOOO 


i-)(MCOTHtOCOl-^00050i-H 


'MCO-^tOCOt—  OOCiO 
T-iT-lTHrHr-lrHr-l,-tC<l 


_i  r-i  --v-i  -*  vO  CD  I"-  CT;  Oi  (^  t-H 
(NC<JC<J(N<NCNC<JC<J(NCOCO 


iibli^gra^lital  |lu0rir. 


A  TREATISE  ON  FRACTURES.  By  J.  P.  Malgaigne,  Chirurgien  de 
THopital  Saint  Louis,  Chevalier  de  la  Legion  d'Honneur  et  du  Merite 
Militaire  de  Pologne,  Membre  de  I'Academie  Royal  de  Medicine. 
With  one  hundred  and  six  Illustrations.  Translated  from  the  French, 
with  Notes  and  Additions,  by  John  H.  Packard,  M.  D.  Phila- 
delphia :  J.  B.  Lippincott  Sr.  Co.     1859. 

This  belongs  to  a  class  of  books  which  we  esteem  so  highly 
as  to  trust  that  the  list  may  be  continually  augmented. 
It  is  so  utterly  impossible  to  do  any  thing  like  justice  to 
the  subject  of  Fractures  in  the  body  of  an  ordinary  woik 
upon  a  general  system  of  Surgery,  that  a  work  like  the 
above  will  be  duly  appreciated  by  the  student  who  aspires 
to  some  thing  more  than  a  mere  knowledge  of  the  method 
of  recognizing  and  treating  Fractures.  The  treatise  in 
question  should  prove  unusually  acceptable  to  the  Profes- 
sion ;  and  in  this  country,  where  the  tendency  to  hold  the 
surgeon  responsible  in  dollars  and  cents,  for  a  perfect  job, 
seems  to  have  obtained  general  prevalence,  it  would  seem 
that  there  is  abundant  inducement  for  study  of  the  sub- 
ject of  which  it  treats. 

The  work  is  well  arranged,  and  constitutes  a  complete 
treatise.  The  cuts  are  printed  on  heavy  and  fine  paper, 
which  hardly,  however,  atones  for  their  separation  from  the 
subject  which  they  illustrate.  Cuts  should  be  interspeised 
through  the  body  of  the  work.  G. 


90  The  Peninsular  and  Independent. 


A  TREATISE  ON  THE  VENEREAL  DISEASE.  By  John  Hunter, 
F.  R.  S.;  with  Copious  Additions  by  Dr.  Philip  Ricord,  Surgeon  of  the 
Hopital  du  Midi,  Paris,  etc.  Translated  and  edited  by  Freeman 
BuMSTEAD,  M.  D.,  Lecturer  on  Venereal  Diseases  at  the  College  of 
Physicians  and  Surgeons,  N.  Y.;  Assistant  Surgeon  to  the  N.  Y.  Eye 
Infirmary.  Second  Edition,  containing  a  Resume  of  Ricokd's  recent 
Lectures  on  Chancre.      Philadelphia:    Blanchard  &  Lea.      1859. 

There  was  great  propriety  in  associating  together  the  views 
of  Hunter  and  Ricord  in  the  first  edition  of  the  above 
work  ;  and  however  much  we  may  differ  from,  or  however 
precisely  we  may  coincide  with,  the  views  of  these  two  great 
men,  we  can  entertain  but  one  opinion  as  to  their  influence 
in  regard  to  the  great  body  of  truth. 

The  present  edition  contains,  in  a  condensed  form,  an 
addition  to  the  notes  of  the  former  issue,  derived  from  the 
published  notes  of  Ricord's  Lectures  on  Chancre,  by  M. 
Tournier  ;  an  addition  which  enhances  not  a  little  its 
value.  G. 

THE  DRUGGIST.  A  Monthly  Newspaper  for  the  Trade.  No.  1,  Vol.  I. 
Cincinnati,  Ohio. 

A  NEATLY  printed  paper,  of  quarto  size,  containing  16 
pages,  to  .be  issued  monthly,  under  the  editorship  of  Henry 
E.  FooTE,  M.  D.,  assisted  bv  a  number  of  Pharmaceutists 
in  different  parts  of  the  Union. 

We  remark,  in  the  present  No.,  the  pen  jottings  of 
Wayne,  on  Pharmacy,  in  which  he  gives  some  examples  of 
ancient  Pharmaceutical  Preparations,  taken  from  an  old 
London  Dispensatory,  of  1696,  in  which  the  excrementitious 
matters  of  horses  and  cows,  and  substances  of  like  medici- 
nal value,  are  tortured  by  maceration  and  distillation  into 
essences  of  wonderful  power  in  disease.  We  feel  thankful 
that  modern  science  does  not  find  such  uses  for  fresh  cow 
dung.  Won't  Mr.  Wayne  give  us  some  more  examples 
from  that  old  book  (which  we  think  must  be  quite  out  of 


Slhlio graphical  Record.  91 

print)  ?  We  think  they  will  convince  the  minds  of  the 
most  obtuse  that  the  Grolclen  Age  of  Pharmaceutical  Sci- 
ence was  not  in  the  past. 

Apropos  of  old  books,  we  have  one,  entitled  '^  An  Essay 
for  the  Keformation  of  the  London  Pharmacopoeia,"  dated 
1746 ;  which  is  filled  with  marginal  notes,  in  manuscript, 
which  notes  denote  a  scientific  knowledge  and  skill  on  the 
part  of  the  writer  that  the  present  age  would  hardly  give 
him  credit  for,  and  containing  suggestions  in  relation  to 
formulae  which  have  not  been  improved  upon  since. 

But  to  return  to  the  '^  Druggist."  At  the  low  price 
of  the  paper,  and  popularity  which  such  publications  assume 
among  Dealers  in  Medicine,  we  may  safely  predict  for  it  a 
large  and  profitable  circulation.  It  has  been  placed  on 
our  exchange  list.  F.  S. 


^YxtGxhl  geprtm^nt. 


Retraction  of  the  Cincinnati  Lancet  and  Observer. 

It  will  be  recollected  that  in  our  March  No.  we  referred 
to  the  slanderous  allegations  of  the  above  journal  against 
our  friend  and  colleague,  Prof.  Sager,  and  ourself,  charging 
us  with  assuming  a  title  which  did  not  belong  to  us.  After 
quoting  the  language  previously  used  by  it,  the  Lancet  and 
Observer  says : 

"Now  it  seems  that  this  statement  is  not  true,  and  we  therefore 
make  the  correction  and  the  amende  honorable  to  Dr.  P." 

It  further  says : 

"Wishing  to  do  no  man  injustice,  more  particularly  to  injure  the 
hard-earned  reputation  of  an  honorable  physician,  we  will  also  correct 
our  statement  in  regard  to  Dr.  Sager.  .  .  We  regret  our  error,  and 
have  thus  donf  all  we  can  to  correct  it." 

This  seems  fair  and  satisfactory;  but  it  is  usually  the 
case  that  those  who  have  been  the  subjects  of  wrong  from 
others,  are  more  or  less  pursued  by  their  traducers  in  the 
same  spirit,  and  in  the  article  from  which  we  have  ex- 
tracted the  above  explicit  retractions,  there  are  some  state- 
ments and  insinuations  which  indicate  that  this  case  will 
not  prove  a  very  brilliant  exception. 

We  do  not  propose  to  bandy  words  with  the  Lancet 
and  Observer,  but  there  are  a  few  statements  in  this  article 
which,  once  for  all,  require  a  little  elucidation.      It  says  we 


Editorial  Department.]  93 

wrote  a  very  threatening  letter,  demanding  their  authority 
for  the  statement  they  had  made,  threatening  with  a  suit 
for  lihel  unless  correction  was  made.  What  was  written 
on  that  point  was  to  this  effect: 

"No  honorable  man  can  rest  quietly  under  such  an  imputation;  and 
you  will  not  be  surprised  that  I  ask  of  you  the  most  explicit  retraction 
and  apology,  giving  it  as  wide  currency  as  the  charge.  .  .  I  do  not 
propose  having  what  purports  to  be  a  respectable  medical  journal  thrust 
before  me,  at  home  or  abroad,  with  such  a  statement  in  it,  without  being 
able  to  show  a  retraction,  or  some  other  evidence  that  it  has  been  pro- 
perly resented." 

Not  one  word  was  said  about  a  libel  suit.  This  was 
probably  what  the  editors  feared,  not  what  we  said. 

We  did  not  demand  the  authority  on  which  the  slan- 
derous statement  was  said   to  be  based.      The  letter  said: 

*'I  have  no  desire  to  raise  insignificance  to  the  dignity  of  contempt, 
but  it  would  seem  necessary,  to  shield  yourse^lves  from  the  imputation  of 
unprompted  and  the  most  malicious  falsehood  published,  and  therefore 
libellous,  that  you  should  reveal,  at  least  to  me,  the  source  of  informa- 
tion from  which  you  made  the  charge." 

This  was  all  on  this  point;  and  it  is  but  just  to  all 
parties  to  say,  that  in  their  letter  to  us  they  state, — 

"We  received  a  communication  from ,  unsolicited  on  our 

part,  from  which  we  took  the  remark  so  offensive  to  you."      [We  omit 
the  name,  only;  the  italic  word  is  theirs.] 

It  is  proper,  in  this  connection,  further  to  say,  in  order 
that  their  correspondent  be  not  censured  more  than  he 
deserves,  that  they  admit  in  the  article  they  did  not  give 
his  precise  words,  though  their  letter  would  clearly  indicate 
they  did.      The  editorial  says: 

"It  is  probably  true  that,  as  we  did  not  use  the  exact  language  of 
our  correspondent,   more  may  have  been  expressed   than  we  intended." 

Whether  their  correspondent  was  properly  echoed  or  not, 
we  can  only  judge  from  the  letter  and  the  editorial  article. 


94  The  Peninsular  and  Independent. 

We  only  Iznow  that  the  Lancet  and  Observer  uttered  the 
slander,  and  has  now  retracted  it.  The  jiarties  must  settle 
between   themselves   the  share   each   has  had   in  the  work. 

One  thing  more:  The  editors  of  the  Lancet  and  Ob- 
server accuse  us  of  insulting  them  by  saying  they  did  not, 
themselves,  write  the  editorial  in  their  January  No.  This 
seems  to  be  regarded  by  them  as  our  greatest  offense. 
What  we  said  was,  that  we  could  not  believe  that  either 
of  the  editors  (connected,  as  one  or  both  of  them  were, 
with  a  school  requiring  not  nearly  as  mu^h  of  students  as 
our  school  does)  wrote  the  article.  We  thought  it  impos- 
sible that  they  could  have  originated  their  own  stultifica- 
tion—  that  they  could  abuse  us  on  their  own  instigation 
for  opposing  requirements  for  entering  our  college  which 
neither  they  nor  any  other  school  in  the  country  apply 
even   to   graduates. 

In  this,  according  to  their  statements,  we  were  mis- 
taken. We  must  admit,  then,  that  they  did  originate 
their  own  stultification  by  vehemently  condemning  in  us 
what  they  practice  to  a  much  greater  extent  themselves. 
We  honestly  believed  they  had  been  tampered  with,  as 
we  knew  others  had  been  —  we  thought  we  had  internal 
evidence  that  unsolicited  communications  had  been  sent 
them  —  and  we  intended  the  remark  which  they  pretend 
to  resent,  rather  as  an  excuse  than  a  reproach.  As  they 
take  it  otherwise,  we  retract  our  charitable  opinion.  It 
was  only  an  opinion,   and  exjDressed   as   such. 

We  have  now  done  with  the  Lancet  and  Observer ^  and 
are  inclined  to  think,  also  with  its  unsolicited  corres- 
pondent. To  the  latter,  if  in  the  future  he  will  but 
keep  out  of  our  path,  we  can  afford  to  say  as  Uncle 
Toby  said  of  the  troublesome  fly  which  he  caught,  and 
which   most   others   would   have   crushed, 

"Go,  poor  devil,  get  thee  gone  *  *  *  this  world  is  surely  wide 
enough  to  hold  both  thee  and  me."  A.  B.  P. 


Editorial  Department.  95 

Tlie  Cultivation  of  MecHcioal  Plants. 

When  the  extent  of  our  'dependence  upon  foreign 
sources  for  important  and  invaluable  elements  of  our 
Materia  Medica  is  considered,  the  question  of  home  cul- 
ture of  foreign  medical  plants  assumes  no  mean  import- 
ance  in   an   industrial   and   commercial   point   of  view. 

It  is  now  generally  conceded  that  the  cultivation  of 
indigenous  medicinal  plants  improves  their  therapeutic 
powers ;  an  improvement  as  marked  nearly  as  that  in- 
duced by  careful  culture  in  products  of  the  uutricious 
plants  which  form  so  large  a  portion  of  our  food.  It 
follows,  as  a  natural  consequence,  that,  due  regard  being 
paid  to  climatic  influences,  to  position,  and  to  soil,  many 
of  the  substances  now  imported  in  enormous  quantities, 
and  at  high  rates,  for  the  supply  of  ths  Drug  trade, 
might,  with  advantage,  be  cultivated  in  our  own  country. 
This  would  open  new  fields  of  industry  and  profit,  and 
tend  directly,  by  mcreased  production,  to  lessen  the  cost 
to   consumers. 

The  successful  cultivation  of  the  narcotic  plants  is 
instanced  in  the  botanic  gardens  of  the  Messrs.  Tilden, 
and  in  the  farms  of  the  several  Shaker  societies  of  the 
Eastern  States,  who  suppl}^,  to  some  extent,  our  markets 
with  pressed  herbs,  &c.  Valeriai^a  officinalis ^  of  excellent 
quality,  is  quite  largely  cultivated  in  New  England,  and 
even  in  this  State  to  an  extent  worthy  of  placing  it 
above  being  termed  an  experiment.  The  successful  cul- 
ture of  the  Liquorice  root  in  this  country  is  almost 
established. 

It  is  gratifying  to  notice  that  the  Agricultural  Bureau 
of  the  Patent  Office  has,  in  connection  with  its  impor- 
tations of  foreign  seeds  and  plants  for  distribution  among 
agriculturalists,  undertaken  the  task  of  importing  those 
of  medicinal  value  also,  with  the  view  of  enabling  it,  con- 
jointly with  the  efforts  of   botanists,  and  especially  of  the 


96  ,    The  Peninsular  and  Independent. 

American  Pharmaceutical  Association,  to  introduce  into 
successful  culture  here  the  most  esteemed  and  valued  me- 
dicinal products  of  other  countries.  It  is  impossible,  we 
think,  to  overestimate  the  value  which  may  accrue  in  com- 
ing time  to  our  country  by  these  efforts  now  being   made. 

The  Agricultural  Bureau  has  already  reported  the  com- 
plete success  of  the  introduction  of  the  Quercm  subra,  or 
Cork  oak  ;  and  when  it  is  considered  we  pay  to  Europe  a 
quarter  of  a  million,  annually,  for  the  item  of  corkwood 
alone  the  commercial  value  of  others  may  be  imagined. 

The  olive,  prune,  ^g,  zante  currant,  liquorice  root,  opium 
poppy,  and  fenugreek,  have  also  been  experimented  with, 
but  with  a  success  not  yet  fully  determined,  owing  to  the 
want  of  botanical  gardens  or  experimental  farms,  and  to 
some  extent,  doubtless,  to  ignorance  on  the  part  of  those 
having  charge  of  the  experiments,  of  the  proper  natural 
requirements  of  plants  under  their  charge. 

Within  our  boundaries,  are  found  the  greatest  possible 
variety  of  soil  and  climate,  and  no  obstacle  seems  to  exist 
in  introducing  medicinal  plants,  except,  perhaps,  the  want 
of  willing  and  interested  parties  to  undertake  the  culture 
of  them  while  success  is  yet  an  experiment. 

In  connection  with  the  culture  of  foreign  medicinal 
plants,  we  see  no  reason  why  that  of  many  of  our  import- 
ant indigenous  ones  might  not  profitably  be  undertaken. 
With  few  exceptions,  the  demand  for  the  most  valuable  of 
them  is  supplied  from  those  districts  where  their  natural 
growth  is  most  plentiful ;  these  supplies  being  very  irregu- 
lar, the  rates  of  value  in  market  are  equally  so.  In  the 
case  of  the  peppermint,  and  of  some  few  others,  cultivation 
has  proved  exceedingly  profitable.  Why  not  supply,  by 
the  same  means,  the  demand  for  the  more  important  of 
indigenous  roots,  herbs,  seeds,  &c.,  for  which  demand,  we 
must,  in  a  measure,  thank  the  so-called  school  of  eclectic 
physicians  ? 


JEcUtorial  Department.  ,07 

Dr.  ZiNA  Pitcher,  of  our  city,  has  determined  to  take 
an  initiatory  step  in  this  direction,  by  establishing  a  bota- 
nical garden  in  the  grounds  of  the  U.  S.  Marine  Hospital 
at  this  place,  for  the  purpose  of  affording  an  agreeable 
occupation  for  the  convalescents  of  the  house,  and  more 
directly  to  afford  an  opportunity  to  all  who  are  interested, 
to  study  the  botanical  characteristics  of  that  portion  of  the 
rich  flora  of  our  State  considered  of  value  in  medicine.  At 
the  same  time,  it  is  intended  to  determine  the  practica- 
bility of  their  successful  cultivation  as  agricultural  products. 

The  Physician  and  Pharmaceutist,  while  confined  to  their 
duties,  may,  if  they  possess  any  taste  for  botany,  readily 
determine  for  themselves  the  practicability  of  cultivating 
home  or  foreign  medicinal  plants,  by  experiments  in  their 
ofiQces  and  stores,  upon  single  specimens  —  abundance  of 
which  may  be  found  at  one's  very  doors  —  the  care  of  which 
will  be  amply  rewarded  by  the  gradual  perfection  of  them 
from  small  beginnings,  affording  no  small  amount  of  pleasure 
and  intellectual  profit.  F.  S. 

langenbeck's  Tracheotomy  Hook. 

This  useful  little  instrument  consists  of  two  parallel 
teuacula :  one  of  which  is  firmly  fixed  into  a  handle ; 
the  other  is  attached  to  its  side  by  a  hinge,  and  is 
worked  either  by  a  lever  or  a  small  set  screw.  Pres- 
sure upon  the  lever  separates  the  points  of  the  tena- 
cula.  In  the  operation  of  tracheotomy,  the  trachea  being 
exposed,  and  the  points  of  the  tenacula  being  set  apart 
by  the  screw"-  at  a  distance  of  one -quarter  of  an  inch, 
the  instrument  is  firmly  inserted  into  the  trachea,  which 
is  thus  securely  held  while  the  surgeon  makes  the  neces- 
sary incision  into  that  organ,  between  the  two  tenacula. 
Pressure  upon  the  lever  now  separates  the  edges  of  the 
incision,   and   opens  wide   the  wound   in   the   trachea,  ad- 

Vol.  II. -Q. 


98  The  Peninsular  and  Independent. 

mitting  at  once  the  air,  and  facilitating "  the  introduction 
of  the  tube.  The  practical  surgeon  will  see  that  the 
instrument  can   be    used   in   many   other   operations. 

G. 


Suspension  of  tlic  Clinical  School  connected  with  the  Medical  De- 
partment of  the  University  of  Micblgau. 

With  the  sanction  of  the  members  of  the  Board  of 
Eegents,  the  undersigned  gives  notice  that  the  course  of 
instruction  in  practical  medicine,  hitherto  given  at  the  hos- 
pitals in  Detroit,  during  the  recess  of  the  term  for  didactic 
tuition,  will,  for  the  present  year,  be  suspended. 

There  is  reason  for  believing  that  this  suspension  will 
be  only  temporary :  that  the  cause  of  it  is  financial,  and 
that,  when  re-established,  it  will  be  placed  on  a  broader, 
more  substantial  and  enduring  basis. 

Z.   PITCHER, 

Clinical  Instructor. 

[We  are  requested  to  state,  in  connection  with  the 
above  notice,  that  Medical  Students  of  adequate  prepara- 
tion can  have  access  to  the  hospitals  during  the  summer, 
the  same  as  if  the  Clinical  School  was  not  suspended. 

F.  S.] 

The  Laryngoscope, 

The  object  of  this  instrument  is  to  expose,  by  re- 
flection, the  parts  about  the  mira  glotidis.  Small  metal- 
lic mirrors,  introduced  into  the  posterior  portion  of  the 
pharynx,  for  the  purpose  of  reflecting  the  image  of  the 
parts  to  be  inspected,  constitute  the  main  feature  of  the 
apparatus,  but  for  the  purpose  of  throwing  a  strong  lip-ht 
into  the  fauces,  a  concave  metallic  mirror,  through  which 
is   a  peep   hole,  is   fixed   to   the   surgeon's   forehead.     The 


Editorial  Department.  99 

surgeon,  now  placing  himself  before  his  patient  and  a 
strong  gas  light,  attempts  to  throw,  by  means  of  his  now 
brilliant  caput,  a  flood  of  light  down  the  patient's  throat, 
while  he,  at  the  same  time,  peeps  through  his  little  peep 
hole. 

Of  the  exact  amount  of  utility  embodied  in  this  ap- 
paratus we  will  attempt  no  estimate,  preferring  to  let 
others   pursue   infinitessimal   investigations.  G. 


Medical  ConTention  for  RcTising  the  Pharmacopceia  of  the  U.  S. 

The  Medical  Convention  for  Kevising  the  Pharmacopoeia, 
which  met  at  Washington  in  May,  1850,  provided  for  as- 
sembling a  Convention,  for  the  same  purpose,  in  the  year 
1860,  by  the  following  resolutions  : 

1st.  The  President  of  the  Convention  shall,  on  the  first  day  of  May, 
1859,  issue  a  notice  requesting  the  several  incorporated  State  Medical 
Societies,  the  incorporated  Medical  Colleges,  the  incorporated  Colleges  of 
Physicians  and  Surgeons,  and  the  incorporated  Colleges  of  Pharmacy, 
throughout  the  United '  States,  to  elect  a  number  of  delegates,  not  ex- 
ceeding three,  to  attend  a  general  Convention,  to  be  held  at  Washington^ 
on  the  first  Wednesday  in  May,  1860. 

2d.  The  several  incorporated  bodies,  thus  addressed,  shall  also  be 
requested  by  the  President  to  submit  the  Pharmacopoeia  to  a  careful 
revision,  and  to  transmit  the  result  of  their  labors,  through  their  dele- 
gates, or  through  any  other  channel,  to  the  next  Convention. 

3d.  The  several  Medical  and  Pharmaceutical  bodies  shall  be  further 
requested  to  transmit  to  the  President  of  this  Convention,  the  names  and 
residences  of  their  respective  delegates,  as  soon  as  they  shall  have  been 
appointed,  a  list  of  w^hom  shall  be  published,  under  his  authority,  for  the 
information  of  the  medical  public,  in  the  nevrspapers  and  medical  journals, 
in  the  month  of  March,  1860. 

In  accordance  with  the  above  resolutions,  the  under- 
signed hereby  requests  the  several  bodies  mentioned  to 
appoint  delegates,  not  exceeding  three  in  number,  to  re- 
present them  in  a  Convention  for  Ee vising  the  Pharma- 
copoeia of  the  United    States,  to  meet  at  Washington    on 


100  The  Peninsular  and  Independent, 

the  first  Wednesday  in  May,  1860  ;  and  would  also  call 
the  attention  of  these  bodies  to  the  second  and  third  re- 
solutions,   and    request    compliance    with    the    suggestions 

therein  contained. 

GEO.   B.  WOOD, 

President  of  the  Convention  of  1850. 
Philadelphia,  May  1st,  1859. 


[The  above  notice,  received  from  Prof  Geo.  B.  Wood, 
Philadelphia,  explains  itself  The  importance  of  the 
Decennial  Kevision  of  the  Pharmacopoeia  peculiarly  com- 
mends its  careful  attention  to  medical  corporations  and  as- 
sociations, delegates  for  which  will  legally  constitute  the 
Convention  to  meet  in  1860.  We  hope  that  the  influence 
of  those  medical  institutions  west  of  the  Alleganies  will 
be  more  apparent  in  the  sitting  of  1860  than  it  has  been 
hitherto.  F.  S.] 


SHut^lj  ^riiths,  g^bsttatts,  &t. 


Dr.  Lampe  on  Cases  of  Premature  Birth  Artifleially  Produced. 

Translated  from  the  German,  by  Dr,  O.  D.  Palmer,  from  the    "  Oesterreichiscke  Zeit^ 

ichriftfur  Praktische  HeilkundeP 


The  resort  to  art  for  the  purpose  of  procuring  premature  delivery,  is 
with  us,  in  the  country,  of  seldom  occurrence.  This  arises  partly,  be- 
cause the  physicians  themselves  can  hardly  justify  the  necessity  for 
dealing  in  flesh  and  blood,  and  ^partly  because  the  opposing  prejudice  of 
the  public  is  an  obstacle  difficult  to  overcome.  The  more  seldom  the 
occurrence,  so  much  the  more  urgent  is  the  duty  of  those  who  have 
witnessed  results  to  contribute  their  experience.  This  must  excuse  me 
for  requesting  for  a  short  time  the  honored  reader's  attention,  to  the 
relation  of  the  following  cases,  which  have  occurred  in  my  own  practice. 
Mrs.  M.,  aged  about  thirty  years,  of  middle  stature,  of  extraord- 
inary obesity,  has  borne  four  living  children  naturally,  and  has  had  one 
abortion.  In  each  of  the  four  births,  the  delivery  was  accomplished 
with  very  great  difficulty.  It  would  seem  from  the  remarkable  indica- 
tions in  her  case,  that  in  the  same  proportion  as  she  gains  in  corpulency 
(which  at  length  has  grown  to  deformity)  her  children  increase  in  rela^ 
tive  size  and  weight.  Thus,  though  the  fourth  child  was  born  alive 
after  unspeakable  suffering,  yet  with  the  fifth  she  was  subjected  to  an 
extremely  tedious  operation  with  the  forceps,  which  consumed  many 
hours,  as  well  as  my  own  strength  almost  to  perfect  exhaustion,  before 
she  was  delivered  of  a  dead  child.  The  child  had  the  unusual  weight 
of  eleven  pounds.  Previous  to  this  last,  and  consequent  to  an  abortion 
Mrs.  M.  had  underwent  a  severe  attack  of  MetrorrTiagia^  and,  later, 
following  the  delivery  by  the  forceps,  she  had  passed  through  an  ex 
tremely  dangerous  puerperal  process ;  so  that,  from  these  circumstances 
and  with  the  evident  increase  of  difficulty  at  each  succeeding  parturition 
she  had  become  very  fearful  of  any  new  pregnancy.  Therefore,  in  view 
of  the  very  great  dangers  to  which  the  mother  might  be  subjected  at 
he  next  time,  the  very  natural  requisition  was  made  upon  me  to  furnish 


102  The  Peninsular  and  Independent. 

some  means  by  which  the  anticipated  difficulty  could  be  prevented, 
promised,  at  the  next  pregnancy,  that  I  would  procure  an  artificial  pre- 
mature delivery,  to  which  resort  I  felt  perfectly  entitled,  after  having 
myself  witnessed  the  antecedents.  The  ominous  pregnancy  was  made 
manifest  in  1845,  and  I  resolved,  at  a  suitable  period,  to  institute  the 
means  for  a  premature  labor.  I  selected  for  this  purpose  the  thirty- 
sixth  week  of  gestation.  There  were,  at  that  time,  besides  rupturing  the 
membranes,  the  Brunhaussen  "Method"  of  Klag,  which  consisted  in- 
troducing compressed  sjmnge  into  the  os  uteri^  as  the  safest;  and 
Schcellek's  method,  of  tamponing  the  vagina^  as  the  most  simple  and 
least  injurious  known.  I  made  use  of  both  at  the  same  time.  As  an 
introduction,  a  warm  bath  was  first  prepared,  and  borax  given  at  long 
intervals,  whilst  I  placed  in  the  vagina  a  tampon  made  of  pieces  of 
soft  linen,  and  used  in  such  a  manner  as  to  exercise  a  moderate  pres- 
sure on  the  vaginal  walls.  Thence  arose  sickness  of  stomach,  great 
restlessness,  and  a  sensation  of  uneasiness,  generally.  Whilst  the  tam- 
pon was  removed  for  the  purpose  of  changing,  I  applied  a  local  vapor- 
bath.  Shortly  after  distinct  pains  were  perceived,  but  very  irregularly. 
After  repeating  the  tampon  three  times,  these  came  on,  during  the 
evening  of  the  second  day,  stronger  pains,  and  the  os  uteri  was  dilated 
to  the  extent  of  one  inch  in  diameter.  At  this  time,  I  introduced  into 
the  open  mouth  of  the  womb,  a  piece  of  pressed  sponge,  made  in  form 
of  a  cone  for  the  purpose,  and  retained  it  there,  by  means  of  the  tam- 
pon, for  twenty-four  hours.  On  removing  it,  and  after  a  few  moderate 
pains,  the  membranes  were  spontaneously  ruptufed,  and  a  small  quantity 
of  the  waters  discharged.  I  now  put  all  in  readiness,  since  generally 
from  that  decisive  moment,  to  which  labor  had  been  brought  by  art, 
no  stand-still  was  longer  to  be  apprehended,  and  haste  was  not  neces- 
sary; on  the  other  hand,  the  patient  was  already  in  a  pretty  excitable 
state,  and  with  the  tumefaction,  and  great  sensibility  of  the  soft  parts, 
even  a  local  vapor  bath  would  not  be  sufferable. 

It  was  not  until  the  fifth  night  that  regular  bearing -down  labor 
pains  were  perfectly  established,  and  about  four  o'clock  in  the  morning 
the  spontaneous  birth  of  a  well  formed,  lively,  living  child  followed, 
coming  to  the  world  by  the  head  presentation.  The  placenta,  on  account 
of  a  partial  adhesion,  and  violent  flooding,  had  to  be  removed  by  the 
introduction  of  the  hand,  and  detaching.  The  patient  was  put  to  bed 
greatly  exhausted ;  her  recovery  very  slow  and  tedious,  and  after  a 
lingering  time  of  several  weeks,  she  still  had  to  undergo  an  attack  of 
pJdegmatia  alba.  The  child,  which  had  the  size  and  appearance  pro- 
portionate to  its  eight  months'  growth,  was  badly  affected  with  icterus^ 
on  which  diarrhcea  supervened,  and  could  only  be  properly  attended  to 
by  the  employment  of  a  nurse,  against  which  arrangement  the  heartlesa 
mother  was  at  first  strongly  opposed. 


Selected  Articles^  Abstracts^  <&c.  103 

I  confess  that  this  case,  from  the  obstinate  delay  of  the  uterus  in 
assuming  a  state  of  activity ;  from  the  extremely  lingering  course,  and 
long  duration;  from  the  many  disagreeable,  nay  highly  threatening 
symptoms,  and  the  unfavorable  accouchement  of  the  lying  -  in  woman, 
affords  anything  but  encouragement  to  a  repetition  of  this  method. 

Very  happily  for  me,  the  next  cases  demanding  interference,  for  the 
purpose  of  anticipating  the  period  in  which  parturition  is  usually  ac- 
complished, happened  just  at  the  time  when  Kiwisch  had  brought  into- 
vogue  the  warm  Uterine  douche.  It  had  been  generally  received,  and 
successfully  applied.  '  I  treated  two  cases  according  to  this  method.  The 
occasion  in  each  case,  was  contraction  of  the  pelvis  —  the  period,  the 
eighth  month.  As  the  two  cases  were  very  analogous  in  their  courses, 
and  afforded  nothing  of  particular  interest,  it  is  sufficient  to  state  that 
the  daily  application  of  the  '■'■uterus  douche^''''  repeated  four  times  in  a 
day,  and  continued  ten  minutes  each  time,  with  water  at  a  temperature 
of  30°  Reau.  (100"  Fahr.)  produced  labor,  followed  by  delivery  on  the 
second  day  spontaneously,  without  very  considerable  reaction,  —  both 
children  coming  to  the  world  alive,  and  fresh,  and  continued  living;  the 
mothers  both  passing  through  their  lying  -in  period  without  accident. 
By  the  favorable  results  in  these  two  cases,  I  had  acquired  confidence 
in  the  method  indicat'^d  above. 

This  method  had  been  generally  adopted,  but  it  could  not  fully 
maintain  its  famed  pretentions  to  precedence,  and,  as  was  to  be  ex- 
pected, new  methods  arose,  with  the  hope  of  supplanting  this  one,  or 
of  being  included  in  the  same  bounds  of  permanency  with  it.  These 
are  the  one  of  Cohen,  and  the  two  of  Scanzoni.  I  had  an  oppor* 
tunity  to  use  the  first  mentioned  during  the  present  year,  to  treat 
the  following  case,  which  I  take  this  occasion  to  report  somewhat  in 
detail : 

Madam  H.,  about  thirty -five  years  of  age,  of  small  stature,  but 
without  other  striking  symptoms  of  a  rachitic  habit,  was  delivered  by 
me  two  years  since,  in  a  normal  pregnancy,  by  perforating  the  cra- 
*nium  of  the  foetus.  Previous  to  my  resorting  to  this  means  she  had 
continued  in  labor  two  days  —  the  last  twenty -four  hours  was  after 
the  discharge  of  the  liquor  amnii ;  and,  according  to  the  testimony 
of  two  colleagues  who  had  preceded  me  in  the  case,  the  head  had 
been  wedged  in  the  pelvis  ten  hours  immovably.  On  a  searching 
examination  of  the  pelvis  I  ascertained  that,  though  perfectly  symme- 
trical in  form,  the  conjugate  diameter  was  but  three  inches.  The 
contraction  of  the  pelvis  in  its  most  important  diameter  was  increased 
still  more  by  the  inward  projection  of  the  superior  rim  of  the  pubic 
bones.  As  Mrs.  H.  found  herself  again  in  a  state  of  pregnancy,  in 
1856,  I  earnestly  represented  to  her  that,  if  she  wished  the  happi, 
ness  of  bringing  to  the  world  a  living  child,  it  could  be  accomplished 


104  The  Peninsular  and  Independent. 

only  by  means  of  a  premature  birth,  and  that  she  herself  could  only 
thereby  be  protected  from  the  mischances  of  a  difficult  delivery.  She 
assented  with  joy.  Her  gestation  proceeded  without  any  material  acci- 
dent in  its  normal  course,  and  the  only  thing  to  be  considered  was 
the  particular  point  of  time  when  the  accouchement  should  be  brought 
about.  Her  last  menstruation  took  place  about  the  middle  of  Octo- 
ber, 1856;  the  first  movement  of  a  quickening  was  perceived  in  the 
first  days  of  March,  1857.  I  therefore  selected  the  second  week  of 
June,  as  being  as  near  as  might  be,  the  thirty -second  week  of  ges- 
ation,  in  which  to  induct  premature  labor.  This  early  date  was  chosen 
as,  in  accomplishing  her  last  delivery  by  perforation  I  had  made  myself 
acquainted  with  the  whole  difficulty.  I  had  ascertained,  by  the  de- 
velopments of  a  child  of  medium  size,  whose  birth  had  been  opposed 
by  the  circumstances  already  related,  that  not  only  the  symphasis, 
but  the  whole  anterior  circle  of  the  pubes,  by  projecting  inwards 
Btrongl}'',  and  by  being  less  concave  than  usual,  had  narrowed  down 
the  entrance   of  the   pelvis. 

The  method  put  in  use  by  me  was  that  of  Cohen  modified.  On 
the  first  day,  I  applied  twice,  the  warm  uterus  douche^  continued  five 
minutes  each  time,  and  as  there  was  no  danger  in  delay,  I  awaited 
in  order  to  have  the  advantage  of  the  natural  'preparation  of  the  parts 
implicated  in  labor.  Following  the  repeated  application  of  the  douche, 
a  light  contraction  of  the  womb,  and  a  peculiar  seizing  of  the  im- 
pregnated female  with  a  sensation  of  lassitude,  was  perceptible.  On 
the  third  day  I  made  the  first  injections  into  the  uterus.  An  elastic 
catheter,  without  stylet,  was  put  in  use,  which  1  carefully  introduced 
through  the  orifice,  and  conducted  along  tho  inner  walls,  perhaps  three 
inches  high,  and  about  three  ounces  of  water  at  30"  Reaumer  was 
injected  through  it,  and  the  catheter  immediately  withdrawn.  A  small 
part  of  the  injected  water  flowed  away  directly,  and  in  the  second  hour 
thereafter  decided  pains  were  manifest,  returning  at  uniform  but  tolerably 
long  intervals.  After  the  second  injections,  made  half  a  day  later, 
the  pains  returned  at  shorter  intervals,  thus  deciding  their  character 
to  be  genuine  regular  labor  throes.  They  acted  so  forcibl}',  that  five 
hours  after,  in  a  regular  progress,  the  waters  were  discharged,  the 
birth  of  the  child  following  in  three  more  hours,  by  the  head  pre- 
sentation. The  whole  course  of  the  labor  was  so  regular,  that  it  was 
distinguished  by  no  indication  from  a  normal,  spontaneous,  labor,  at 
the  full  period  of  gestation.  The  child  exhibited  lively  action,  and 
cried  with  a  full  voice.  It  showed  the  size  and  developments  of  a  seven 
months'  child,  but  was  much  weaker  than  we  had  expected  it  to  be- 
The  parturient  esteemed  herself  even  happy,  in  comparison  with  her 
state  at  the  birth  of  the  first  child.  Then,  she  suffered  such  excru- 
tiation  and  martyrdom,  for  such  a  mournful  result:  now  her  labor  had 


Selected  Articles^  Abstracts^  dbc.  105 

been  so  easy,  and  so  soon  over,  affording  her  already  the  foretaste 
of  a  mother's  joys.  The  placenta  came  away  of  itself  in  about  ten 
minutes.  Her  accouchement  was  passed  over,  and  her  lying-in  ac- 
complished, without  the  least  thing  to  disturb  it.  She  left  her  bed 
on  the  tenth  day,  and  found  herself  impregnated  again  in  the  course 
of  a  few  weeks.  The  child  was  put  to  the  breast  of  a  wet-nurse, 
but  apparently,  in  spite  of  the  best  attention,  it  grew  so  little,  that 
I  soon  doubted  its  coming  through.  It  notwithstanding  reached  the 
age  of  nearly  five  months,  and  died  of  atrophy  without  an  attack  of 
any   disease. 

Though,  in  consideration  of  the  above  detailed  grounds,  I  can  not 
reproach  myself  with  having  chosen  a  too  early  point  of  time  in  which 
to  induce  labor,  yet  the  desired  result,  with  its  remote  consequence, 
and  the  knowledge  acquired  by  witnessing  the  course  of  the  last  par- 
turition, in  regard  to  the  relative  dimensions  of  the  pelvis  compared 
with  the  size  of  the  cliild,  in  this  individual  case,  are  very  suitable 
to  assist,  in  the  appointment  of  that  precise  point  of  time  at  a  future 
period.  This  is  a  question  the  decision  of  which  is  to  exert  an  in- 
fluence on  the  happiness  of  future  results,  in  all  time.  The  scale  pro- 
posed by  Stolz,  KiwiscH,  and  others,  for  the  purpose  of  determining 
the  time  for  inducing  premature  labor,  agreeable  to  the  relative  mea- 
surements of  the  head  and  pelvis,  is  certainly  not  proper  to  guard 
against  accidents.  It  appears  plausible  enough  in  theory,  but  is  so 
little  valuable  in  practice  that  at  every  elaborated  case  the  mocking 
voice  of  fame  echoes  in  the  ears  hie  Rhodus  —  hie  salta!  As  there  are 
generally,  in  the  minute  measurements  of  midwifery,  calculations  made 
for  particular  exceptions,  in  viv^,  and  as,  for  example,  one  tug  at  the 
forceps,  with  experienced  hands,  tells  more  a  thousand  times  than  the 
most  ingenious  pelvimetre  and  kephalometre  can  ever  tell,  so  it  is  in 
this  case  also ;  nothing  but  the  most  judicious  weighing  of  every  pos- 
sible influence  that  can  have  a  bearing,  at  the  moment  will  protect 
against  fatal   accidents,    though   never   wholly   insure   against   them. 

I  know  full  well  that  one  case  only  is  insufficient  to  furnish  data 
from  which  an  unprejudiced  opinion  can  be  pronounced  on  any  new 
process  in  the  practice  of  midwifery,  but  when  I  reflect  how  widely 
different  was  the  parturient  course  in  the  last  detailed  case  from  the 
one  that  immediately  preceded  it,  with  what  regularity  and  how  per- 
fectly analagous  to  the  spontaneous  and  timely  birth,  I  can  not  for- 
bear to  render  my  verdict  unconditionally  in  favor  of  the  method  of 
Cohen.  There  can  be  no  method  given  for  those  partially  experienced 
that  is  more  simple  —  none  more  easily  practiced,  or  more  little  dan- 
gerous than  this ;  and,  according  to  the  experience  hithtrto  collected 
( the  whole  number  of  cases  in  which  premature  birth  has  been  ef- 
fected by   Cohen's   method,   according    to  his   estimate,   rates  from  70 


106  Tlie  Peninsular  and  Independent. 

to  80),  there  is  none  that  exceeds  it  in  safety.  In  the  expression 
"little  dangerous"  there  should  not  be  associa|:ed  an  idea  of  total  want 
of  danger  in  the  process  of  procuring  premature  birth.  In  regard  to 
danger:  in  every  method  ever  discovered,  or  that  is  likely  ever  to  be 
discovered,  cavilers  can  point  to  unfavorable  cases.  Whoever  observes, 
with  impartial  eyes,  the  process  of  parturition  as  enforced  by  art,  and 
compares  it  with  the  natural  process,  the  difference  between  the  two  will 
not  escape  his  view.  In  the  former,  when  the  storm  of  reaction  com- 
mences, be  it  ever  so  mildly,  it  may  still,  in  comparison  with  the  natural 
action,  be  named  a. storm ;  and  there  is  a  time  when  any  one  predisposed  to 
deal  in  charms  would  willingly  invoke  a  power  to  banish  the  pain  -  spirits 
did  he  but  understand  the  magic  formulae  of  command.  Would  it  not  be 
wrong,  therefore,  if  the  operations  for  artificial  birth  were  undertaken  in  a 
dare-devil  manner,  at  least  with  the  same  indifference  that  many  Gyna- 
colleagues  (sage-femmes?)  make  incision  into  the  os  uteri,  as  a  masterly 
stroke  of  art  for  the  cure  of  sterility.  I  wished,  in  using  the  expression 
"little  dangerous  method,"  to  have  said  only  that  the  method,  when 
put  in  use  according  to  Cohen's  project,  with  necessary  care,  contains 
nothing  that  can  involve  directly  in  its  train,  dangerous  consequences. 
I  might  rather  have  recommended  the  uniform  use  of  flexible  tubes  instead 
of  the  tin  and  bone  ones  mentioned  by  Cohen,  a  modification  which 
Cohen  himself  has  proposed,  as  a  protection  against  the  danger  of  a 
false  passage  (i.  e.  between  the  decidua  and  uterus),  and  which  he 
recommended  on  a  more  recent  occasion,  when  Prof.  Grenser  and  Dr. 
Jack  communicated  to  him  the  unfortunate  cases  published  by  an 
over  precise  critic  {S.  MonatscKrift  fur  Geburtskunde,  Berlin,  1857). 
These  reported  cases,  in  my  view,  'are  as  little  attributable  to  the 
method,  as  many  unfavorable  accidents  in  the  various  obstetric  mani- 
pulations, even  when  they  are  carried  out  according  to  the  letter  of 
the  law,  if  are  neglected,  the  necessary  foresight  and  patience,  and, 
instead  of  these,  haste  and  violence  prevail.  The  adage,  '■'■Duo  si 
faciunt  idem,  non  est  idem,  suits  nowhere  better  than  here.  Nowhere 
depends  so  much  upon  the  Tiow  the  application  is  made,  as  in  obstetrical 
science ;  where,  for  the  most  part,  the  consequences  are  irreparable,  and 
even  the  "detail -consequences,"  as  evidences  of  irremediable  injury, 
proceed  as  much  from  the  sins  of  commission  as  of  omission. 


Selected  Articles^  Abstracts^  dbc.  IG"? 


Abstracts  ard  Seleciions  from  late  Medical  Journals. 


Prepared  for  the  Peninsular  and  Independent  Medical  Journal, 
By  M.  A.  Patterson,  M.  D.,  Tecumseh. 


DIPHTHERIA. 

In  England,  Diphtheria  has  become  a  common  household  word  of  fear- 
ful import.  It  is  the  name  of  a  disease  which  has  prevailed  within  that 
kingdom  during  the  last  two  or  three  years  with  great  severity,  affect- 
ing children  mostly,  though  in  some  localities  it  has  swept  away  whole 
families. 

In  addition  to  former  lengthy  descriptions  of  this  epidemic,  spread 
through  the  European  Medical  Periodicals,  we  have  before  us  thirteen 
of  the  large  pages  of  the  last  London  Lancet,  devoted  to  the  considera- 
tion of  this  "mysterious  malady." 

From  these  voluminous  details  we  learn  that  our  trans-x\tlantic 
brethren  have  expressed  very  different  views  respecting  its  nature  and 
origin.  The  vexed  questions  appear  to  be — Whether  the  disease  is  of 
domestic  origin,  or  an  importation  from  France  of  the  veritable  "diph- 
therite,"  originally  described  by  Bretonneau;  whether  it  is  allied  to  the 
epidemic  croupy  throat  affections  which  at  different  times  have  appeared 
in  widely  separated  districts  of  the  American  continent,  or  an  anomalous 
malignant  variety  of  common  sore  throat,  croup,  scarlatina  or  erysipelas, 
homonymous  in  form,  from  interchange  of  types ;  whether  it  is  of  para- 
sitic origin,  the  produce  of  the  fungus  ovidum  albicans,  as  gravely  an- 
nounced by  Prof  Laycock,  or  whether  the  parasitical  adherents  noticed 
by  the  learned  Professor  and  others  were  incidentally  attached  as  the 
disease  progressed,  and  not  the  originators  of  the  mischief;  whether  it 
is  contagious  or  non-contagious;  and,  lastly,  whether  this  is  the  first 
time  the  epidemic  has  visited  England,  or  whether  it  is  not,  in  reality, 
a  disease  described  Ijy  some  of  the  old  writers  as  prevalent  in  Britain 
years  ago,  again  revived  and  slightly  modified  by  existing  atmospheric 
influences. 

As  near  as  we  can  learn  from  the  documents  referred  to,  these^ 
questions  are  not  fully  settled.  The  weight  of  testimony,  however,  is 
decidedly  opposed  to  the  ovidium  albicans  theory  ;  and  the  most  reliable 
authorities  agree  that  the  English  "diphtheria"  and  the  continental  or 
French  "diphtherite"  are  essentially  similar;  and  from  the  brief  des- 
criptions of  peculiar  epidemic  throat  affections  given  by  some  of  our  old 
physicians,  commencing  with  the  epidemic  of  1771,  described  by  Dr. 
Bard,  together  with  the  recent  testimony  of  Dr.  Campbell,  the  intelli- 
gent Editor  of  the  Georgia  Southern  Medical  and,  Surgical  Journal,  there 
are  good  grounds  for  concluding  that  similar  epidemics  have  been  observed 
from  a  somewhat  remote  period,    in  the   United  States.      Should  thia 


108  The  Peninsular  and  Independent. 

conclusion  be  sustained  by  the  Profession  of  our  country,  it  will 
strengthen  the  apprehensions  already  expressed,  that  this  dangerous 
malady  may  again — perhaps  soon — invade  our  land  and  visit  our  own 
households.  In  this  view,  the  subject  assumes  an  aspect  of  importance 
beyond  its  mere  connection  with  the  literature  of  our  science.  There 
is  a  striking  uniformity  in  the  symptoms  of  the  disease,  as  described 
by  the  French  and  English  writers,  and,  according  to  Dr.  Campbell, 
the  cases  observed  by  him  in  Georgia,  in  1848,  presented  the  same 
peculiar  and  unmistakable  features.  Dr.  R.  J.  Foukgueaud  accurately 
describes  this  disease  in  the  Pacific  Medical  and  Surgical  Journal^  as 
it  prevailed  in  ihe  valley  of  Sonora,  California,  in  1856;  and  Dr.  Wil- 
LAKD,  in  the  Medical  and  Surgical  Reporter^  states  that  cases  of  true 
diphtherite,  of  a  most  fatal  character,  have  recently  been  noticed  in 
Albany,  New  York. 

Diphtheria  expends  its  force  upon  the  fauces  and  upper  respiratory 
tract,  producing  what,  in  intelligible  English,  is  called  "membranous 
sore  throat."  In  dangerous  cases  the  rapidity  with  which  false  mem- 
brane is  secreted,  and  spread  on  the  lips,  fauces,  and  upper  respiratory 
tract,  as  far  even  as  the  large  bronchial  tubes,  distinguishes  the  disease 
from  all  other  maladies.  It  may  prevail  in  a  sporadic,  endemic,  or  in 
a  wide -spread  epidemic  form;  but,  unlike  croup,  in  either  case,  the 
earliest  local  symptoms  and  first  deposit  of  false  membrane  appears 
above  the  windpipe.      Speaking  of  the  symptoms,  Dr.  Rankin  says : 

"  Sometimes  the  tonsils,  soft  palate,  and  uvula  are  seen  to  be  simply 
red:  and,  on  a  casual  view,  nothing  more  would  be  noticed.  But  even  in 
a  few  hours  after  the  first  feeling  of  uneasiness  a  more  careful  examination 
will  disclose  one  or  more  white  patches  on  the  tonsil,  not  larger,  perhaps, 
than  a  split  pea,  but  enough  to  warn  any  one  who  has  previously  seen  the 
disease  that  he  has  to  arm  himself  for  a  conHict  which  the  inexpeiienced 
would  scarcely  anticipate.  This  apparently  insignificant  patch  (oi-  patches) 
is,  in  fact,  the  diagnostic  sign  of  the  disease,  and,  unless  checked  speedily 
by  appropiiate  treatment,  is  destined  to  spread  over  the  whole  soft  palate, 
and  too  often  to  invade,  with  fatal  effect,  the  trachea  and  larger  bronchial 
tubes. 

'*In  a  certain  proportion  of  cases  we  are  warned  by  increased  difiBculty 
of  breathing,  attended  with  a  peculiar  croupy  sound^  that  the  diphtheritic 
me7nhr'ane  has  spread  to  the  larynx  and  trachea,  producing  a  state  of  things 
which  may  be  regarded  as  almost  inevitably  fatal." 

We  have  no  space  for  descriptions  of  the  treatment  pursued  by  the 
foreign  physicians,  and  can  only  add,  that  Dr.  Campbell  found  the  local 
application  of  powdered  alum  and  internal  use  of  quinine  "almost  spe- 
cific", in  his  cases  of  "  diphtheritis." 


Selected  Articles^  Abstracts,  dc.  io& 


"ON   THE    MANAGEMENT    OF  THE  SHOULDERS   IN  EXAMINATIONS    OF 
THE    CHEST." 

Dp.  John  W.  Couson,  late  Physician  to  Brooklyn  City  Plospita),  &c.,  has 
published,  in  the  JST.  Y.  Journal  of  Medicine,  ViYsdusihle  article  on  the  above 
subject.  His  rules  appear  to  us  of  much  importance,  especially  as  aids  for 
detecting  the  incipient  signs  of  consumption. 

In  the  ordinary  modes  of  exploration^  the  sounds  at  tops  of  the  lunga 
are  so  frequently  muffled  as  to  greatly  embarrass  our  diagnosis.  Any  ra- 
tional measures,  therefore,  proposed  to  assist  us  in  discovering  early  phy- 
sical signs  of  this  insidous  disease  are  entitled  to  consideration. 

The  proper  management  of  the  shoulders  can  not  be  mistaken  by  at- 
tention to  the  following  Summary : 

1.  That  remembering  the  great  value  of  many  reputed  "little  things," 
in  the  science  of  saving  life ;  and  that  the  chests  of  lean  persons  give 
clearest  sounds,  and  are  best  marked — we  may  seize  this  hint  fiom  nature, 
and  increase  the  "physical  signs,"  by  either  lessening  or  removing  more 
especially  those  principal  natural  obstacles,  the  great  pectorals  in  front,  and 
the  two  scapulae  and  their  muscles  behind. 

2.  This  may  be  effected  by  using  the  arms  as  levers,  and  the  hands  as: 
hooks  to  pull.  The  process,  in  each  case,  involves  three  principles — thin^ 
ninff,  condensing,  and  tightening.  It  is  illustrated  by  the  simple  experi.- 
ment  of  placing  one  forearm  of  a  muscular  man  behind  his  back,  while 
the  other  hangs  loosely  by  his  side,  when  the  sound,  especially  of  percus- 
Fion,  will  be  found  heightened  below  the  clavicle  of  the  stretched  side  in 
front. 

3.  That  the  suggestions  here  offered  are  not  fanciful  theories,  but  the 
results  of  practical  observations  on  several  hundred  patients  in  private, 
and  in  two  large  Dispensaries,  during  the  past  year.  The  drawings,  too 
were  copied  from  nature.  To  throw  back  the  shoulders  and  bare  ihewholo 
front,  we  need  the  ^^ first  position^  It  is  a  repetition  of  the  above  expe- 
riment with  hothvLvm^.  The  left  wrist  is  simply  held  easily  with  the  right 
hand  behind  the  loins.  This  has  many  little  advantages  in  obscure  cases. 
It  gives  symmetry,  gets  rid  of  the  arms,  and  fits  the  coat  of  flesh  closely, 
like  a  bandage,  for  "  inspection,"  makes  it  tense  to  increase  the  resonance 
of  delicate  percussion,  and  conducts  better  the  sounds  within.  It  thus  aids 
in  distinguishing  the  more  difficult  cases  of  tubercles,  pleurisy,  pneumonia, 
or  aneurism. 

4.  That  the  ^'second  position''^  is  the  common  one  of  locking  the 
hands  over  the  head  to  examine  the  axillae,  and  is  mentioned  to  avoid 
omission.  The  ^' third  position*^  crosses  the  arms  at  the  back  of  the  head, 
with  the  hands  grasping  near  the  elbows,  so  as  to  hoist  the  shoulder  blades 
high  up  behind,  and  thin  the  muscles,  to  search  for  obscure  or  limited 
pleurisy  or  pneumonia  low  down  near  the  diaphragm  posteriorly. 

5.  It  is  very  important  early,  in  suspicious  cases  of  cough,  to  examine 
carefully  the  tops  of  the  Ivngs  behind.  For  without  any  distinct  signs  in 
front,  consumption,  often  thus  mistaken  for  a  mere  throat  affection,  begins 
here.  A  few  scattered  tubercles  are  apt  to  hurrow,  as  it  were,  beneath  the 
top  of  the  shoulder.  Here  we  need  the  '''fourth  position.''''  For  this  the  pa- 
tient crosses  arms  in  front,  slightly  stooping,  hoohs  the  handsat  the  loins,or 
false  ribs,  and  then  stretching  upward  he  holds  fast  to  increase  the  tension. 
The  physician  aids  from  behind,  by  pressing  down  firmly  the  shoulders. 


110  The  Peninsular  and  Independent. 

They  are  thus  did  ojf,  the  muscles  are  smoothed  dou'n,  and  the  ear,  com- 
ing closer  upon  the  top  of  the  lung,  hears  better  the  sounds. 

6.  As  worth  more  than  all  the  rest,  we  commend  the  ^'Jifth  'position^'* 
for  by  natural  machinery  it  wrenches  the  shoulders  forward  out  of  their 
heds^  and  widely  severs  them  in  the  rear.  In  thin  persons  it  often  thus 
stretches  out  their  intervening  muscles  till,  like  stout  broadcloth,  it  thus 
quite  uncovers  the  inner  and  upper  part  of  the  lungs  behind.  To  accom- 
plish this  the  patient  crosses  arms  in  front,  with  the  stronger  outside, 
grasps  with  the  opposite  hands  the  two  shoulder  joints,  pulls  both  strongly, 
and  holds  fast  to  keep  them  tense.  The  ph3^sician  aids  to  fix  the  shoulder 
blades  widely  apartat  the  back  by  firmly  pushing.  Even  in  health,  as  any 
one  can  prove,  the  soft  breathing  murmur  attheformer  place  of  the  scapula 
can  be  thus  nearly  doubled.  In  tubercles  it  here  opens  a  new  field  for  j^a^ 
^aiz6>?i,  and  especially  {or  percussion.  It  intensifies  harsh  respiration,  or 
"  fatty  crackling."  In  pneumonia,  it  exaggerates  the  clear,  barrel-like 
echo  of  ''  bronchophony,"  and  in  pleurisy  that  line  between  wind  and  wa- 
ter, the  trembling  "  egophony."  It  brings  out  a  delicate  7?6?c  sign,  we  have 
discovered,  in  bronchitis.  It  is  a  kind  of  prolonged  liquid  breathing,  as  if 
through  a  layer  of  wet  sponge,  heard  before  or  after  mucous  rales,  which 
we  venture  to  name  moist  respiration. 

7.  Another  new  and  really  useful  "  physical  sign  "  we  have  to  commu- 
nicate, is  the  comparative  stiffness  of  the  shoulder  over  the  lung  most  dis- 
eased, in  strong  breathing,  seen  and  felt  from  behind.  For  this  we  may  use 
the  ^^  sixth  position.'*''  Facing  the  back  of  patient,  a  yard  distant,  near  a 
window  or  white  wall,  you  tell  him  to  drop  his  arras,  let  them  hang  easily 
by  the  sides,  "as  if  dead,"  and  then  breathe  deeply  for  a  few  moments, 
"like  a  man  a  little  out  of  breath."  You  then  *^'take  aim,"  like  a  rifleman, 
across  the  tops  of  the  shoulders,  and  then  shut  your  eyes  and  feel  them 
gently  swell.  Drawing  nearer  you  notice  that  the  "  inferior  angles"  of  the 
scapulae  move  gently  in  breathing  like  the  fins  of  a  fish.  You  can  both  see 
2kX\i\feel  this  movement.  The  stiffness  of  the  shoulder  in  breathing  may  be 
decided,  or  slight,  local,  or  general.  When  most  at  the  top,  we  term  it,  for 
convenience,  "  acomial,"  and  when  most  at  the  lower  extremity,  or  inferior 
angle,  we  call  it  "angular."  Curiously  enough,  these  last  features  seem 
to  depend  on  the  higher  or  lower  location  of  the  disease  which  thus,  as  it 
were,  paralyzes  theparfs  nearest.  An  elegant  way  of  testing  "angular  stiff- 
ness," even  in  a  lady  fully  clad,  is  to  place  your  two  index  fingers  on  the 
lower  points  of  her  shoulder  blades,  and  watch  and  feel  their  movement  as 
she  sighs.  The  causes  of  this  stiffness  are  supposed  to  be  loss  of  upward 
expansion  in  the  lung,  tenderness,  pleuritic  adhesions,  and  weight  of  morbid 
deposits.  A  table  of  eighteen  cases  is  added,  illustrative  of  this  sign.  It 
was  least  in  recent  attacks ;  varied  most  in  phthisis ;  was  slightest  in  pneu- 
monia, and  greatest  in  chronic  pleurisy. 

8.  A  statement  of  measurements  of  ten  males,  shows  the  gain  in  inches 
and  decimals,  by  "third,"  "fourth,"  or  "fifth,"  positions  respectively, 
between  the  inferior  angles  of  the  scapula  and  the  lowest  lumbar  vertebra : 
the  "  superior  angles  "  and  the  vertebra  prominens  of  the  neck  and  between 
the  two  upper  and  the  two  lower  angles  of  the  scapula.  Of  the  whole  of 
the  six  positions,  the  first,  ionvth,  fifth,  and  sixth  are  the  most  frequently 
useful.  The  others  apply  to  particular  cases.  Taking  into  account  the 
pulmonary  complications  of  other  diseases  as  well  as  the  range  of  "  chest 
disease,"  it  is  believed  these  various  improvements,  slight  as  they  seem  in 
detail,  really  throw  light,  perhaps,   upon  many  forms  of  one-third  of  the 

fatal  maladies  of  the  race. 

9.  On  account  of  its  fearful  importance,  it  is  hoped  they  will  mainly 


Selected  Articles^  Abstracts^  cbc.  111 

benefit  tubercular  consumption.  Tracing,  faitbfally  by  various  "  marks," 
and  the  unhealthy  habits  of  the  patient,  the  agencies  leading  to  the  two 
prevailing  causes, y^eS/e  organization  2iX\di  depraved  nutrition — by  prompt 
reform  of  abuses,  generous  animal food^  and  free  exercise  in  the  open  air^ 
with  tonics  and  cod-liver  oil — we  may  do  much  to  arrest  the  disease.  Oc- 
casionally we  maij  cure.  The  encouraging  researches  of  Hughes  Bennett, 
and  Messrs.  Rogee  and  Boudet  show  that  from  the  numerous  chalky  con- 
cretions, puckerings,  and  cicatrices  found  at  the  tops  of  the  lungs  in  very 
aged  persons,  it  is  probable  that  about  one-half  have  recovered  from  more  or 
less  tubercular  deposits  during  their  lives.  Four  living  cases,  from  several 
others,  are  reported  by  the  writer,  of  arrest  or  cure  of  phthisis  of  several, 
years'  standing.  The  great  question  of  this  paper  then  is,  What  may  he 
the  result  of  average  notice^  say  thre4  months  sooner  J  Time  only  can  tell. 
Each  physician  who  reads  this  is  earnestly  requested  to  aid  by  a  faithful 
trial  of  this  system  of  examinations  in  at  least  three  suitable  cases.  The 
malady  is  still  widely  and  deplorably  fatal.  From  extensive  trial,  we  firmly 
believe  that,  simple  as  they  may  seem,  this  management  of  the  shoulders^ 
these  expedients  for  thinning^  condensing.,  and  tightening  the  fleshy  walls  of 
the  chesty  add  fully  one-third  to  our  power  of  detecting  the  earliest  signs  of 
consumption. 


ORTORRHCEA  AND  ARTIFICIAL  TYMPANUMS. 

In  the  April  No.  of  the  American  Medical  Monthly,  we  notice  some 
judicious  remarks  on  these  subjects,  by  Dr.  J.  Henry  Clark. 

Muco- purulent  discharges  from  the  ears  may  be  generally  and  sea- 
sonably arrested  by  proper  early  treatment,  and  the  prospect  of  a  life -long, 
loathsome  disease,  with  partial  or  total  deafness,  prevented.  The  following 
remarks  are  sensible,  and  to  the  point : 

*'  If  the  ear  received  the  same  watchful  attention  during  an  attack  of 
scarlatina,  and  subsequently,  a  smaller  number  of  children  would  be  per- 
manently deaf;  and  if  the  cases  were  followed  up  by  the  treatment  of  the 
anaemic  condition  that  frequently  ensues,  fewer  tympanums  would  be  de- 
sti'oyed.  The  worst  cases  of  scarlatina  occur  in  scrofulous  subjects,  in 
which  measures  termed  anti- phlogistic  would  be  inadmissible.  The 
prompt  administration  of  tonics  and  anti  -  scrofulous  remedies,  with  due 
regard  to  the  condition  of  the  bowels,  with  counter  -  irritation  behind  the 
ears,  will  generally  prevent  mischief. 

"  Some  physicians  discourage  the  treatment  of  the  discharge  after  re- 
covery from  the  eruptive  disease  of  childhood,  and  in  this  way  induce  fatal 
neglect.  Parents  are  told  that  'the  child  will  outgrow  it,'  that  it  will  get 
no  worse,  that  it  is  dangerous  to  arrest  the  discharge,  and  are  sometimes 
advised  to  stuff  the  meatus  with  cotton,  and  wait  for  time  and  improved 
health  to  do  the  rest.  The  truth  is,  these  cases  do  seldom  improve  without 
interference.  It  is  just  as  safe  to  arrest  a  discharge  in  this  situation  as  in 
any  other.  It  is  dangerous,  highly  so,  not  to  do  it  just  as  soon  as  it  can  be 
pone  in  a  proper,  legitimate  manner.  It  is  dangerous  to  life,  as  well  as  to  the 
faculty  of  hearing,  to  permit  the  discharge  to  continue,  while  it  is  to  the 
highest  degree  unpleasant  and  mortifying  to  a  sensitive  patient.  If  the 
discharge  must  continue,  it  is  better,  far  better,  not  to  put  cotton  in  the 
ear.  That  hole  was  never  designed  to  be  stuffed.  Cases  could  be  cited 
which  have  recently  come  under  our  own  observation,  in  which  a  cure  was 


112  The  Peninsular  and  Independent. 

effocterl  by  simply  removing  the  cotton  and  ordering  a  discontinuance.  *  ^ 
With  regard  to  the  treatment  of  these  cases,  imlcss  produc*  d  by  morbid 
growths,  we  rely  upon  astringents  and  alternatives  locally  applied,  with 
constitutional  treatment  if  required.  It  is  frequently  a  mere  local  disease. 
"  In  a  majority  of  cases  of  ortonha^a  occurring  in  adults,  the  tym- 
panum is  ruptured  or  paitially  obliterated.  AVlien  the  disease  is  fully  ar- 
rested, the  discharge  wholly  ceases,  and  the  surface  that  has  secreted  a 
muco- purulent  fluid,  fuinishes  wax.  After  the  first  stage  of  cure  is  pass- 
ed— during  which  the  hearing  is  impaired,  rather  than  improved,  because 
the  fluid  aflbidcd  a  medium  for  the  transmission  of  sound  to  the  internal 
ear — the  artificial  tympanum  may  be  used  often  with  manifest  advantage." 

By  way  of  encouraging  those  who  may  have  cases  of  this  nature  un- 
der their  chaige,  in  the  persevering  use  of  local,  and,  when  indicated,  con- 
stitutional tieatment,  we  add  the  following: 

"  On  referring  to  our  record,  which  includes  patients  of  nearly  every 
agD,  from  a  few  months  to  full  maturity,  we  conclude  that  if  the  patient  is 
under  ten  5'cars  of  age,  six  months  may  be  named  as  tlie  possible  limit  of 
the  continuance  of  the  disease.  It  is  oftener  cured  in  less  time.  If  the 
patient  is  under  fifteen,  nine  months  may  be  named,  with  the  expectation 
of  effecting  a  cure  in  less  time.  If  over  fifteen,  one  year  is  the  lea>t  period 
of  time  that  it  is  safe  to  calculate  upon,  and  if  older,  it  may  require  years; 
but  if  patience  does  not  fail,  a  cure  may  be  promised  as  likely  to  result. 
As  is  true  of  all  diseases,  some  cases,  in  the  present  state  of  our  knowl- 
edge, are  incurable,  but  they  are  believed  to  be  very  rare." 

After  alluding  to  Yearsley's  moistened  cotton  plug,  and  Toynbee's 
splierical  rubber  drum,  Dr.  Clakk  recommends,  as  generally  preferable  to 
these,  an  egg-shaped  or  elliptical  artificial  tympanum  of  his  own  invention, 
which  may  be  procured  of  Mr.  Tiemann,  Chatham  street,  N.  Y.  A  perfect 
artificial  tympanum,  however,  is  still  a  desideratum,  and  the  following 
closing  remarks  call  upon  Yankee  ingenuity  to  tax  its  best  powers  for 
the  relief  of  the  afflicted : 

*'  It  would  seem  as  if  the  bladder  of  some  animal,  or  some  otHer 
unexamined  material,  would  furnish  the  article  required  for  the  best 
artificial  tympanum.  If  we  can  succeed  in  stimulating  to  more  diligent 
inquiry  in  this  direction,  our  whole  object  will  be  accomplished.  We 
should"  be  glad  to  see  a  better  drum  than  the  one  that  we  introduce. 
In  the  meanwhile,  we  would  beg  for  it  a  fair  trial." 


PURULENT  OPTHALMIA. 

M.  DeConde,  a  Surgeon  in  the  Belgian  army,  recommends  the  in- 
troduction of  a  thin  slip  of  wadding  beneath  the  upper  eye  Ijds  to  pre- 
vent the  heated,  rough,  and  pus  flooded  surlace  of  the  lids  from  direct 
contact  with  the  eyes.  He  regards  this  immediate  contact  of  the  lids, 
covered  as  they  generally  are  with  acrid  pus,  a  main  cause  of  the  exces- 
sive irritation  and  frequent  disorganization  of  the  cornea.  The  slip  of 
wadding  may  be  medicated  before  its  introduction  with  one  of  the  follow- 
ing articles,  the  therapeutic  effects  of  which  are  thus  explained : 


Twelfth  A7inual  Meeting  of  Am.  Med.  Association.     113 

1.  Cod -liver  oil  exercises  a  powerful  action  in  diseases  of  the  mucous 
membranes,  modifying  and  suppressing  their  secretions.  It  strengthens 
the  fibrous  tissues  of  the  eye  and  the  cornea,  and  tends  to  prevent  ramol- 
lissement.  It  is  especially  in  ulceration  and  chronic  ramollissement  of 
this  membrane  that  this  double  action  is  perceived. 

2.  The  red  precipitate  ointment  (four  parts  to  fifteen  of  lard  and  fifteen 
of  linseed  oil),  is  an  excellent  substitutive  agent,  sufficing  alone  to  arrest 
the  disease,  when  applied  earlj^.  It  is  the  best  remedy  for  cutting  short 
the  opthalmia  of  new-born  infants. 

3.  A  solution  of  chloride  of  lime  (thirty  parts  to  two  hundred  of 
water),  is  an  energetic  modifier,  neutralizing  with  certainty,  the  virulence 
of  the  secretions. 

4.  Perchloride  of  iron  exerts  an  instantaneous  hoemostatic  effect  upon 
the  ha3morrhagic  mucous  membrane,  and  an  indubitable  modifying  influ- 
ence upon  the  mucous  secretion. 

[Atumls  (V  Oculist  [que— Trans,  for  Br.  ^'  Foreign  Med.  df  Chir.  Revieio. 


THE   TWELFTH   AXXIAL    MEETING    OF   THE   AMERICAJf   MEDICAL 

ASSOCIATION. 


Louisville,  May  3,  1859. 
The  Association  met  at  eleven  o'clock  A.  M.  in  Mozart  Hall,  the  Presi- 
dent, Dr.  Harvey  Lindsley,  of  the  District  of  Columbia  in  the  chair, 
supported  by  Drs.  AV.  L.  Sutton,  of  Kentuck}',  Thomas  0.  Edward  of  Iowa, 
Josiah  Crosby,  of  Massachusetts,  and  W.  C.  Warren,  of  North  Carolina, 
as  Vice-Presidents,  with  Drs.  Alexander  J.  vSemmes,  of  the  District  of  Co- 
lumbia, and  S.  M.  Bemiss,  of  Kentucky,  acting  as  Secretaries.  Dr.  Caspar 
Wistar,  of  Penn.,  Treasurer,  was  also  in  attendance. 

The  President  announced  the  Rev.  Mr.  Robinson,  of  Louisville,  who 
opened  the  proceedings  with  prayer. 

Dr.  Robert  J.  Breckinridge,  chairman  of  the  committee  of  arrange- 
ments, then  welcomed  the  delegates  to  the  city. 

Prof.  Joshua  B.  Flint  of  Louisville,  accompanied  by  Drs.  Sutton, 
Chiplej',  Spillman,  and  Snead,  then  came  forward  and  addressed  the  Presi- 
dent as  follows : 

Mr.  President :  At  a  late  annual  meeting  of  the  "  State  Medical  Society 
of  Kentucky,"  the  following  resolution  was  unanimously  adopted,  and  the 
gentlemen  before  you,  all  of  them  ex  -  Presidents  of  the  Society,  constituted 
a  committee  charged  with  carrying  it  into  effect : 

Resolved,    That be  a  committee  to  wait  upon  the  A.  M.  Association,  so 

soon  as  it  shall  have  opened  its  session  in  Louisville,  and  in  behalf  of  this  Society  bid  it 
welcome  to  the  medical  jurisdiction  of  Kentucky,  assure  it  of  the  cordial  interest  of  the 
profession  of  the  State  in  the  objects  and  purposes  of  its  institution,  and  of  the  readiness 
of  this  Society  to  co-operate  in  all  its  endeavors  to  promote  the  honor  and  usefulness  of 
our  common  calling. 

Vol.  II.  — H. 


114  The  Peninsular  and  Independent. 

In  regard  to  assurances  of  welcome,  Mr.  President,  so  far  as  they  ap- 
ply to  yourself  and  your  associates,  as  individual  guests  of  your  Kentucky 
brethren,  those  gentlemen  would  hardly  pardon  me  for  adding  a  word  to 
the  general  terms  of  the  resolution.  Already,  if  I  mistake  not,  there  are 
demonstrations  of  the  spirit  of  hospitality,  which  render  any  assurances 
on  that  subject  worse  than  superfluous. 

But  I  am  happy  to  assure  you,  Mr.  President,  that  the  Association 
over  which  you  preside,  in  its  corporate  capacity,  with  its  well  known  pur- 
poses and  ends,  will  find  an  equally  cordial  reception  in  the  general  com- 
munity which  it  has  now  honored  with  its  presence.  The  people  of  Ken- 
tucky, Sir,  are  generally  supposed  to  appreciate  as  it  deserves  every  enter- 
prise of  a  public  spirited  or  philanthrophic  character  which  presents  itself 
to  their  notice,  and  I  think  I  may  say  especially  disposed  to  befriend  the 
cause  of  Medical  Education.  They  have  certainly  done  somewhat  a  little 
to  their  credit  in  evidence  of  their  intelligent  interest  in  Medical  vScience 
and  the  best  means  of  its  advancement.  Through  the  munificence  of  the 
State,  in  one  case,  and  of  this  liberal  city  in  the  other,  two  medical  libra- 
ries have  been  procured  in  Kentucky,  each  of  which  is  superior  to  any 
and  all  the  public  collections  of  medical  books  that  can  be  found  in  most 
of  the  other  States  of  the  Union.  Not  more  than  two  of  our  sister  States, 
so  far  as  I  can  learn,  can  be  compared  with  us  in  this  interesting  par- 
ticular. 

One  of  those  Libraries,  belonging  to  the  Medical  Department  of  the 
University  of  Louisville,  as  its  best  estate,  numbering  4,000  volumes,  you 
will  doubtless  visit  during  your  sojourn  among  us ;  and,  although  much 
defaced  and  mutilated  by  the  conflagration  which  laid  that  institution  in 
ruins  two  years  ago,  you  will  still  find  it  to  be  a  large  and  choice  collection 
—  adequate  to  the  requisitions  of  medical  research,  and  presenting  satis- 
factorily the  course  of  medical  literature  from  the  time  of  Hippocrates  to 
the  present  day. 

The  other  library  to  which  I  refer  belongs  to  the  Medical  Department 
of  Transylvania  Univcrsit)^  and  contains  b,000  volumes.  I  hope  that 
not  a  few  of  the  members  of  the  Association  before  leaving  Kentucky  will 
find  their  way  into  that  also,  in  the  course  of  a  visit  to  the  beautiful  inland 
city  in  which  it  is  located  —  a  city  distinguished  throughout  the  land  for 
the  general  intelligence  and  refinement  of  its  population,  as  well  as  for  the 
eminent  public  men  who  have  signalized  it  as  their  home ;  but  to  medical 
men,  not  only  of  our  own,  but  of  foreign  countries,  especially  memorable  as 
the  residence  of  the  great  lithotomist  of  our  day  and  surgical  patriarch  of 
the  West — Benjamin  W.  Dudle}^ 

Such  benefactions  as  these  to  the  means  of  medical  study,  attest,  as 
I  have  already  intimated,  so  enlightened  an  interest  in  the  improvement 
of  our  Profession  as  to  guarantee  not  only  a  welcome  to  the  Association 
which  represents  it,  but  efficient  co-operation  in  its  endeavors  on  the  part 
of  the  Profession  and  people  of  Kentucky. 

May  your  present  session,  Mr.  President,  be  an  agreeable  one  to  the 
members  of  the  Association,  and  prove  eminently  beneficial  to  the  interests 
of  American  medicine. 

The  Secretary,  Dr.  Bemiss,  then  called  the  roll  of  the  members  of 
the  Association,  and  two  hundred  and  forty  gentlemen  were  in  attend- 
ance. 

The  President  then  appointed  the  following  gentlemen  a  committee 
on  voluntary  essays :  Drs.  L.  P.  Yandell  of  Kentucky,  Bryan  of  Philadel- 
phia, and  Comegys  of  Ohio. 

Dr.  R.  J.  Breckmrdge,  fi'om  the  Committee  of  Arrangements,  an- 
nounced the  hours  of  business  from  9  a.m.  to  12  m.,  and  from  3  p.  m.  until 


Twelfth  Annual  Meeting  of  Am.  Med.  Association.     115 

such  hour  as  the  Convention  should  adjourn  upon  resolution,  which  arrange- 
ment was  adopted. 

Dr.  Harvey  Lindsley,  the  President  of  the  Association,  then  read  his 
retiring  Address,  which  was  listened  to  with  marked  attention,  and  was 
an  eloquent  tribute  to  the  dignity  of  the  medical  profession  and  the  im- 
portance of  its  improvements. 

After  he  had  concluded.  Dr.  Landon  A.  Smith  of  New  Jersey,  moved, 
that  the  thanks  of  the  Association  be  tendered  to  the  President  for  his 
able  and  eloquent  address,  and  it  was  ordered  to  be  placed  in  the  hands 
of  the  appropriate  committee,  for  publication  among  the  proceedings  of  the 
meeting. 

Dr.  Caspar  Wistar,  chairman  of  the  Committee  on  Publication,  read 
the  Annual  Report ;  and,  on  motion  of  Dr.  Sayers,  of  New  York,  the  follow- 
ing resolutions,  appended  to  it,  were  unanimously  adopted : 

Resolved,  That  hereafter  every  paper  intended  for  publication  in  the  Transactions 
must  not  only  be  placed  in  the  hands  of  the  Committee  of  Publication  by  the  1st  June, 
but  it  must  also  be  so  prepared  as  to  require  no  material  alteration  or  addition  at  the 
hands  of  the  author. 

Resolved,  That  authors  of  papers  be  required  to  return  their  proofs  within  two 
weeks  after  their  reception,  otherwise  they  will  be  passed  over  and  omitted  from  the 
volume. 

Adjourned  until  3  o'clock  p.m. 

Afternoon  Session. 

Dr.  W.  L.  Sutton,  one  of  the  Vice  -  Presidents,  took  the  chair  in  the 
absence  of  the  President. 

Dr.  D.  Meredith  Reese,  of  New  York,  chairman  of  the  Committee 
on  Nominations,  reported  the  following  officers  for  the  ensuing  year: 

President — Henry  Miller,  of  Kentucky. 

Vice  -  Presidents  —  H.  F.  Askew,  Delaware  ;  Chas.  S.  Tripler,  U.  S.  Army ;  L.  A- 
Smith,  New  Jersey  ;  Calvin  West,  Indiana. 

Treasurer  —  Caspar  Wistar,  Pennsylvania. 
Secretary  —  S.  M.  Bemiss,  Kentucky. 

Dr.  Sayre,  moved  the  adoption  of  the  Report,  which  was  unanimously 
agreed  to. 

Dr.  Brainard,  of  Illinois,  moved  the  appointment  of  a  committee  to 
conduct  the  newly  appointed  officers  to  their  respective  chairs.  The 
acting -President  selected  Drs.  Brainard,  of  111.,  Mattingly,  of  Ky.,  Sutton, 
of  Ind.,  McDowell,  of  Mo.,  and  R.  J.  Breckinridge  of  Ky.,  and  they  ac- 
cordingly performed  the  duties  assigned  to  them. 

The  newly -elected  President,  on  taking  the  chair,  addressed  the  Con- 
vention  in  substance  as  follows : 

Gentlemen  of  the  American  Medical  Association:  I  am  wholly  at  a 
loss  to  command  language  to  express  the  deep  sense  of  obligation  put  upon 
me  by  calling  me  to  the  Presidency  of  your  Association.  It  is  an  honor 
any  man  may  well  be  proud  of,  and  although  I  admit,  in  all  sincerity, 
that  you  might  without  difficulty  have  selected  an  individual  more  worthy 
the  position,  I  may  be  allowed  to  say  you  could  not  have  conferred  it 
upon  one  who  would  prize  it  more  highly  or  cherish  it  longer  with  the 
most  grateful  recollection.  I  do  esteem  it  the  greatest  honor  ever  confer- 
red upon  me  by  the  Profession  that  I  love  and  to  which  I  have  devoted 
a  long  life ;  nay,  more  —  it  is  the  greatest  honor  that  could  be  conferred 
upon   any  man  by  the  medical  or  any  other  profession  in   this   or  any 


116  The  Peninsular  and  Independent, 

other  country ;  for  any  decoration  of  honor  or  any  mark  of  approbation 
conferred  by  a  crowned  head  I  should  regard  as  a  bauble  in  comparison. 
Who  are  you,  gentlemen,  when  rightly  considered  ?  You  are  the  rightful 
representatives  of  the  great  American  Medical  Profession  —  an  arm}-  forty 
thousand  strong,  and  a  body  of  men,  no  matter  what  captious  criticism 
may  say  in  disparaging  comparison  with  the  European  branch  of  the  pro- 
fession, in  my  humble  judgment,  far  superior  to  the  same  number  of 
medical  men  to  be  found  in  any  quarter  of  the  globe.  Although  as  a 
body  you  may  not  be  so  learned,  so  critically  and  nicely  framed  in  all 
the  minutiae  of  the  Profession,  yet,  for  strength,  integrity,  and  precision 
in  all  the  great  principles  guiding  to  a  successful  combat  with  disease, 
this  body  is  equal,  if  not  superior,  to  that  of  any  kingdom  of  continental 
Europe. 

To  be  called  to  the  Presidency  of  such  a  body  of  men,  is  in  my 
sober  judgment,  the  greatest  compliment  that  could  be  conferred  upon 
mortal  man,  provided  that  man  is  a  devotee  of  medicine,  who  has  given 
his  whole  mind,  soul,  heart,  and  strength  individually  to  the  Profes"<ion, 
and  has  that  high  rcgai'd  for  it  which  will  not  sutler  any  less  noble  pur- 
suit to  interfere  with  the  dail}'-  though  laborious  duties  of  the  Profession. 
Coming  so  recently  from  a  sick  bed,  and  still  enfeebled  in  health,  I  beg  to 
be  excused  from  further  remarks,  and  desire  3'ou  to  accept  this  brief  and 
imperfect  acknowledgment  of  the  distinguished  honor  conferred  upon  me, 
instead  of  what,  under  other  circumstances,  I  might  be  disposed  to  say. 

The  President,  after  this  gi^ceful  Address,  sat  down  amid  much  ap- 
plause; when  Dr.  R.  J.  Breckenridge  moved  that  the  thanks  of  the  As- 
sociation be  tendered  to  the  retiring  ofhcers  for  the  faithful  and  assidu- 
ous manner  in  which  they  have  conducted  the  business  committed  to 
their  charge ;  which  was  unanimously  adopted. 

A  long  and  discursive  debate  then  ensued  on  the  admission  of  mem- 
bers by  invitation.  The  plan  of  organization  permits  practitioners  of  re- 
spectable standing  from  sections  of  the  United  States,  not  otherwise  repre- 
sented at  the  meeting,  to  receive  appointment,  by  invitation,  of  the  meet- 
ing, after  an  introduction  from  any  of  the  members  present,  or  any  absent 
permanent  members,  to  hold  connection  with  the  Association  until  the  close 
of  the  annual  session  at  which  they  are  received,  and  to  be  entitled  to  par- 
ticipate in  all  its  affiiirs  as  in  the  case  of  delegates.  The  point  of  diffi- 
culty seemed  to  be  whether  the  invitations  should  be  extended  by  the 
Committee  of  Arrangements  or  by  open  vote  of  the  Association.  It  wa^ 
finally  settled  by  referring  all  the  applicants'  names  to  the  Committee  on 
Arrangements. 

Dr.  J.  B.  Lindsley,  of  Tennessee,  offered  the  following : 

Resolved,  That  a  committee  of  three  be  appointed  by  the  Chair  to  inquire  into 
and  report  upon  the  propriety  of  dividing  the  Association  into  sections,  for  the  pui-poso 
of  performing  such  parts  of  its  scientific  labors  as  may  relate  to  particular  branches  of 
•medicine  and  surgerJ^ 

Dr.  Brodie  moved  its  reference  to  the  Xominating  Committee. 

Dr.  Brainard  explained  at  some  length  the  object  of  the  resolution  of 
inqmry,  and  enforced  its  adoption  as  the  means  of  giving  more  effect 
and  usefulness  to  the  proceedings  of  the  Association,  the  reports  of  which 
had  heretofore  gone  out  unmatured,  in  consequence  of  the  want  of  con- 
centrated action. 

A  motion  by  Dr.  Sayre  to  lay  the  motion  on  the  table  was  negatived, 
and  the  motion  of  Dr.  Lindsley  was  then  adopted. 

Dr.  Davis  moved  that  no  person  be  permitted  to  speak  more  than 
twice  on  the  same  subject,  or  more  than  ten  minutes  at  one  time,  except 
by  consent  of  the  Association  ;  which  was  adopted. 


Twelfth  Annual  Meeting  of  Am.  Med.  Association.     117 

The  Standing  Committee  on  Prize  Essays  was  called  on  for  their 
Report,  but  without  a  response.  This  was  also  the  case  with  the  Com- 
mittee on  Medical  Education.  The  Committee  on  Medical  Literature  had 
no  Report  to  present. 

A  letter  from  Dr.  J.  G.  F.  Holston,  of  Ohio,  Chairman  of  the  Special 
Committee  on  the  Microscope,  was  read,  reporting  progress,  and  begging 
a  continuance  for  more  extended  investigation,  which  was  referred  to  the 
Committee  on  Nominations. 

A  letter  from  Dr.  Stephen  Smith,  of  New  York,  from  the  Special 
Committee  on  Medical  Jurisprudence,  had  the  same  reference. 

The  Special  Committee  on  Quarantine  was  not  ready  to  report. 

Dr.  Mattingly,  of  Ky.,  from  the  Special  Committee  on  Diseases  and 
Mortality  of  Boarding  Schools,  asked  a  continuance  until  next  year,  in 
order  to  obtain  further  information  requisite  to  the  full  investigation  of  the 
important  subject.  The  request  was  referred  to  the  Committee  on  Nomi- 
nations. 

The  Special  Committees  on  Surgical  Operations  for  the  relief  of  De- 
fective Vision,  on  Milk  Sickness,  and  on  the  Blood  Corpuscle  had  the  same 
reference. 

A  Report  from  the  Committee  on  Medical  Ethics,  signed  by  Dr.  John 
Watson,  of  New  York,  was  read,  laid  on  the  table,  and  made  the  special 
order  for  to-morrow,  at  12  o'clock  m.  This  is  an  important  subject,  and 
will  probably  give  rise  to  much  debate  to-day.  We  publish  the  Report  in 
full,  as  follows : 

To  the  American  Medical  Association: 

Tho  Committee  on  Medical  Ethics  beg  leave  to  state  that,  of  the  subjects  referred  to 
them  at  the  last  meeting  of  the  Association,  they  find  the  following  notice  in  the  minutes: 

"  Dr.  Grant,  of  New  Jersey,  presented  a  complaint  made  by  the  Newark  Medical 
Society  against  the  New  York  Medical  College,  for  a  violation  of  the  ethics  of  the  Profes- 
sion. Dr.  Edwards,  of  Iowa,  presented  a  similar  complaint,  and  Dr.  Oakley,  of  New 
Jersey,  a  complaint  from  the  Union  and  Essex  Coimty  Medical  Society." — [Transactions, 
Vol.XI.  p.  41.j 

Upon  these  several  complaints  your  Committtec  beg  leave  most  respectfully  to  re- 
port : 

That  the  two  complaints  from  the  Medical  Societies  of  New  Jersey  refer  only  to  one 
and  the  same  grievance,  the  particulars  of  which  are  set  forth  in  a  memorial  which  was 
presented  to  the  American  Medical  Association  on  the  6th  of  May,  1848,  and  which  is 
entitled,  "  Statement  of  the  Newark  Medical  Association  in  Keference  to  a  Diploma 
granted  by  the  New  York  Medical  College." 

The  facts  stated  in  this  memorial  which  is  now  appended  to  this  Report,  were,  during 
the  last  annual  meeting  of  the  American  Medical  Association,  examined  as  carefully  as 
time  and  opportunit}''  would  allow.  The  charges  therein  contained  against  the  New  York 
Medical  College  were  admitted  to  be  true  by  Dr.  Horace  Green,  President  of  said  college, 
who,  in  apology  for  the  same,  submitted  a  written  statement  to  your  Committee,  which 
was  at  the  time  accepted  as  satisfactory  by  the  gentlemen  then  present  before  your  Com-  > 
mittee  on  behalf  of  the  parties  aggrieved  ;  and  being  afterwards  presented  with  a  verbal 
report  by  the  Committee,  was  received  and  entered  upon  the  minutes  in  the  following 
terms  : 

"  Whereas,  it  appears  from  undoubted  testimony  that  the  New  York  Medical  Col- 
lege have  conferred  the  degree  of  Doctor  of  Medicine  upon  a  notorious  quack  of  the 
name  of  John  F.  Dunker,  of  Newark,  the  Faculty,  in  the  person  of  the  President  of 
said  College,  wish  here  to  declare,  that  the  degree  was  obtained  under  gross  deception 
and  false  testimonials  furnished  by  said  Dunker  and  his  friends:  and  they  therefore  re- 
voke and  annul  his  diploma,  and  declare  said  Dunker  to  be  unworthy  of  patronage  or 
Support  from  authority  conferred  upon  him  by  this  diploma." — [Transactions,  Vol.  XI. 

P-— ■] 

These  complaints  being  thus  disposed  of,  your  Committee  have  only  to  add  in  refer- 
ence to  them  that  the  memorial  presented  to  the  American  Medical  Association  from  the 
Newark  Medical  Association  is  worthy  of  special  notice,  as  setting  forth  the  negligent 
manner  in  which  mere  verbal  and  hearsay  statements  are  at  times  accepted  in  place  of 
authentic  written  testimonials,  from  individuals  presenting  themselves  as  candidates  for 
the  honors  of  our  Profession  at  some  of  the  Medical  Colleges  of  this  country.    In  this 


118  The  Peninsular  and  Independent. 

respect  there  is  reason  to  believe  that  the  New  York  Medical  College  does  not  stand  alone  .^ 
and  the  publication  of  the  accompanying  memorial  may  be  of  service  in  putting  a  per- 
manent check  to  this  crying  evil. 

The  only  other  complaint  referred  to  your  Committee  was  that  presented  by  Dr. 
Edwards,  of  Iowa,  preferring  a  charge  from  the  Dubuque  Medical  Society  against  one 
of  her  members  who  had  been  expelled  for  an  alleged  infraction  of  the  code  of  medical 
ethics.  This  complaint  does- not  appear  to  be  of  such  a  character  as  to  require  adjudica- 
tion here.  It  has,  since  the  last  annual  meeting  of  the  American  Medical  Association, 
been  adjudged  by  the  Iowa  State  Medical  Society  [see  Transactions  of  the  annual  meet- 
ing of  said  Society,  published  at  Dubuque,  Iowa,  1858],  and  having  been  then  settled  in 
the  State  in  which  the  parties  reside,  it  should  now  be  dismissed. 

All  of  which  is  respectfully  submitted. 

JOHN  WATSON,  M.D.,  Chairman. 

New  York,  April  28,  i859. 

Continuances  were  asked  by  the  Committees  on  the  Pons  Varolii, 
Medulla,  Oblongata,  and  Spinal  Marrow  —  their  Pathology  and  Therapeu- 
tics ;  on  American  Medical  Necrology ;  on  the  Hygienic  relations  of  Air, 
Food,  and  Water,  the  Natural  and  Artificial  Causes  of  their  Impurity,  and 
the  best  methods  by  which  they  can  be  made  most  effectually  to  contribute 
to  the  Public  Health ;  on  the  Effect  of  the  Virus  of  Rattlesnakes,  &c., 
when  introduced  into  the  system  of  the  Mammalia ;  on  the  Climate  of  the 
Pacific  Coast,  and  its  Modifying  Influences  upon  Inflammatory  Action  and 
Diseases  generally;  on  the  Constitutional  Origin  of  Local  Diseases,  and 
the  Local  Origin  of  Constitutional  Diseases ;  on  the  Physiological  Effects 
of  the  Hydro-Carbons ;  on  Epilepsy  ;  on  the  Causes  of  the  Impulse  of  the 
Heart,  and  the  Agencies  which  influence  it  in  Health  and  Disease  ;  and  on 
the  best  substitutes  for  Cinchona,  and  its  Preparations  in  the  Treatment  of 
Intermittent  Fever,  &c. ;  all  of  which  were  referred  to  the  Committee  on 
Nominations. 

The  Special  Committee  on  Government  Meteorological  Reports  made 
a  Report,  written  by  Dr.  R.  H.  Coolidge,  of  the  U.  S.  Army,  but  read  by 
Dr.  Paul  F.  Eve,  of  Tennesee,  which  was  referred  to  the  Committee  on 
Publication. 

The  Committee,  appointed  in  May,  1857,  on  Criminal  Abortion,  sub- 
mitted a  Report,  written  by  Dr.  Storer,  of  Boston,  which  was  read  by  Dr. 
Blatchford,  of  New  York,  and  referred  to  the  Committee  on  Publication. 
The  following  resolutions  appended  to  this  Report  were  unanimously 
adopted : 

Resolved,  That  while  physicians  have  long  been  united  in  condemning  the  act  of 
producing  abortion,  at  every  period  of  gestation,  except  as  necessary  for  preserving  the 
life  of  either  mother  or  child,  it  has  become  the  duty  of  this  Association,  in  view  of  the 
prevalence  and  increasing  frequency  of  the  crime,  publicly  to  enter  an  earnest  and  solemn 
protest  against  such  unwarrantable  destruction  of  human  life. 

Resolved,  That  in  pursuance  of  the  grand  and  noble  calling  we  profess  —  the  saving 
of  human  lives  —  and  of  the  sacred  responsibilities  thereby  devolving  upon  us,  the  Asso- 
ciation present  this  subject  to  the  attention  of  the  several  Legislative  Assemblies  of  the 
Union  with  the  prayer  that  the  laws  by  which  the  crime  of  procuring  abortion  is  attempted 
to  be  controlled  may  be  revised,  and  that  such  other  action  may  be  taken  in  the  premises 
as  they  in  their  wisdom  may  deem  necessary. 

Resolved,  That  the  Association  request  the  zealous  co-operation  of  the  various  State 
Medical  Societies  in  pressing  the  subject  upon  the  Legislatures  of  their  respective  States, 
and  that  the  President  and  Secretaries  of  the  Association  are  hereby  authorised  to  carry 
out  by  memorial  these  resolutions. 

The  Convention  then  adjourned  until  to-morrow  morning  at  9  o'clock. 

Second  Day's  PROCEEorN-GS. 

"Wednesday,  May  4,  1859. 
The  President,  Dr.  Miller,  called  the  Association  to  order  at  9  o'clock. 
Dr.  D.  Meredith  Reese,  chairman  of  the  Committee  on  Nominations, 
called  attention  to  the  fact  that  the  Committee  could  not  act  definitely 


Twelfth  Annual  Meeting  of  Am.  Med.  Association.     119 

until  the  place  for  next  year's  meeting  should  be  designated.  He  stated 
also  that  the  Medical  State  Society  of  Connecticut  had  requested  that  an 
amendment  to  the  Constitution,  proposed  two  years  since,  should  be  taken 
from  the  table,  relative  to  the  time  of  meeting. 

It  was  moved  by  Dr.  Blatchford,  and  seconded  by  Dr.  Sayre,  that 
the  amendment  to  the  third  article  of  the  Constitution  be  taken  up,  which 
proposes  to  add  after  the  words  " first  Tuesday  of  May"  the  words  "or 
first  Tuesday  of  June,"  and  after  the  words  "  shall  be  determined  "  add 
the  words  "with  the  time  of  meeting." 

The  amendment  was  adopted  by  a  constitutional  vote. 

Dr.  D.  M.  Reese  also  stated  that  the  Connecticut  State  Society  had 
extended  a  pressing  invitation  to  the  Association  to  hold  its  next  meeting 
at  New  Haven  ;  which  invitation  was  referred  to  the  Committee  on  Nomi- 
nations. 

Dr.  Reese  also  called  attention  to  the  necessity  of  some  radical  change 
in  the  mode  of  appointing  committees  to  prepare  treatises  on  scientific 
subjects  to  be  reported  at  the  annual  meetings.  It  had  been  seen,  that,  on 
yesterday,  a  large  majority  of  the  committees  made  no  reports,  and  did 
not  even  see  proper  to  send  in  any  communication  explanatory  of  delay. 
The  difficulty  heretofore  has  originated  in  the  mode  of  selection  adopted 
by  the  Nominating  Committee.  It  has  been  customary  for  gentlemen  to 
hand  in  their  names  and  the  proposed  subjects  on  slips  of  paper,  and  the 
committee,  without  further  investigation,  have  so  published  in  the  annual 
reports.  Thus  it  has  happened  that  appointments  have  been  most  injudi- 
ciously made,  and  gentlemen  to  whom  a  special  duty  has  been  assigned 
have  been  found  to  know  less  of  that  than  any  other  subject.  He  there- 
fore hoped  that  no  committee  of  last  year  would  be  re -appointed  or  con- 
tinued from  which  no  Report  had  been  had  and  no  communication  received. 

On  motion,  the  Nominating  Committee  was  unanimously  instructed  to 
act  upon  the  suggestions  of  the  chairman,  who  also  stated  that  there 
should  be  some  definite  expression  of  disapprobation  as  to  the  course  of 
those  gentlemen  who  had  volunteered  essays,  and  had  their  names  reported 
in  the  newspapers  and  spread  over  the  land,  and  then  paid  no  further  at- 
tention to  the  matter. 

Dr.  Flint,  from  the  Committee  on  Prize  Essays,  begged  leave  to  re- 
port that  they  had  received  four  dissertations  in  time  for  a  careful  and 
thorough  examination,  and  two  others,  quite  voluminous,  only  two  days 
before  the  meeting  of  the  Association.  The  latter  we  have  felt  constrained 
to  exclude  altogether  from  the  competition  of  the  present  year,  on  account 
of  the  absolute  impossibility  of  reading  them  with  a  critical  purpose  and 
effect.  The  others  have  been  carefully  examined  by  all  the  surviving 
members  of  the  Committee  —  one  estimable  associate.  Dr.  Evans,  having 
been  called  from  all  his  earthly  labors  before  the  active  duties  of  the 
Committee  began. 

More  than  one  of  the  four  essays  we  have  examined  exhibited  much 
labor,  and  a  commendable  scholarship  in  their  preparation — are  voluminous, 
and  in  some  respects  very  meritorious  papers ;  but,  in  the  unanimous 
judgment  of  the  Committee  neither  of  them  possess  the  degree  and  species 
of  merit  which  should  entitle  its  author  to  the  Association  Prize. 

The  Committee  beg  leave  furthermore  to  report  that,  in  their  opinion, 
and  as  the  suggestion  of  their  own  recent  experience,  the  Association 
should  determine,  in  more  precise  and  formal  manner  than  has  yet  been 
done,  the  terms  and  conditions  of  competition  and  of  success  in  the 
contest  for  prizes,  for  the  government  alike  of  contestants  and  the  com- 
mittee of  adjudication,  and  that  a  committee  be  now  appointed  to  consider 
and  report  upon  that  subject. 


120  Tlie  Peninsular  wul  Independent. 

Dr.  Gordon,  of  Ohio,  from  the  Committee  on  Epidemic  Cholera,  made 
an  interesting  written  Report;  which  wasjead,  approved,  and  referred  to 
the  Committee  on  Pubhcation,  and  the  request  of  Dr.  Gordon,  that  the 
Committee  be  continued,  was  referred  to  the  Committee  on  Nominations. 

Dr.  J.  B.  Lindsley,  Chairman  of  the  Committee  appointed  to  inquire 
into  the  propriety  of  dividing  the  Association  into  sections,  for  the  better 
performance  of  its  work  in  considering  the  various  branches  of  medicine 
and  surgery,  recommended  the  adoption  of  suc'n  a  plan  as  being  indispen- 
sably necessary  to  making  this  body  a  working  scientific  association. 
They  do  not  deem  it  necessary  to  enter  into  any  argument  in  favor  of 
this  plan,  it  being  the  one  already  universally  adopted  by  similar  bodies. 
They  would  simply  recommend,  for  the  present,  a  division  into  the  follow- 
ing sections,  as  being  most  suitable  to  facilitate  the  transaction  of  business, 
viz. : 

1.  Anatomy  and  Physiology. 

2.  Chemistry  and  Materia  Medica. 

3.  Practical  Medicine  and  Obstetrics. 

4.  Surgery. 

The  Committee  do  not  propose  that  this  subdivision  of  labor  shall  in 
any  manner  interfere  with  the  regular  business  of  the  Association  as  now 
conducted ;  but  only  that  after  having  assembled  each  day  in  general  ses- 
sion, each  section  shall  meet  separately  for  the  purpose  of  hearing  and  dis- 
cussing papers  on  such  subjects  as  properly  belong  to  them,  and  they 
therefore  recommend  that  the  Committee  of  Arrangements  for  the  ensuing 
year  be  requested  to  provide  suitable  accommodations  for  the  services  of 
these  sections,  and  that  each  of  said  sections  shall  be  authorized  to  make 
such  arrangements  as  may  be  required  for  the  proper  transaction  of  its 
business. 

This  Report  was  considered,  and  adopted  after  a  very  able  speech  in 
its  support  by  Dr.  Davis. 

Dr.  J.  W.  Singleton,  of  Ky.,  moved  the  suspension  oT  the  rules  for 
the  introduction  of  the  following  : 

Resolved,  That  in  the  death  of  Dr.  A.  Evans,  of  Kentucky,  the  As.«ociation  has  lost 
one  of  its  most  manly  and  efi5cient  members,  and  ^-ociety  a  friend  and  benefactor. 

The  resolution  was  unanimously  adopted. 

Dr.  W.  L.  Sutton,  imder  the  resolution  appointing  a  Committee  on 
registration  of  births,  marriages,  &c.,  proposed  a  plan  of  general  action, 
an  abstract  of  which  he  read  on  motion  of  Dr.  Gibbs,  of  S.  C,  and  on 
motion  of  Dr.  L.  P.  Yandell  the  subject  was  referred  to  a  committee,  to 
report  during  the  present  session. 

Drs.  Sutton,  Lindsley,  W.  R.  Gibbs,  Br3-an,  Pitcher,  and  Crosby 
were  appointed  such  committee. 

Dr.  Blatchford  stated  that  he  had  received  from  Dr.  Willard,  Secre- 
tary of  the  New  York  State  Medical  Society,  50  volumes  of  their  Trans- 
actions for  1850,  for  distribution  to  the  Medical  Press,  the  Medical  Col- 
leges, and  all  Medical  Societies  of  the  South,  and  sent  with  a  request 
for  an  interchange  of  civilities.  Gentlemen  present  can  be  supplied  by 
application  to  Dr.  Bemiss,  and  if  the  number  sent  be  not  sufficient  for 
the  supply  they  will  be  cheerfully  forwarded  to  any  gentleman  by  ap- 
plication to  the  Secretary,  Dr.  S.  D.  Willard,  Albany,  N.  Y.,  the  postage 
being  included  in  the  application,  which  is  twenty-two  cents. 

A  voluminous  report  from  Dr.  Thomas  Logan,  of  California,  on  Me- 
dical Topography  and  Epidemics,  was  received,  and  referred  to  the  Com- 
mittee on  Publication. 

The  Chairman  of  the  Committee  on  Voluntary  Essays  stated  that  he 
had  received  a  paper  on  a  case  of  extra-uterine  foetation  from  Dr.  Enos 


Tioelfth  Annual  Meeting  of  Am.  Med.  Association.     121 

Hoyt,  of  Transylvania,  Mass.,  and  another  on  a  case  of  accidental  poison- 
ing by  strychnine  from  Dr.  Douglas  Bly,  of  Rochester,  N.  Y.  He  also 
presented  a  very  voluminous  paper,  entitled  "Observations  on  some  of 
the  changes  of  the  Solids  and  Fluids  in  Malaria  Fever,  by  Joseph  Jones, 
Prof  of  Medical  Chemistry  in  the  Medical  College  of  Georgia,  at  Augusta." 
By  request.  Prof.  Jones  gave  a  verbal  abstract  of  his  paper  and  an  expo- 
sition of  his  theory ;  and  on  motion  of  D.  W.  Yandell  the  communication 
was  referred  to  the  Committee  on  Publication. 

Dr.  D.  W.  Yandell  announced  that  the  following  railroad  companies  had 
agreed  to  pass  delegates  to  this  Convention  over  their  roads  at  half  price : 
Pittsburgh,  Fort  Wayne,  and  Chicago;  Pennsylvania  Central;  Jefferson- 
ville ;  New  Albany  and  Salem :  Louisville  and  Nashville  ;  and  Cleveland 
and  Pittsburgh. 

On  motion,  a  vote  of  thanks  was  tendered  to  these  companies  for 
their  liberality. 

Dr.  J.  B.  Flint  offered  the  following  resolution: 

Whereas,  Our  brethren  of  Great  Britain  are  engaged  in  erecting  a  monument  to 
the  memory  of  John  Hunter,  whose  invaluable  services  in  behalf  of  Physiology  and 
Surgery  are  recognized  and  honored,  as  well  on  this  side  of  the  Atlantic  as  in  Europe  ; 
and  whereas,  this  Association,  as  the  representatives  of  American  Medicine,  would  re- 
joice in  some  suitable  manner  to  participate  in  so  grateful  a  testimonial  of  gratitude  and 
respect;  therefore. — 

Resolved,  That  a  committee  of  three  be  appointed  to  consider  in  what  manner  this 
participation  can  best  be  effected,  so  as  to  be  acceptable  to  our  British  brethren,  and 
consistent  with  our  own  means  and  opportunities  of  action,  with  instructions  to  report  at 
the  next  annual  meeting. 

The  resolution  was  adopted;  and  Drs.  Flint,  Bowditch,  and  Shattuck 
appointed  as  the  Committee. 

Dr.  Harvey  Lindsley  offered  the  following : 

Whereas,  Parliamentary  rules  of  order  are  numerous,  complicated,  sometimes 
obscure,  and  often  inapplicable  to  such  a  body  as  the  American  Medical  Association ;  and 
whereat",  from  the  nature  of  the  pursuits  of  medical  men,  they  can  not  be  familiar  with 
these  rules  :     Therefore, — 

Resolved,  That  a  Select  Committee  of  three  members  be  appointed  to  prepare  a 
system  of  rules  for  the  government  of  this  Association,  as  few  in  number,  as  concise  and 
perspicuous  as  possible,  to  bo  reported  to  the  next  annual  meeting. 

This  resolution  was  adopted,  and  Drs.  Lindsley,  Comegys,  and  Blatch- 
ford  appointed  as  the  Committee. 

The  paper  of  Dr.  Bly,  on  Accidental  Poisoning  by  Strychnine,  was 
read  by  its  author;  and  as  individual  cases  are  not  reported  in  the  journals 
of  the  Association,  thanks  were  returned  for  the  communication,  with  a 
request  that  it  be  published  in  some  medical  journal. 

An  invitation  from  Grand  Master  Morris,  of  the  Masons,  was  received, 
urging  Medical  brethren  to  attend  the  Masonic  Convention  now  in  session 
in  this  city. 

The  Nominating  Committee  made  the  following  report : 

The  next  annual  meeting  to  take  place  at  New  Haven,  on  the  first 
Tuesday  of  June,  1860.  Dr.  Eli  Ives  is  elected  Junior  Secretary. 

Committee  of  Arrangements  —  Drs.  Chas.  Hooker,  Stephen  G.  Hub- 
bard, and  Benjamin  Sullivan,  Jr.,  with  power  to  add  to  their  numbers. 

Committee  on  Prize  Essay's  —  Drs.  Worthington  Hooker,  Conn;  G. 
C.  Shattuck,  Mass. ;  Usher  Parsons,  R.  L ;  P.  A.  Jewett,  Conn. ;  and 
John  Knight,  Conn. 

Committee  on  Publication  —  Drs.  F.  G.  Smith,  Philadelphia,  Pa.; 
Wistar,  do. ;  Bemiss,  Louisville,  Ky. ;  Ives,  New  Haven,  Conn. ;  HoUings- 
worth  and  Hartshorne,  Philadelphia,  Pa. ;  and  Askew,  Wilmington,  Del. 

Committee  on  Medical  Literature  —  Drs.  Henry  Campbell,  Ga. ;  D.  F. 
Wright,  Tenn. ;  0.  Wendell  Holmes,  Mass. ;  S.  G.  Ormer,  Ohio ;  and  W. 
H.  Byford,  111. 


122  The  Peninsular  and  Independent. 

Committee  on  Medical  Education  —  Drs.  D.  M.  Reese,  New  York  ;  W. 
R.  Bowling,  Tenn. ;  Chas.  Fishback,  Ind. ;  John  Bell,  Penn. ;  Z.  Pitcher. 
Mich. 

The  following  Special  Committees  were  appointed  : 

On  Morbus,  Coxarius,  and  Surgical  Patliology  of  Articular  Inflammation — 
Dr.  Lewis  A.  Sayre,  of  New  York. 

On  the  Surgical  Treatment  of  Strictures  of  the  Urethra — Dr.  James  Brj-an,  of 
Philadelpliia. 

On  Drainage  and  Sewerage  of  Large  Cities,  their  Influence  on  Public  Health 
— Drs.  A.  J.  Semmes,  D.  C,  cliairman,  Comdius  Boyle,  and  G.  M.  Dove. 

On  the  Periodicity  of  Diseases  PrevaiUng  in  the  Mississippi  Valley — Dr.  J. 
W.  Singleton,  of  Smithland,  Ky. 

On  Puerperal  Tctjinus,  its  Statistics,  Pathology,  and  Treatment — Dr.  D.  L. 
McGugin,  of  Keokuk,  Iowa. 

On  Hospitjil  Epidemics — Dr.  R,  K.  Smith,  of  Philadelphia. 

On  Puerperal  Fever — Dr.  J.  N.  Green,  of  Stelisville,  Ind. 

On  Anjemia  and  Chlorosis — Dr.  H.  P.  Ayres,  of  Fort  "Wayne,  Ind. 

On  Ve'ratrum  Viridt — Dr.  James  B.  McCmw,  of  Richmond,  Va. 

On  Alcohol,  Its  Therapeutical  Effects — Dr.  J.  R.  W.  Dunbar,  of  Balti- 
more, Md. 

On  Meteorology — Dr.  J.  G.  "Westmoreland,  Atalanta,  Ga. 

On  Milk  Sickness — Dr.  Robert  Thomj)Sun,  Columbus,  Ohio. 

On  Manifestations  of  Disease  of  Nerve  Centres — Dr.  C.  B.  Chapman, 
Wisconsin. 

On  the  Medical  Topography  of  Iowa — Dr.  T.  0.  Edwards,  Iowa. 

On  Microscopic  Ouservations  on  Cancer  Cells — Dr.  Geo.  D.  Noiris,  New 
Market,  Ala. 

On  the  Philosophy  of  Practical  Medicine^ — Dr.  Chas.  Graham,  Cincinnati, 
Ohio. 

On  Some  of  the  Peculiaiities  of  the  North  Pacific  and  their  Relations  to 
Climate— Dr.  Wm.  H.  Doughty,  Ga. 

The  following  special  committees  were  continued  or  altered: 

On  Microscope — John  C.  Dalton,  Jr.,  N.  Y. ;  David  Hutchinson,  Ind. ;  A.  R. 
Stout,  Cal. ;  Calvin  Ellis,  Mass. ;  Christopher  Johnson,  Md. 

On  Diseases  and  Mortality  of  Boarding  Schools — Dr.  C.  Mattingly,  Ky. ;  and 
Dixi  Crosby,  N.  H. 

On  the  Various  Surgical  Operations  for  the  Relief  of  Defective  Vision — Drs. 
M.  A.  Pullen,  Mo. ;  T.  J.  Cogley,  Ind.,  and  W.  Hunt,  Penn. 

On  the  Blood  Corpuscle — Dr.  A.  Sager,  Michigan. 

On  American  Medical  Necrology — Dr.  C.  C.  Cox,  Maryland. 

On  the  Hygenic  Relations  of  Air,  Food,  and  Water,  the  natural  and  artificial 
causes  of  their  impurity,  and  the  best  methods  by  which  they  can  be  made  most 
efiectually  to  contribute  to  the  public  healtli — Dr.  C.  C.  Cox,  Maryland. 

On  the  Effect  of  Virus  of  Rattlesnake,  <fce.,  when  introduced  into  the  system 
of  Mammalia — Dr.  A.  S.  Payne,  Virginia. 

On  the  Climate  of  the  Pacific  Coast,  and  its  Modifying  Influences  upon  In- 
flammatory Action  and  diseases  generally — Dr.  0.  Harvey,  California. 

On  the  Constitutional  Origin  of  Local  Diseases,  and  the  Local  Origin  of 
Constitutional  Diseases — Drs.  W.  H.  McKee,  North  Carolina,  and  C.  F.  Hey  wood. 
New  York. 

On  motion  of  Dr.  Brodie,  Dr.  A.  J.  Semmes  was  requested  to  serve  as 
Secretary  pro  tern,  during  the  remainder  of  the  session. 

The  Association  took  up  the  special  order,  being  the  report  on  Medical 
Ethics,  to  which  had  been  referred  the  action  of  the  Dubuque  Medical 
Society,  which,  after  debate,  was  laid  over  until  12  o'clock  to-morrow. 

Amendments  to  the  Constitution  of  the  Association  were  then  taken 
up,  and  a  provision  was  acted  upon  that  no  individual  who  shall  be  under 
sentence  of  expulsion  or  suspension  from  any  State  or  Local  Medical 
Society,  of  which  he  may  have  been  a  member,  shall  be  received  as  a 


Twelfth  Annual  Meeting  of  Am.  Med,  Association.    123 

delegate  to  this  body,  or  be  allowed  any  of  the  privileges  of  a  member, 
until  he  shall  have  been  relieved  from  such  sentence  by  such  State  or 
Local  Society.     This  amendment  to  the  Constitution  was  adopted. 

The  next  amendment,  lying  over  from  last  year,  was  the  proposition 
of  Dr.  Kyle,  of  Ohio,  — 

That  the  Constitution  of  the  Association  be  so  amended  as  to  prohibit 
the  admission  as  a  delegate  or  the  recognition  as  a  member  of  any  person 
who  is  not  a  graduate  of  some  respectable  medical  college. 

This  amendment  was  rejected;  but,  on  the  question  of  reconsideration, 
a  long  and  animated  debate  ensued,  which  called  forth  all  the  oratorical 
abilities  and  much  of  the  personal  feelings  of  the  delegates.  Without 
arriving  at  a  vote,  the  Association  adjourned  for  dinner. 

The  following  gentlemen  have  been  admitted  to  the  Association  as 
members  by  invitation : 

Indiana:  B.  C.  Rowan,  N.  D.  Field,  John  S.  Rowe,  R.  Curran, 
D.  Wiley,  J.  A.  Windle,  A.  V.  Talbot,  J.  W.  Davis. 

Ohio :     W.  C.  Hall,  N.  B.  Davis. 

Tennessee:     J.  M.  Brannoch. 

Kentucly:  W.  N.  Garther,  S.  B.  Fields,  W.  S.  Cain,  J.  A.  Hodge, 
S.  B.  Merrifield,  Joshua  Gore,  H.  M.  Berkeley. 

MissotiTh:     J.  M.  Allen. 

Alabama:     Dr.  Boylman,  Dr.  Turney. 

Neio  Hampshire :     David  Kay. 

United  States  Army:     Charles  S.  Tripler. 

Afternoon  Session. 

Upon  the  re  -  assembling  of  the  Association,  the  discussion  was 
renewed  on  the  motion  to  reconsider  the  vote  by  which  the  amendment 
to  the  Constitution  was  negatived,  prohibiting  the  admission  as  a  delegate 
or  the  recognition  as  a  member  of  any  person  who  is  not  a  graduate  of 
some  respectable  medical  college. 

Dr.  Kincaid  moved  a  further  amendment,  to  insert  the  word  "  here- 
after" after  "prohibiting." 

Dr.  Askew,  of  Delaware,  one  of  the  Vice-Presidents  in  the  chair, 
ruled  the  amendment  out  of  order  at  the  present  stage,  or  until  the  Asso- 
ciation decide  upon  the  question  of  reconsideration. 

After  a  long  discussion.  Dr.  Davis,  of  Indiana  moved  to  lay  the  motion 
to  reconsider  on  the  table ;  which  was  carried,  97  yeas,  nays  not  counted. 
So  the  amendment  stands  registered. 

The  next  proposed  amendment  to  the  Constitution  was  that  suggested 
by  the  New  Jersey  Medical  Society,  asking  for  such  changes  as  would 
establish  a  Board  of  Censors  in  every  judicial  district  of  the  Supreme 
Court,  who  should  examine  and  grant  diplomas  to  all  proper  members  of 
the  Association. 

This  was  temporarily  laid  on  the  table,  for  Dr.  Crosby  to  offer  a  report 
of  the  Medical  Teachers'  Convention,  which  met  ori  Monday  last.  He 
strongly  recommended  a  committee  from  this  body  to  confer  with  the 
Teachers'  committee,  and  felt  great  confidence  that  something  beneficial 
to  medical  education  would  be  the  effect  of  such  conference. 

Dr.  Comegys  moved  the  appointment  of  a  committee  of  five  to  confer 
with  a  committee  of  Medical  Teachers,  and  report  at  the  next  annual 
meeting,  provided  that  no  medical  teacher  be  selected  on  the  part  of  this 
Association. 

This  again  gave  rise  to  an  excited  debate,  clearly  showing  that  there 
was  a  great  deal  of  bad  feeling  between  the  Professors  and  the  laymen  of 


124  The  Peninsular  and  Independent. 

the  profession.  Prof.  McDowell,  of  Missouri,  was  extremely  happy  in 
some  of  his  hits,  and  kept  his  auditors  in  a  roar  of  laughter.  He  acknow- 
ledged that  Philadelphia  and  New  York  had  the  advantage  of  location ; 
the  railroads  took  students  there  as  they  did  the  horses  and  cattle  of  the 
West,  and  sometimes  its  asses. 

Prof  Crosby,  of  Dartmouth  College,  contended  that  the  elevation 
of  the  standard  of  medical  education  depended  more  upon  practitioners 
than  the  colleges ;  if  bad  materials  were  sent  up  from  physicians'  offices 
for  Professors  to  model  into  physicians,  it  could  not  be  expected  that  good 
results  would  follow.  He  wanted  a  committee  of  conference,  not  based  on 
any  sectional  feelings,  and  he  believed  the  whole  matter  could  be  arranged 
satisfactoril)\ 

Dr.  D.  W.  Yandell  wished  to  reply  to  one  remark  of  Prof  Crosby,  as 
to  the  bad  materials  sent  by  private  teachers  to  the  colleges.  He  had 
himself  rejected  students  who  were  too  big  fools  to  be  made  physicians, 
and  these  same  persons,  in  a  few  months,  had  gone  to  some  of  the  colleges 
and   come   back   with   their   diplomas   in   their   pockets. 

After  a  very  eloquent,  appropriate,  and  conciliatory  speech  from 
Dr.  Davis,  the  resolution  of  Dr.  Comegys  was  unanimously  adopted. 

The  resolutions  from  the  New  Jersey  Medical  Society  were  then  taken 
from  the  table,  and  referred  to  the  Committee  of  Conference., 

Dr.  Davis  offered  a  resolution  instructing  the  same  committee  to 
confer  with  the  State  Medical  Societies,  for  the  purpose  of  procuring  more 
decisive  and  uniform  action  throughout  the  profession  in  carrying  into 
effect  the  standard  of  preliminary  education  adopted  by  this  Association  at 
its  organization  in  1847.     This  was  carried. 

Dr.  Gibbes,  from  the  committee  to  examine  into  a  Plan  of  Uniform 
Registration  of  I3irths,  Marriages,  and  Deaths,  offered  the  following  report: 

They  have  given  the  same  a  careful  consideration,  and  they  unanimously  recom- 
mend that  the  Report  be  adopted  and  referred  to  the  Committee  on  Publication. 

They  also  recommend  that  the  same  committee  be  continued,  with  instructions  to 
add  to  the  Hcport,  in  time  for  publication  in  the  ensuing  volume  of  Transactions,  a  form 
of  registration  law  which  may  be  likely  to  answer  the  requirements  of  the  several  States. 

Dr.  Sayre,  of  New  York,  offered  the  following : 

Wheeeas,  The  medical  profession  at  lar^e  have  an  interest  in  the  character  and 
qualijBcations  of  those  who  are  to  be  admitted  as  their  associates  in  the  profession; 
Therefore,  — 

Resolved^  That  each  State  Medical  Society  be  requested  to  appoint  annually  two 
delegates  for  each  college  in  that  State,  whose  duty  it  shall  be  to  attend  the  examination 
of  all  candidates  for  graduation ;  and  that  the  colleges  be  requested  to  permit  such 
delegates  to  participate  in  the  examination  and  vote  on  the  qualifications  of  all  such 
candidates. 

This  was  referred  to  the  Committee  of  Conference. 

The  paper  of  Dr.  Jones,  presented  at  the  morning  session,  was  taken 
from  the  Committee  on  Publication,  and  referred  to  the  Committee  on 
Prize  Essays. 

Dr.  Eve  moved  to  record  the  name  of  Dr.  Benj.  W.  Dudley  as  a 
permanent  member ;  which  was  adopted  by  a  unanimous  vote,  the  dele- 
gates all  rising  to  their  feet  in  token  of  respect. 

Adjourned  till  to-morrow  morning. 

The  followino;  members  of  the  Association  registered  their  names 
during  the  day : 

Indiana:  John  M.  Kitchen,  S.  Davis,  Geo.  W".  New,  J.  H.  "Wood- 
burn,  S.  M.  Linton,  C.  Brown,  A.  G.  Boynton,  F.  M.  Mothershead, 
T.  Bullard,   W.  W.  Hitt,   A.  J.  Mullen,   Jno.  M.  Hinkle,  J.  D.  Maxwell, 


Ticelfth  Amiual  Ifeeting  of  Am.  Med.  Association.     125 

Jno.  M.  Reily,   J.  A.  Windle,   B.  C.  Rowan,   L.  Ritter,   R.  Curran,   J.  W. 
Davis,  W.  T.  S.  Cornett,  A.  V.  Talbert. 

Missouri:    J.  M.  Allen,  E.  S.  Frazer. 

Iowa:     Wm.  Watson. 

JSfew   YorJc :     Daniel  G.  Thomas,  John  L.  Zabriskie,  M.  M.  Marsh. 

Alabama:     J.  N.  Turney. 

Pennsylvania :     W.  W.  Townsend,  Caleb  Swaine. 

Ohio:  Geo.  Mendenhall,  S.  G.  Armor,  E.  B.  Stevens,  L.  G.  Lecklider, 
W.  L.  Schneck,  J.  P.  Judkins,  D.  B.  Cotton,  W.  F.  Kincaid,  Jno.  Davis, 
W.  C.  Hull,  W.  B.  Davis,  P.  H.  Kelly,  Usher  P.  Leighton. 

United  States  Army  :     Charles  S.  Tripler. 

KentiicTty :  E.  0.  Brown,  S.  B.  Richardson,  A.  H.  Shively,  F.  Q. 
Montgomery,  J.  A.  Hodge,  W.  W.  Cleaver,  Hugh  Berkley,  S.  B.  Field, 
W.  N.  Garther,  Ed.  Richardson. 

Illinois :  F.  B.  Haller,  H.  Nance,  Thomas  Wilkins,  T.  D.  Fitch, 
C.  Jolinson,  D.  0.  McCord. 

Tennessee:     J.  M.  Brannoch. 

The  whole  number  of  delegates  in  attendance  is  therefore  301,  exclu- 
sive of  members  by  invitation. 

Second  Day's  Proceedings. 

Thursday,  May  5th,  1859. 

The  President  called  the  Association  to  order  at  9  o'clock,  and  the 
reading  of  the  minutes  of  yesterday  was  dispensed  with. 

The  first  business  in  order  was  an  amendment  to  the  Constitution, 
laid  over  from  last  year,  and  proposed  by  Dr.  T.  L.  Mason,  of  New  York, 
to  insert  in  the  first  line  of  the  second  paragraph  of  Article  2,  after  the 
words  "shall  receive  the  appointment  from,"  the  words  "any  medical 
society  permanently  organised  in  accordance  with  the  laws  regulating  the 
practice  of  physic  and  surgery  in  the  State  in  which  they  are  situated, 
and  consisting  of  physicians  and  surgeons  regularly  authorised  to  practice 
their  profession."  Also,  to  add  to  the  sixth  paragraph  of  the  same 
article  the  words  "but  each  permanent  member  of  the  first  class  desig- 
nated in  this  plan  of  organization  shall  be  entitled  to  a  seat  in  the 
Association,  on  his  presenting  to  this  body  a  certificate  of  his  good 
standing,  signed  by  the  Secretary  of  the  Society  to  which  he  may  belong 
at  the  time  of  each  annual  meeting  of  this  body. 

Dr.  Linden  A.  Smith,  of  New  Jersey,  said  amendments  to  the 
Constitution  should  be  adopted  with  care,  and  though,  perhaps,  that  now 
proposed  might  be  desirable,  still,  as  Dr.  Mason  who  had  proposed  it,  was 
not  present  to  explain  his  views,  he  moved  that  the  subject  be  laid  over 
until  next  year.     This  suggestion  was  adopted. 

Another  constitutional  amendment,  proposed  by  Dr.  Henry  Harts- 
home,  of  Pennsylvania,  and  laid  over  from  last  year  under  the  rules, 
provides  to  add  to  the  second  article  the  words :  "  No  one  expelled  from 
this  Association  shall  at  any  time  thereafter  be  received  as  a  delegate  or 
member,  unless  by  a  three-fourths  vote  of  the  members  present  at  the 
meeting  to  which  he  is  sent,  or  at  which  he  is  proposed." 

This    amendment   was   adopted. 

Another  amendment  proposed  by  J.  Berrien  Lindsley,  of  Tennessee, 
was  called  up,  to  omit  in  Article  2  the  words  "  medicar  colleges,  hospitals, 
lunatic  asylums,  and  other  permanently  organized  medical  institutions  in 
good  standing  in  the  United  States,"  and  also  to  omit  the  words  :  "  The 
faculty  of  every  regularly  constituted  medical  college  or  chartered  school 
of  medicine  shall  have  the  privilege  of  sending  two  delegates.     The  pro- 


,126  The  Peninsular  and  Inde^jendent. 

fessional  staff  of  every  chartered  or  municipal  hospital  containing  an 
hundred  inmates  or  more  shall  have  the  privilege  of  sending  two  delegates, 
and  every  other  permanently  organised  medical  institution  of  good  stand- 
ing shall  have  the  privilege  of  sending  one  delegate." 

This  was  laid  on  the  table  until  the  next  annual  meeting. 

An  invitation  was  received  from  Mons.  Groux,  requesting  the  delegates 
to  meet  him  at  the  hall  of  the  University  at  noon  to-day,  to  witness 
experiments  on  his  congenital  fissure  of  the  sternum;  which  was  deferred- 
until  four  o'clock  this  afternoon,  as  the  Association  had  previously  accepted 
the  hospitality  of  Mr.  and  Mrs.  Robert  J.  AVard  at  the  former  hour. 

Dr.  McDermont  submitted  the  following  resolutions : 

•  Whereas,  A  vast  proportion  of  the  disease  and  misery  that  afflict  our  race  is 
caused  by  the  excessive  use  of  intoxicating  liquors ;  and  whereas  in  the  opinion  of  this 
Association  the  evils  of  intoxication  can  be  most  effectually  remedied  by  the  establish- 
ment of  Inebriate  Asylums,  wherein  the  victims  of  intemperance  may  bo  subjected  to 
Buch  restraints  and  treatment  as  shall  effect  a  thorough  reformation  of  their  habits  ; 
therefore, — 

Resolved,  That  this  Association  recommend  the  establishment  of  Inebriate 
Asylums  in  the  various  States  of  the  Union. 

Resolved,  That  the  State  and  County  Medical  Societies,  and  all  members  of  the 
medical  profession,  be  requested  to  unite  in  diffusing  among  the  people  a  better  knowledge 
and  appreciation  of  the  beneficent  purposes  and  important  benefits  that  would  be  confer- 
red upon  society  by  the  establishment  of  such  Asylums  throughout  the  various  sections 
of  the  country. 

This  resolution  was  referred  to  the  mover,  as  a  special  committee, 
with  a  request  that  he  would  report  thereon  at  the  next  meeting  of  the 
Association. 

Dr.  Shattuck  offered  the  following,  which  was  adopted : 

Resolved,  That  the  committee  appointed  in  May,  1S57,  on  Criminal  Abortion,  be 
requested  to  continue  their  labors,  and  especially  to  take  all  measures  necessary  to  carry 
into  effect  the  resolutions  reported  by  them  on  the  first  day  of  the  meeting. 

Dr.  Yandell,  from  the  Committee  on  Voluntary  Essays,  made  a 
further  report  that  a  communication  had  been  received  from  Dr.  Langer, 
of  Iowa,  on  Subentaneous  Injections  as  remedials;  which,  on  motion, 
the  author  read. 

The  essay  was  referred  to  the  writer  as  a  special  committee,  with 
the  request  that  he  would  report  further  at  the  next  annual  meeting  of 
the  Association,  and  continue  his  investigations. 

Invitations  to  visit  the  Insane  Asylum,  and  the  Library  and  Museum 
of  Transylvania  University,  were  received. 

The  President  appointed,  as  the  committee  of  conference  to  meet  the 
committee  from  the  Teachers'  Convention,  the  following  gentlemen:  Dr. 
Blatchford,  Troy,  N.  Y. ;  Condie,  Philadelphia,  Pa. ;  Bozeman,  Montgo- 
mery, Ala. ;  Brodie,  Detroit,  Michigan ;  and  Sneed,  Frankfort,  Ky. 

Dr.  D.  Meredith  Reese  from  the  Nominating  Committee  made  the 
following  final  Report: 

Special  Committees  continued: 

On  Quarantine  —  Drs.  D.  D.  Clark,  Penn. ;  Snow,  R.  I. ;  Jewell, 
Penn. ;  Fenner,  La. ;  and  Houck,  Md. 

On  Medical  Ethics  —  Drs.  Schuck,  Penn. ;  Murphy,  Ohio ;  Linton, 
Mo.  ;  Powell,  Ga. ;  Eve,  Tenn. 

On  Tracheotomy  in  Membranous  Croup — Dr.  A.  Y.  Dougherty,  N.  J. 

On  the  Effects  of  Lithotomy,  Performed  in  Childhood,  upon  the 
Sexual  Organs  in  After  Life — Dr.  White,  Memphis,  Tenn. 

On  Mercurial  Fumigation  in  Syphilis — Dr.  D.  W.  Yandell,  Louis- 
ville, Ky. 

On  the  Improvements  in  the  Science  and  Art  of  Surgery,  made 
during  the  last  Half  Century — Dr.  Jos.  McDowell,  St.  Louis,  Mo, 


Twelfth  Annual  Meeting  of  Am.  Med.  Association.     127 

On  the  Cause  and  Increase  of  Crime  and  Its  Mode  of  Punishment 
—Dr.  W.  C.  Sneed,  Frankfort,  Ky. 

On  the  Education  of  Imbecile  and  Idiotic  Children — Dr.  H.  P.  Ayres, 
Fort  Wayne,  Ind. 

On  the  Uses  and  Abuses  of  the  Speculum  Uteri — Dr.  C.  H.  Spill- 
man,  of  Kentucky. 

On  the  Topography  of  Vermont — Dr.  Perkins,  of  Vermont. 

On  the  Pons  Varolii,  &c.— Dr.  S.  B.  Richardson,  of  Kentucky,  and 
Dr.  Fishback,  of  Indiana. 

On  the  Physical  Effects  of  the  Hydro  -  Carbons— Dr.  F.  W.  White, 
of  Illinois. 

On  the  Effect  of  the  Periodical  Operations  for  Urinary  Calculi  upon 
Procreation  in  the  Male — J.  S.   White,  of  Tennessee. 

The  paper  from  Dr.  Ellis,  of  Massachusetts,  on  the  subject,  "Does 
the  microscope  enable  us  to  make  a  positive  diagnosis  of  Cancer,  and 
what  if  any  are  the  sources  of  error?"  was  referred  to  the  special 
committee  on  the  microscope,  of  which  Dr.  Dalton  is  chairman. 

Honorary  resolutions  were  passed  to  the  memory  of  the  following 
members  of  the  Association,  deceased :  Dr.  W.  W.  Bowling,  of  Alabama ; 
Dr.  Thomas  D.  Mutter,  of  Penn. ;  Dr.  P.  C.  Gaillard,  of  S.  C. ;  Dr. 
Jabez  G.  Goblc,  of  New  Jersey;  Dr.  John  K.  Mitchell,  of  Penn. 

Dr.  R.  K.  Smith,  of  Philadelphia,  submitted  the  following : 

Resolved^  That  the  death  of  Dr.  John  K.  Mitchell,  one  of  the  members  of  this  Asso- 
ciation, has  been  to  this  body  a  loss  keenly  felt  by  every  man  who  knew  him.  His  emi- 
nence as  a  teacher,  his  varied  acquirements  in  every  department  of  learning,  and  his 
generous  social  qualities  in  every  relation,  endeared  him  to  every  member  of  the  profes- 
sion who  had  the  pleasure  of  his  personal  acquaintance. 

Resolved,  That  the  family  be  notified  of  the  action  of  this  Association. 

Other  more  formal  resolutions  were  offered  and  feeling  eulogies 
pronounced. 

Dr.  Sayre  offered  the  following,  which  were  adopted  by  acclamation : 

Resolved,  That  the  thanks  of  the  American  Medical  Association  are  eminently  due 
and  are  hereby  presented  to  the  citizens  of  Louisville,  Ky.,  for  the  princely  hospitality 
publicly  and  privately  extended  to  the  members  of  this  body  during  its  present 
session. 

Resolved,  That  to  the  Committee  of  Arrangements,  and  to  the  profession  of  Louis- 
ville generally,  our  thanks  are  due  for  their  kind  and  assiduous  attention  to  the  Asso- 
ciation and  for  the  hearty  welcome  with  which  they  have  greeted  our  convention  in  their 
flourishing  city. 

After  the  transaction  of  some  other  unimportant  routine  business, 
On  motion  of  Dr.  Davis,  the  Association  adjourned,  to  meet  at  New 
Haven  on  the  first  Tuesday  in  June,  1860. 

The  registration  book  during  the  day  announced  the  names  of  Drs. 
D.  G.  Thomas,  of  New  York ;  William  S.  Cain,  of  Kentucky,  and  Peter 
Allen,  R.  K.  McMeans,  and  W.  R.  Kable,  of  Ohio — making  305  mem- 
bers in  attendance  during  the  session  of  the  Association. 


» ♦  ♦- 


NEWS    ITEMS. 


It  is  commonly  believed,  and  it  is  stated  in  many  chemical  works, 
that  charcoal  is  antiseptic.  This,  according  to  Dr.  Stenhouse,  is  the  very 
reverse  of  the  fact,  as  shown  by  the  condition  of  the  bodies  of  animals 
which  have  been  long  buried  in  charcoal,  which  are  usually  in  an  advanced 


128  The  Peninsular  and  Independent. 

stage  of  decay.  This  opinion  has  doubtless  arisen  from  the  fact  that  char- 
coal absorbs  the  gases,  and  thus  prevents  any  disagreeable  efiluvia. . 

The  statistics  of  Ohio  for  the  year  1858,  show  that  the  number  of  suicides 
in  that  State  was  sixty  in  all,  or  one  in  every  forty  thousand  of  the  popu- 
lation.  The  mode  of  suicide  is  mainly  confined  to  hanging,  drowning,  cut- 
ting the  throat,  shooting,  and  poison.  Of  the  suicides  in  Ohio,  the  mode  se- 
lected by  seventeen  was  that  of  hanging,  seven  by  drowning,  six  by  cutting 
the  throat,  and  ten  by  poisoning;  the  remaining  modes  wei-e  generally 
some  violence  occasioned  by  delirium  tremens  or  intoxication.  The  suicides 
in  cities  appear,  as  a  general  fact,  to  be  much  more  numerous  than  in  the 
country,  as  for  example — in  New  York,  1  in  10,500;  in  Cincinnati,  1  in 
15,000;  in  London,  1  in  6,000:  in  Paris,  1  in  2,100.  The  number  of  sui- 
cides given  for  Europe,  by  Balbi,  some  twenty  years  since,  was  as  follows: 
in  France,  1  in  20,000;  in  Austria,  1  in  20,000;  in  Prussia,   1  in  15,000; 

in  Russia,  1  in  49,000.  A  curious  libel  suit  has  recently  come  off  in 

Paris.  Twelve  homeopathic  physicians  sued  the  Union  MedicaJe  for  having 
asserted  that  homeopathy  was  "neither  a  doctrine,  nor  a  science,  but  a 
trade,"  and  that  "if  an  epoch  had  ever  presented  itself  at  which  the  me- 
thod of  Uanneman  could  be  employed  b}^  any  one  who  was  not  abjectly  ig- 
norant— a  crack-brained  visionary,  or  a  wretched  charlatan — it  was  certainly 
not  the  present  one."  The  editors  and  proprietors  of  the  Union  Aledicale 
pleaded  by  way  of  defense  and  justification,  that  what  they  had  stated  was 
only  the  truth.  The  tribunal  before  which  the  suit  was  brought,  without 
passing  any  judgment  on  the  respective  sj'stcms  of  allopathy  and  homeo- 
pathy, held  that  the  plaintiffs  had  no  ground  of  action,  and  dismissed  the 

case  with  costs.  The  number  of  persons  now  known  to  have  been 

been  poisoned  by  eating -the  lozenges  having  arsenic  in  them,  at  Bradford 
(Eng.),  is  225,  of  whom  eighteen  have  died.  Five  or  six  others  are  still 
suffering  from  the  effects  of  the  poison,  and  the  recovery  of  two  of  them 

is  doubtful.     Of  the  poisoned,   130  were  adults.  Chloroform  has 

been  administered  thirty  tliousand  times  in  the  hospitals  of  London,  during 

the  last  ten  years,  for  the  performance  of  surgical  operations.  The 

Microscopists  of  Germany  have  entered  into  an  arrangement,  by  which, 
once  a  year,  an  exchange  of  microscopical  specimens  takes  place.  At  the 
last  meeting,  twenty-four  Microscopists  were'prcsent,  and  3000  preparations 

offered  in   exchange. Some  of  the  European  journals  are  making 

merry  over  the  fact  that  a  iconwn  has  sent  to  the  Academy  of  Medicine, 
Paris,  a  suf>2^ensoriuin  scroti !    The  inventorcss  submits  it  to  the  approval 

of  the  Medical  Faculty,  assuring  them  that  it  is  a  masterpiece. The 

odorous  principle  of  the  Vanilla  bean,  which  has  been  supposed  to  be  form- 
ed by  a  sort  of  fermentation  during  the  curing  of  the  bean,  is  proved  by 
GoBLEY  to  pre-exist  in  it,  in  the  form  of  a  crystalline  principle,  somewhat 
analogous  to  the  coumarin  of  the  Tonka  bean,  and  which  he  has  named 

Vanillin.  Chemical  matches  have  been  introduced  into  Europe  by 

a  chemist  (M.  Canouil),  which  are  made  without  white  or  red  phosphorus 
or  other  poison.  They  are  formed  essentially  of  chlorate  of  potash,  mixed 
with  a  small  quantity  of  a  metallic  peroxide,  bichromate,  or  oxysulphuret, 
when  it  is  desired  to  render  them  more  inflammable.  These  matches  dif- 
fuse no  odor,  either  in  the  manufacture  or  in  the  use.  They  Hght  without 

explosion  or  projection. X  whaling  vessel  arriving   at   Nantucket 

last  fall,  brought  750  pounds  of  Ambergris,  taken  from  one  whale.  It  was 
sold  to  a  Boston  drug-house  for  $10,000.  This  substance  is  a  morbid  se- 
cretion of  the  Spei'maceti  whale.  It  is  generally  found  in  whales  of  a  lean 
and  sick  appearance ;  indicating  that  the  Ambergris  is  the  product  of  dis- 
ease; and  usually  in  lumps  of  from  one  to  thirty  pounds  weight.  The 
largest  piece  hitherto  known  weighed  182  pounds,  and  was  bought  by  the 
Dutch  East  India  Company  of  the  King  of  Tidore.  Another  piece,  from 
the  inside  of  a  whale  killed  near  the  ATindward  Islands,  was  sold  for  ^2500. 


THE 


PENINSULAR  and  INDEPENDENT 


MEDICAL  JOURNAL. 


Vol.  II.  DETROIT,-  JUNE,  1859.  No.  3. 


riginal  Cffmrannitations. 


-•♦^- 


ART.  II.— Report  to  the  State  Medical  Society  on  Criminal  Abortions. 

^  By  E.  P.  Christian,  M.  D. 


Messrs.  Editors:  —  My  apology  for  sending  the  following  Report, 
corrected  and  comjiJeted,  for  publication  in  the  Journal,  is  not  on  account 
of  the  egregious  orthographic  and  grammatical  liberties  taken  with  the 
copy  in  the  published  Transactions  of  the  State  Medical  Society  —  for,  as 
regards  these,  I  could  have  contented  myself  with  having  fellow  -  suffer- 
ers— but  it  is  rather  that,  by  cutting  it  in  two  in  the  middle,  the  whole 
point  of  it  was  lost,  and  it  would  have  served  a  far  better  purpose  to 
have  published  the  latter  half  than  the  former. 

It  was  certainly  a  very  bold  liberty  to  take,  but  evidently  the 
matter  was  not  scrutinized  by  any  proof-reader  at  all. 

Owing  to  the  fact  of  not  having  the  manuscript  by  me,  I  have 
been  unable  to  make  a  true  copy,  but  the  addition  now  made  to  the 
Report  as  published  in  the  Transactions  embraces  all  that  was  omitted 
from  the  original  paper.  E.  P.  0. 

Wyandotte,  May  18,  1859. 


At  the  last  meeting  of  this  Association,  the  writer  was 
appointed  to  report  at  this  meeting  on  Criminal  Abortions. 
A  snhject   so  indefinitely  stated,  occasions   an   uncertainty 

Vol.  11. -I. 


130  The  Peninsular  and  Independent, 

as  regards  the  special  design  of  such  a  Keport,  and  gives 
to  the  reporter  no  small  amount  of  discretionary  power  in 
his  choice  of  the  manner  in  which  the  subject  is  to  be 
considered.  From  the  simple  statement  of  the  subject  in 
such  general  terms  it  could  not  be  known  whether  the 
Report  was  expected  to  treat  of  the  causes,  and  means  of 
prevention,  of  Criminal  Abortion,  or  of  the  best  and  safest 
mode  of  procuring  it,  or  of  any  other  particular  mode  of 
consideration. 

I  have  chosen  to  consider  some  of  the  special  causes  of, 
and  incentives  to,  the  commission  of  this  crime,  and  the 
remedy,  the  means  of  prevention  thereby  suggested.  I 
shall  not  infringe  upon  the  province  of  medical  jurispru- 
dence to  treat  of  the  legal  nature  of  this  crime,  and  to 
define  what  constitutes  it,  &c.  I  simply  state  that  our 
statutes  make  it  penal  for  any  one  to  attempt  to  joroduce 
miscarriage  without  the  advice  of  two  medical  men  that  it 
is  necessary  to  preserve  the  life  of  the  mother.  No  person, 
not  even  a  medical  man,  is  authorized,  or  justified,  in  at- 
tempting to  procure  it  on  his  own  judgment  and  his  own 
responsibility  alone.  Yet,  though  such  cases  are  penal, 
they  are  not  to  be  considered  in  the  class  of  Criminal  Abor- 
tions here  treated  of.  I  have  reference  to  deliberate  and 
premeditated  destruction  of  an  embryo,  unnecessary  on 
account  of  the  life  or  health  of  the  mother. 

We  are  not  so  Utopian  as  to  anticipate,  very  speedily, 
that  condition  of  society  in  which  this  crime  shall  be  un- 
known, nor  do  we  expect  its  complete  cessation  by  other 
means  than  by  such  as  we  hope  to  check  the  commission 
of  all  crime  —  not  by  penal  codes,  but  the  universal  'faith- 
ful Christian  observance  of  the  whole  Divine  decalogue. 

And  yet,  as  there  are  strong  and  peculiar  reasons  for 
the  occurrence  of  this  crime,  even  in  an  otherwise  moral 
community,  so,  on  the  other  hand,  are  there  strong  and 
peculiar  reasons  for  hoping  to  effect  its  prevention ;  and  the 


'     Christian  07i  Criminal  Abortions.  131 

ineans  of  effecting  this  lie  almost  entirely  with  the  Medical 
Profession.  It  comes  peculiarly  within  the  physician's  mis- 
sion, no  less  than  in  ministering  to  the  relief  of  disease  and 
suffering.  The  means  for  use  are  within  his  power ;  and  the 
responsibility  rests  upon  him  for  a  proper  use.  We  do 
not  propose  any  severer  legal  penalties  as  a  means  of  its 
prevention.  The  enactments  are  already  sufficiently  rigor- 
ous, and  all  experience  shows  that  crime  is  not  so  entirely 
prevented  by  severity  of  penalties,  and  least  of  all  could 
we  expect  this  crime  to  be  so  influenced.  We  would,  how- 
ever, make  patent  and  conspicuous  Nature's  penalties — the 
moral  and  physical  penalties  which  can  not  be  evaded — by 
far  more  terrible  than  any  legal  penalty  that  can  be  applied, 
and  a  just  appreciation  of  which  would  do  more  towards 
preventing  this  crime  than  Draconian  laws.  This  is  what 
belongs  to  the  physician,  and  is  wherein  his  duty  and 
responsibility  lie. 

But  though  we  propose  no  severer  penalties,  we  do  not 
consider,  by  any  means,  our  statute  as  unamenable  to  criti- 
cism, and  incapable  of  being  bettered,  for  it  displays  the 
relics  of  barbarism,  being  based  upon  ignorance  and  a  physi- 
ological lie. 

What,  then,  is  a  query  next  suggested,  are  the  peculiar 
circumstances  bearing  on  this  crime,  which  prompt  to  its 
commission,  and  occasion  its  prevalence  amongst  all  classes 
of  society,  even  in  intelligent  and  reputably  moral  commu- 
nities, and  which  render  it  less  liable  to  be  influenced  by 
the  nature  of  the  penalty  imposed  than  other  crimes.? 

1st.  Ignorance  of  the  true  nature  of  the  crime,  and  of 
the  real  guilt  attaching  to  it;  a  morbid,  illicit  perversion 
of  the  moral  sense  on  this  matter,  or  rather,  perhaps,  an 
uneducated  and  undeveloped  moral  status  in  regard  to  it. 
It  is  surprising  how  little  guilt  is  attached  to  the  crime  of 
infanticide  among  all  nations,  civilized  as  well  as  barbarous! 
This    is  evinced   by   its    so    frequent   occurrence  among  all 


132  The  Peninsular  and  Independent. 

communities,  and  by  its  being  an  established  custom  among 
some  nations,  and  a  custom  whose  observance  is  not  only- 
laudable,  but  regarded  as  an  act  of  obedience  to  Divine 
will.  However  we  may  account  for  such  a  perversion  of 
natural  feelings  and  of  moral  sense,  which  would  not  be 
difficult  to  do,  it  has  its  existence  and  influence ;  and  where 
infanticide  is  regarded  so  lightly,  how  much  less  importance 
is  attached  to  the  destruction  of  foetal  life  where  ignorance 
of  the  physical  penalties  is  almost  universal. 

2d.  Why  is  it  less  liable  to  be  influenced  by  the  nature 
of  the  penalty  imposed  ?  For  several  reasons.  As  a  gene- 
ral fact  we  may  state  that  the  frequency  of  any  particular 
crime  will  be  governed  by  the  special  temptations  to  its 
commission,  and  by  the  risk  of  detection  and  punishment. 
As  regards  the  risk  of  detection  and  punishment,  we  shall 
presently  show  why,  in  these  cases,  it  is  particularly  small ; 
but  even  the  certainty  of  conviction  and  suflering  the  pen- 
alty of  crime,  does  not  avail  to  prevent  its  commission 
when  the  temptation  is  strong.  Human  nature,  under  the 
influence  of  ungoverned  passion,  takes  no  thought  of  the 
legal  penalties,  and  much  less  of  the  natural  j^enalties ;  and 
strong  and  prevailing,  too,  must  be  the  moral  sense  where 
the  commission  of  an  error  or  a  course  of  erroneous  action^ 
and  escape  from  detection,  will  not  render  more  facile  the 
commission  of  a  second,  with  the  prospect  of  eradicating 
the  evidences  of  the  former  and  the  latter.  Facilis  de- 
scensus Averni  is  a  trite  quotation  from  the  heathen  writer, 
no  less  philosopher  than  poet;  but,  like  an  algebraic 
formula  in  mathematics,  expresses  in  the  fewest  and  truest 
words  this  downward  tendency.  Shame,  the  wish  and 
expectation  of  escaping  the  scorn  and  ridicule  of  the  world, 
when  the  moral  sense  has  been  seared,  proves  as  great  an 
incentive  to  crime  as  passion  itself.  Do  I  say  too  much 
in  stating  that  capital  crimes  are  as  frequently  thus 
prompted  as  by  passion  itself  ?      How  many  murders,  rob-- 


Christian  on  Criminal  Abortions.  V6% 

beries,  arsons,  &c.,  are  prompted  by  the  hope  and  expecta- 
tion of  concealing  and   repairing  the  wrongs  originated   in 
the  drinking  -  room  and  at  the  gaming-table.      Since,  then, 
statute  Hpan    statute,  and   jDenaltj  upon  penalty,  can   not 
effect   the  suppression   of  ordinary   crimes,  how   much   less 
would  naturally   be  their  influence  upon  one  of  this   char- 
acter, where,  in   a  large  proportion  of  cases,  the  discovery 
of  the  error  which   is  sought    thereby   to  be   concealed,  is 
held  as  a  greater  punishment,  a  more  dreadful  alternative, 
than  any   the  law  can   inflict.      Not  only,  too,  is  there   in 
many  cases  the  expectation  of  concealing  former  errors,  and 
of  escaping  the  scorn  and   ridicule  of  the  community,  but 
of  escaping  the  cares  and  anxieties  of  maternity' — to  many, 
even  in  the  bonds  of  wedlock,  no  small  temptation,  when 
depressed   by  poverty  and   harrassed  with   the  cares  of  an 
already  large  family,  or  perhaps  of  an  ill -mated,  intemperate, 
or  improvident  husband  ;    and  how  much  greater,  then,  to 
one   having  no   husband's  sympathies   or   succor,  and   only 
cold  and   ungenerous  contempt   and   disdain  to   anticipate ! 
As  regards  the  risk  of  detection  and  punishment,  the  dan- 
ger is  in  reality  small — if  in  a  married  woman,  how  insig- 
nificantly small  is  it.?      Where  is  the  memory,  and  where 
the  records  of  punishment   of  such  a  case  ?      And  yet,  as 
regards  its  frequency,  let  any  medical  man,  for  an  answer, 
consult   the  record   of  the  applications   made   to  him,  and 
the  physical  evidences  he  has  observed  in  sufl*erings  he  has 
been   called   upon   to   relieve.      We   might   ask  where   and 
when   has   been  a  conviction  in   any  case,  except  when    of 
more   than  ordinary   malignity,  as  where  a  double   murder 
has  been  committed  of  both  mother  and  child,  which   has 
spasmodically  excited  public  feeling  to  a  higher  pitch  than 
usual  ?      And  is  not  a  conviction  in  such  cases  the  excep- 
tion ?      Most  certainly  it  is ;  and  I  am  ignorant  of  any  such 
in   our   State,  though   arraignments   have   been   made,  and 
.justice  has  aemanded  satisfaction.      But  usually  the  risk  is 


134  The  Peninsular  and  Independent. 

in  reality  small;  and  from  this  very  fact  the  temptation 
becomes  the  stronger.  The  crime  is  against  a  being  that, 
as  yet,  has  attached  itself  to  no  one  by  strong  ties  of  sym- 
pathy or  interest.  There  are  none  so  strongly  bound  to 
it  that  their  friendship  prompts  them  to  care  for  its  rights 
or  avenge  its  wrongs.  Its  natural  protectress  —  she  who 
should  guard  it  from  evil  and  administer  to  its  wants — be-, 
comes  the  agent  of,  or  accessory  to,  the  crime.  The  friends 
of  the  agent,  if  cognizant,  are  urged  by  interest  to  prevent 
disclosure. 

Again,  we  have  observation  and  experience  to  the  full 
to  show  us  that  enactments  against  what  are  not  repugnant 
to  the  common  ideas  of  morality  of  a  large  part  of  the 
community,  unless  a  palpable  and  unequivocal  benefit  is 
sought  thereby  to  be  conferred  on  a  larger  part,  are  a 
complete  nullity.  Look,  for  example,  at  the  enactments 
against  liquor  vending,  against  Sabbath  breaking,  profane 
swearing,  &c. ;  and  this  is  the  case,  as  we  have  before  stated, 
on  this  subject.  The  fact  is,  and  a  lamentable  one  it  is, 
that  with  a  large  number  of  otherwise  moral,  intellectual, 
and  respectable  individuals,  it  is  not  considered  at  all  as  a 
crime — hardly  as  a  misdemeanor :  an  individual  who  would 
shudder  at  the  thought  of  maiming  a  brute — who  could 
not  look,  unmoved  by  pity,  upon  the  writhings  of  an 
entrapped  mouse — will  willingly  and  eagerly  submit  to, 
and  aid  in,  the  unnecessary  destruction  of  a  vital  embryonic 
human  being — her  own  offspring — to  which  she  should  be 
attached  by  the  strongest  feelings  which  God  has  implanted 
in  her  breast.  Oh,  blush  Humanity! — how  much  less  hu- 
man in  this  than  the  Brute  creation ! 

The  state  of  public  sentiment  on  this  subject,  and  the 

insufficiency  of  mere  penal  enactments  may  be  exhibited  by 

a  statement  of  very  competent   authority  on   this  point, — » 

Alf.  S.  Taylok,  author   of  a   standard   work   on  medical 

jurisprudence.     Says  he : 


Christian  on  Criminal  Abortions.  135 

*'Most  trials  for  child  -  murder  end  in  the  escape  of  the  prisoner. 
She  is  acquitted  of  the  murder,  in  opposition  to  the  strongest  evi- 
dence against  her,  and  found  guilty  of  concealment  of  birth ;  so  that  no 
other  punishment  is  inflicted  than  that  to  which  a  female  would  be 
sentenced  who  had  been  secretly  delivered  of  a  child  that  had  died  from 
natural  causes,  and  the  body  of  which  she  had  afterwards  concealed. 
But  can  the  former  serious  crime  be  placed  in  comparison  with  a  trivial 
offense  of  this  description?" 

This  exhibits  the  strong  disinclination  of  juries  to  convict 
of  infanticide ;  and,  a  fortiori,  how  much  stronger  the  dis- 
inclination to  convict  of  foeticide,  when  the  law  makes  the 
distinction  of  calling  the  former  murder,  which  in  the  latter 
would  be  only  manslaughter,  and  that,  too,  only  after 
quickening. 

The  ignorance  and  abnormal  sentiment  —  we  hardly  wish 
to  characterize  it  as  immorality  —  which  results  therefrom,^ 
pervades  all  ranks.  Newspaper  proprietors  exhibit  it  in  a 
lamentable  degree,  or  else  are  thrice  guilty  in  accepting 
pieces  of  silver  as  the  price  of  innocent  blood.  We  refer 
to  the  glaring  advertisements  to  be  daily  perused  in  promi- 
nent corners  of  even  the  most  respectable  journals,  of  safe 
and  ready  means  of  effecting  this  purpose.  For  example, 
such  as  the  following : 

"This  medicine,  to  married  ladies,  is  invaluable,  as  they  (it)  will, 
in  all  cases,  bring  on  the  monthly  flow  with  regularity." 

Thus  is  the  crime  encouraged  and  fostered. 

The  dealing  in  lotteries  of  any  kind  is  contrary  to  our 
laws,  and  even  their  advertisement  is  prohibited ,  and  why 
is  it  that  such  advertisements  as  these — far  more  pregnant 
with  evil,  with  wickedness,  with  perdition,  are  tolerated 
and  so  openly  displayed — destructive  to  morality  and  de- 
bauching to  innocence.^ 

But  this  is  not  alone  where  our  legislators  have  been 
remiss.  The  same  ignorance  and  its  consequences  has 
pervaded   oiir  legislative  halls^  where  we  ought  reasonably 


136  '     The  Peninsular  and  Independent. 

to  look  for  the  most  intelligent  representation  of  community. 
It  is  there  manifested  in  the  character  of  the  enactments 
on  this  subject,  which  thence  emanate,  and  exert  their  influ- 
ence over  community.  The  character  of  the  laws  in  a 
self-governing  people  is  the  rejflex  of  the  intelligence  and 
morality  of  the  people ;  and,  as  such,  what  is  our  exhibit 
is  this  respect  ?      Here  is  our  statute : 

[5742.]  Sec.  32.  The  willful  killing  of  an  unborn  quick  child  by 
any  injury  to  the  mother  of  such  child,  which  would  be  murder  if  it 
resulted  in  the   death  of  such  mother,  shall   be  deemed  manslaughter. 

[5743.]  Sec.  33.  Every  person  who  shall  administer  to  any  woman 
pregnant  with  a  quich  child,  any  medicine,  drug,  or  substance  what- 
ever, or  shall  use  or  employ  any  instrument,  or  other  means,  with 
intent  thereby  to  destroy  such  child,  unless  the  same  shall  have  been 
necessary  to  preserve  the  life  of  such  mother,  or  shall  have  been  advised 
by  two  physicians  to  be  necessary  for  such  purpose,  shall,  in  case  the 
death  of  such  child  or  of  such  mother  be  therely  produced,  be  deemed 
guilty  of  manslaughter. 

[5744.]  Sec.  34.  Every  person  who  shall  willfully  administer  to 
any  pregnant  woman  any  medicine,  drug,  substance,  or  thing  what- 
ever, or  shall  employ  any  instrument  or  means  whatever,  with  intent 
thereby  to  produce  the  miscarriage  of  any  such  woman,  unless  the 
same  shall  have  been  necessary  to  preserve  the  life  of  such  woman, 
or  shall  have  been  advised  by  two  physicians  to  be  necessary  for  that 
purpose,  shall,  upon  conviction,  be  punished  by  imprisonment  in  a 
county  jail  not  more  than  one  year,  or  by  a  fine  not  exceeding  five 
hundred  dollars,  or  by  both  such  fine  and  imprisonment. 

From  which  we  learn — 

That  what  constitutes  murder  in  case  of  the  death  of 
the  mother,  in  case  of  the  death  of  an  unborn  quick  child, 
by  willful  killing,  constitutes  manslaughter.  Should  death 
not  ensue  to  the  child  till  subsequent  to  its  birth,  in 
consequence  of  such  injuries,  we  suppose  it  would  then 
constitute  murder. 

And,  again :  The  destruction  of  a  quick  child,  by  at- 
tempts to  produce  abortion,  with  intent  to  destroy  such 
child,  like  the  death  of  the  mother  in  the  same  case,  con- 
stitutes manslaughter. 


Christian  on  Criminal  Abortions.  137 

In  the  first  case,  the  evil  intent  is  supposed  to  be 
airainst  the  mother,  and  hence  her  death  is  murder :  whilst 
the  death  of  the  child  being  accidental,  or  at  least  the 
design  being  not  against  the  child,  its  death  constitutes 
manslaughter.  In  the  second  case,  the  design  being  against 
the  child,  the  death  of  the  mother  is  accidental,  and  is 
only  manslaughter ;  and  the  death  of  the  child,  too,  is  man- 
slaughter, as  it  is  not  yet  regarded  as  a  living  being. 

But  how  is  the  destruction  of  a  child  not  yet  quick 
regarded,  and  what  the  penalty  ?  Why  there  is  no  pro- 
vision against  it,  and  no  penalty  except  such  as  is  imposed 
tipon  the  mere  aitemi^t  to  procure  miscarriage. 

And  what  is  the  penalty  for  attempting  to  procure 
miscarriage,  which  is  adjudged  sufficient,  also,  for  the  de- 
struction of  a  not  yet  quickened  foetus  ?  Imprisonment  in 
a  county  jail  not  more  than  one  year,  or  a  fine  not  exceed- 
ing five  hundred  dollars,  or  both — a  penalty  of  the  same 
grade,  and  almost  identical,  with  that  prescribed  for  simple 
assault  and  battery ;  a  penalty  less  severe  than  those  for 
^ny  oftenses  against  persons  which  are  directly  specified  in 
our  statutes,  and,  with  hardly  an  exception,  less  severe  than 
those  prescribed  for  any  offenses  against  property  of  which 
our  statutes  take  cognizance. 

Such,  then,  is  the  trivial  character  of  the  legal  enact- 
ments by  which  this  crime  is  designed  to  be  suppressed  — 
ubout  as  prophylactic  as  infinitesimal  globules  of  belladonna 
«;gainst  scarlatina — a  hawser  of  cotton  twine  to  bring  to  a 
check  the  headway  acquired  both  by  wind  and  tide.  And 
what  is  the  moral  force  of  such  enactments.^  Can  it  be 
anything  but  to  engender  too  lax  a  sentiment  in  regard  to 
the  criminality  of  the  offense,  to  create  the  opinion  that 
the  offense  consists,  not  in  the  successful  accomplishment, 
but  in  the  discovery  and  publicity  of  the  act.? 

On  what  principles  of  morality  or  facts  of  physiology 
is  this  distinction  made   as   regards  the   criminality  of  the 


138  The  Peninsular  and  Independent. 

destruction  of  a  not  yet  quickened  foetus?  Why  is  the 
destruction  of  a  five  months'  foetus  so  much  more  heinous 
an  offense  than  that  of  a  four  months'  foetus  ?  The  whole 
idea  is  a  relic  of  mediaeval  barbarism  and  ijrnorance  which 
should  be  eradicated  from  jurisprudence,  as  it  has  been  from 
physiological  science. 

If  there  is  to  be  a  distinction  in  criminality  based  upon 
development  of  the  foetus,  would  it  not  be  more  rational 
that  the  dividing  line  should  be  indicated  by  some  phe- 
nomenon more  unequivocally  indicative  of  independent  exist- 
ence, as  the  sound  of  the  foetal  heart,  indicating  an 
independent  circulation  ?  But  the  whole  thing  is  an 
implied  falsehood.  No  phenomenon  —  neither  motion,  foetal 
circulation,  nor  any  other  —  indicates  incipient  individual 
existence,  as  the  laws  falsely  intimate.  Physiology  only 
knows  existence  to  commence  with  conception.  But  if  it 
be  proper  or  politic  to  make  a  legal  distinction  in  regard 
to  the  destruction  of  the  foetus  at  different  periods,  let  not 
this  distinction  be  based  upon  false  conceptions  of  facts, 
and  thereby  inculcate  a  false  morality  on  the  subject.  It 
is  full  time  that  some  legal  barbarisms  should  be  banished 
where  many  gross  medical  ones  have  long  since  been  sen- 
tenced, to  add  an  interest  to  musty  tomes,  by  gratifying 
the  curious  student  of  ancient  knowledge. 

But,  as  we  have  before  intimated,  the  Medical  Profession 
has  a  duty  imposed  upon  it  in  relation  to  this  matter. 
The  means  of  prevention  are  more  effectively  in  the  power 
of  the  physician  than  in  that  of  the  executors  of  justice; 
or^  if  any  change  in  regard  to  legal  enactments  and  judicial 
executions,  respecting  this  matter,  it  requisite  or  advisable, 
the  influence  to  effect  that  must  come  mainly  through  the 
Medical  Profession,  who  alone  are  competent  witnesses  to 
the  frequency  of  the  crime,  and  to  the  necessity  of  means 
for  its  check.      His   duty  is,  as  we  have   said,  to  cause  to 


Christian  on  Criminal  Abortions,  139 

be   known  the   physical   penalties   which   must   be  paid,  of 
which  there  is  no  evasion. 

That  it  is  an  evil  of  some  importance,  too,  even  as 
regards  political  economy,  there  can  be  no  question ;  it  is 
one  destructive  of  life,  productive  of  impaired  health 
and  strength,  and  conducive  to  weakly  and  impaired  off- 
spring. How  much  of  an  evil,  in  this  light,  physicians 
only  know ;  and  they,  perhaps,  having  very  indefinite 
ideas  of  the  aggregate  in  any  large  community  for  certain 
periods. 

But  is  there  any  physician  of  any  considerable  practice 
who,  if  not  directly  applied  to  for  that  purpose,  does  not 
yet  frequentl  witness  the  baleful  effects  of  injudicious, 
and  perhaps  successful,  efforts  to  procure  abortion  ?  Cer- 
tainly within  the  writer's  own  experience,  in  a  limited 
practice  among  a  manufacturing  and  rural  population,  he 
has  had,  within  the  year,  several  open  applications,  evi- 
dently made  in  conscious  innocence,  to  have  abortion 
induced  ;  he  has  witnessed  several  severe  and  dangerous 
cases  of  illness  so  induced  ;  can  point  to  individuals 
whose  whole  life  is  one  of  continual  suffering  from  im- 
paired functions,  to  be  attributed  to  this  cause,  and  at 
least  one  death  may,  with  much  probability,  be  charged 
to  an  unsuccessful  attempt  of  this  nature.  How  much 
then  must  be  the  aggregate  of  the  experience  of  phy- 
cians  of  large   communities,  or   of  a   large  section ! 

Now,  as  an  array  of  figures  will  have  more  force  in  im- 
pressing a  truth  than  single  facts  now  and  then  reported, 
we  would  suggest  that,  inasmuch  as  it  is  desirable  that 
the  amount  of  prevalence  of  this  crime  should  be  known, 
and  the  nature  of  the  evils  resulting  from  it,  both  in  a 
moral,  political,  and  scientific  view,  that  the  members  of 
this  Society  be  requested  to  collate  facts  regarding  it, 
during  the  ensuing  year,  such  as  applications  made  for 
its    procurement,    cases    of    sickness   and    death    resulting 


140  Tke  Peninsaiar  and  Independent. 

from  efforts  of  the  kind,  character  of  physical  evils  re- 
sulting, convictions,  &c.,  and  that  these  statistics  be  for- 
w^arded  as  early  as  January  1st,  1860,  to  some  one  who 
shall  be  appointed  by  this  Society,  at  this  meeting,  to 
report  on  the  subject  of  Criminal  Abortions  at  the  next 
meeting.  We  are  confident  that  by  such  means,  if  faith- 
fully carried  out,  an  array  of  facts  could  be  displayed, 
surprising   even   to    the    Medical   Profession. 


AUT.  XII.— Selections  from  Surgical  \otes. 
By  Moses  Gunn,  M.  D. 


Case  I.     February  23d,  1859. — Mrs.  L ,  age  56  years, 

presented  herself,  with  a  large  tumor  upon  the  side  of  the 
face  and  neck,  extending  from  the  temple  to  within  two 
inches  of  the  clavicle,  and  projecting  outwards  about  four 
inches  beyond  the  angle  of  the  inferior  maxilla.  The  ear 
occupied  a  position  upon  the  posterior  surface  of  the  tu- 
mor. The  disease  was  of  thirty -two  years'  standing,  and 
its  progress  had  been  for  a  long  time  very  slow  ;  but  for 
the  last  few  months  its  advance  had  been  much  more 
rapid.  The  mass  was  distinctly  lobulated,  and  j)erceptibly, 
though  not  extensively,  movable  ;  it  was  also  clearly  un- 
blended with  adjacent  tissues.  The  integument  was  much 
attenuated,  but  unadherent  to  the  tumor. 

These  facts,  taken  in  connection  with  a  tolerable  pre- 
servation of  the  patient's  general  health,  led  to  the  diag- 
nosis of  the  benignant  nature  of  the  disease,  and  of  its 
probable  adipose  character.  The  prognosis  was  of  course 
favorable,  and  an  operation  was  advised  and   submitted  to. 

Operation :  An  elliptical  incision,  inclosing  a  small  por- 
tion of  the  integument  upon  the  summit  of  the  tumor,  and 
extending  from  the  upper   to   the   lower   extremity   of  the 


Gunn's  Selections  from  Surgical  Notes.  141 

mass,  was  made  down  to  the  substance  of  tlie  disease, 
It  was  now  found,  as  anticipated,  that  the  tumor  had  de- 
veloped for  itself  a  sort  of  capsule  in  the  areolar  tissue, 
from  which  it  could  be  readily  enunculated,  as  is  generally 
the  case  in  circumscribed  adipose  accumulations.  The  dis- 
ease, however,  was  observed  to  present  no  other  peculiar- 
ity of  this  substance. 

The  extirpation  of  the  mass  was  rapidly  accomplished, 
mainly  by  the  fingers  and  handle  of  the  scalpel.  The  fin- 
gers were  easily  carried  deep  into  the  neck  behind  the 
disease,  where  the  pulsation  of  the  carotids  could  be  dis- 
tinguished. A  few  bands,  only,  required  the  edge  of  the 
scalpel  for  their  separation,  and  these  were  upon  the  deep 
surface  of  the  mass.  Due  caution  was  observed  in  making 
these  sections..  The  parotid  gland  was  completely  absorbed, 
and  the  disease  occupied  its  place,  pushing  before  it  the 
branches  of  the  portio  dura  constituting  the  pes  anserinus. 
A  few  of  these  were  adherent  to  the  tumor,  and  were 
divided,  but  most  of  them  remained  intact,  and  could  be 
traced  in  the  wound  after  the  extirpation.  One  lobe  of 
the  diseased  mass  extended  deep  into  the  neck,  and  occu- 
pied a  portion  internal  to  the  styloid  process. 

Not  a  single  vessel  required  a  ligature.  The  wound 
healed  readily,  and  the  patient  made  a  good  recovery,  with 
only  slight  paralysis  of  the  muscles  of  the  face. 

Nature  of  the  disease  :  As  intimated  above,  the  diag- 
nosis as  to  the  probable  nature  of  the  disease  was  incorrect. 
It  was  not  an  adipose  growth  ;  but  presented  a  uniform 
grayish  flesh  color.  In  substance,  it  was  exceedingly  friable 
and  granular,  appearing  not  unlike  the  earlier  stages  of  en- 
cephaloid  disease.  Under  the  microscope,  its  heterologous 
character  was  distinctly  shown,  being  composed  mainly  of 
cells,  and  component  parts  of  cells  of  great  variety,  and 
conforming  to  Rokitansky's  description  of  one  variety  of 
encephaloid  disease. 


142  The,  Peninsular  and  Independent, 

The  above  case,  it  will  be  seen,  presents  features  of 
peculiar  interest.  The  slowness  of  the  growth,  the  un- 
blending  character  which  it  preserved  through  so  long  a 
period,  and  the  continued  health  of  the  patient,  are  symp- 
toms, the  union  of  which  would  point,  clearly  it  would 
seem,  to  the  non-malignancy  of  the  disease.  Its  structure, 
however,  both  as  it  appeared  to  the  naked  eye  and  under 
the  microscope,  as  plainly  point  to  an  opposite  quality. 
Should  the  disease  recur,  its  nature  will  then  be  clearly 
established  ;  but  its  anomalous  features  will  be  rendered 
only  more  distinctly  prominent  thereby.  Should  the  disease 
never  recur,  and  the  patient  attain  the  allotted  period  of 
man,  its  non-malignancy  would  then  be  undoubted  ;  yet  its 
structural  character  would  then  only  be  more  apparently 
inconsistent  with  received  doctrines  as  to  the  structure  of 
malignant  growths. 

Case  II.  December  5th,  1857. — Adam  Smith,  age  53  years, 
presented  himself,  with  a  flat  lobulated  tumor  covering  the 
greater  portion  of  the  dorsum  of  the  nose.  It  was  soft  and 
elastic,  and  had  existed  for  twelve  years.  It  had  ulcerated 
two  or  three  times  during  that  period,  discharging  (from 
his  description)  a  thin,  ill  -  conditioned  fluid,  which  could 
hardly  be  called  pus.  It  was  free  from  pain,  fixed,  and 
continually  increasing  in  size — latterly  with  greater  raj)idity. 
The  integument  was  healthy  except  at  the  cicatrix  of  the 
ulceration. 

Extirpation  was  advised,  and  performed  by  making  a 
crucial  incision  through  the  skin,  avoiding  the  cicatrix, 
dissecting  back  the  flaps  and  scraping,  rather  than  dissect- 
ing, the  diseased  mass  from  the  bony  and  cartilaginous  frame 
of  the  nose.  The  structure  of  the  disease  was  soft,  friable, 
and  granular,  and  closely  resembling  in  microscopic  appear- 
ance that  of  Case  I. 

The  flaps  were  adjusted,  and   united  partly  by  first  in- 


Gunn's  Selections  from  Surgical  Notes.  143 

tention,  but  mainly  by  granulation,  attended  by  free  and 
laudable  suppuration. 

There  has  been  no  return  of  the  disease  yet;  and  from 
the  appearance  of  the  patient,  there  seems  no  probability 
of  such  an  event. 

87  Shelby  Street,  May  18th,  1859. 


ART.  XIII,  — A  Criticism. 


By  J.  A.  Brown,  M.  D. 


In  the  Peninsular  and  Independent,  for  November,  1858, 
I  notice  a  very  well  -  written,  and  probably  well  -  intended, 
article,  from  the  pen  of  0.  C.  Gibbs,  M.  D.,  entitled  "  A 
Case  of  Obstruction  of  the  Boivels  relieved  by  Copious 
Injections  J   after  the   Failure   of  other  Means  J' 

On  looking  over  a  few  back  Nos.  of  the  Journal,  I  find 
that  this  Dr.  Gibbs  is  also  author  of  a  few  strictures  upon 
the  able  and  interesting  Eeport  of  the  talented  Dr.  S.  Du- 
Bois,  of  Michigan,   a  fine   scholar   and  ripe  student  of  his 
Profession,  upon  the  subject  of  '^  Rheumatism,"  read  before 
the    Michigan    State    Medical    Association    last    spring,    in 
which  he  (Dr.  G.)  seems  to  manifest   more   of  an   inclina- 
tion to  say  something  in  the  Journal  than  to  communicate 
any  new  fact  (notwithstanding  the  following  preface  to  his 
remarks  : — "  Its  reading  [viz.  that  of  the  Eeport]  has  sug- 
gested a  few  thoughts,  which  we  wish  to  express,  and  that 
too    in   no    spirit  of   criticism,  influenced  only  by  the  con- 
sciousness  that   it   is  every  man's  duty,  who  is  engaged  in 
the  noble  work  of  mitigating   pain   and    disease,  to  contri- 
bute his  mite  to  enhance  the  efficiency  of  his  art''),  as  he 
criticised   not   only  a  quotation  from   one  of  our   standard 
authorities,  which  was  just  as  much  open  to  criticism  be- 
fore  ever    it    appeared  in   that   Eeport  as  afterwards,  and 


144  The  Peninsular  and  Independent. 

which  we  think  he  must  previously  have  read,  but  suggest- 
ed no  new  idea,  either  in  the  pathology  or  treatment,  thai- 
his  effort  seemed  to  indicate  Dr.  DuBoiS  had  omitted,  oi 
mentioned  no  additional  agent,  except  cimicifuga,  which, 
of  course,  may  be  used  in  almost  any  case  where  a  diapho- 
retic is  desired.  This,  however,  being  a  digression  from  our 
subject  proper,  we  shall  leave  to  Dr,  DuBois. 

In  the  first  place,  then,  in  describing  his  case,  Dr.  G, 
says  : 

''^January   Ist,    1858.  —  I   was    called    to    see   Mrs.    R ,    aged 

about  55  years.  She  complained  of  severe  pain  in  the  bowels,  was 
vomiting  some,  the  pulse  was  quick,  tongue  furred,  bowels  tender 
on  pressure,  the  countenance  haggard  and  indicative  of  much  distress 
and  prostration.  I  suspected  strangulated  hernia,  but,  on  inquiry  and 
examination  this  supposition  proved  groundless.  Opium,  in  full  doses, 
combined  with  small  doses  of  calomel,  was  advised  internally,  and  hot 
fomentations   locally. 

"  Jamiary  2d.  —  The  patient  was  suffering  less  pain,  but  not 
otherwise  improved.  The  treatment  was  continued,  the  opium  in  du 
minished,    and   the   calomel   in   increased   doses. 

^'■January  Sd.  —  The  patient  was  no  better;  the  pulse  was  more 
frequent,  and  the  vomiting  still  continued.  Castor  oil  was  now  or- 
dered in  tablespoonful  doses,  to  be  repeated  every  hour  until  it  ope- 
rated ;  the  action  of  the  oil  to  be  aided  by  injections  of  infusion  of 
senna." 

The  bowels  now  becoming  "  bloated  and  tympanitic," 
the  external  application  of  hot  oil  of  turpentine  was 
adopted,  with  little  or  no  other  change  in  the  treatment 
until  after  the  seventh  day,  except  an  increase  of  the 
mercury  to  gr.  5,  with  an  evident  aggravation  of  all  the 
symptoms,  as  he  himself  states,  and  no  evacuation  from 
the  bowels  ;  for  the  simple  reason,  evidently,  that  up  to 
this  time  no  efficient  and  reliable  cathartic  agent  had 
been  administered — at  least,  in  anything  like  efficient  doses, 
especially   with   such   an   object   in   view. 

Now,    does   this    appear   at   all   like   rational   treatment 
for   obstruction    of    the    bowels ;    viz.    The    use    of   solid 


Brown. — A  Criticism.  145 

opium   for   three    or   four    days    together,   loith    little    or 
nothing   else;    and,    indeed,    nothing   else   in   anything   like 
sufficient    quantities    to    produce    catharsis  ?      Indeed,    it 
would   seem   from   the   treatment,    that    the   case   was   not 
regarded,    whatever    else    it   might   have   been   thought   to 
be,    as    one    of    obstruction ;    as    it    appears    no   attempt 
was    ever   was   made    to    clear   the    primce  vice,    until,    at 
least,    the   third   or   fourth   day,    when   castor  oil  was   pre- 
scribed  in   doses    of  only   a   tablespoonful,    at   intervals   of 
an   hour,    in   which    quantities   it   would   be   very  likely  to 
be   digested   in    the   stomach,  with   no   cathartic   effect,  in- 
stead   of    administering    it    in   a  full   dose    at   once    (viz. 
two   or   three   large   spoonfuls)  ;    and  nothing   more  potent 
than   this   resorted   to    until   the   seventh   day,   and   indeed 
not   at   all   for    this  purpose,  unless   it  was   the  eaii  chaud 
(warm    water),    pumped   in   from   below. 

We   do    not    know   whether   it    is   correct   or   not,    but 
it   seems    to   us,    from   his  own   statement    of  the   case,  to 
be    the   only  reasonable   inference,    that  Dr.  G.,    mistaking, 
or   at   least   not   appreciating,  the   true   nature  of  the   dif- 
ficulty,   commenced   his    operations   rather   in    the   dark,  or 
empirically,    without    reference    to    any   definite   or   specific 
object   or   end,    and   contented   himself  with   battling,  with 
an    energy   and   perseverance   in    the   use   of    the   measures 
adopted  that,  had  they  been  wisely  or  difierently  directed, 
would   have   done   him   vastly   more   credit    against,    or   in 
endeavoring   to   remove,   what   would    seem    to    be    rather 
the   result,    or   symptoms,  of  a   more   serious   disease   than 
the   disease   itself      Indeed,    looking   at   the    symptoms    as 
detailed  by  himself — viz.    ^^ severe   pain  in   the  bowels   and 
tenderness  on  pressure,  vomiting,  quick  pulse,  furred  tongue, 
countenance   haggard   and   indicative  of  great   distress,  ob- 
stinate  constipation,   and   prostration," — what  tyro  in  me- 
dicine,   with   any   degree   of  diagnostic   skill   and   discrimi- 
nation,   would  not  readily   have    predicted   the   real   diffi- 

Vol.  II.- K. 


146  The  Penuisular  and  Lidependent. 

culty,  viz.  Inflammation  of  tlie  LoweLs  (peritoneal  coat)^ 
to  which  the^  above  phenomena  all  pointed  with  almost 
an  infalible  certainty  ?  and  yet  Dr.  G.  tells  us,  "  he 
first  suspected  strangulated  hernia,"  until  after  an  exa* 
mination  and  inquiry,  without  having  had  his  attention 
directed  to  any  such  local  affair,  as  is  always  done  in 
those  cases  by  the  patients  themselves,  usually  stating 
'Hhey  are  burst,  or  have  a  breech,"  &c.  What,  we  ask, 
in  the  name  of  reason,  could  it  have  been  but  perito- 
nitis ?  and,  hence,  how  perfectly  irrelevant  the  following ; 
which  we  repeat :  ^^  I  first  suspected  strangulated  hernia"!! 
Again ;  Dr.  G.,  evidently  looking  upon  the  case  aa 
nearly,    or   quite   hopeless,    says  : 

*'  I  now  explained  to  the  friends  that  it  was  possible  that  a 
copious  injection  might  overcome  the  obstruction^  and  afford  relief; 
this,  I  said,  will  occasion  much  pain,  but  we  certainly  ought  not  to 
let  the  patient  die  without  making  at  least  one  more  efrort  to  afford 
relief  Of  the  many  present,  I  selected  two  women  of  nerve  and 
decision  to  carry  out  my  directions.  With  a  pump,  I  ordered  thera 
to  inject  tepid  water  into  the  bowels,  so  long  as  they  could"  prevail 
upon  the  patient  to  endure  it.  This  they  did,  and  returned  to  me 
soon,  informing  me  that  they  had  injected  only  about  a  pint.  The^ 
patient's  sufferings,  they  said,  wore  extreme.  Less  had  been  accom- 
plished  than   I   had   expected. 

"I  now  took  the  pump  myself,  closed  the  door  against  specta- 
tors, and  commenced  injecting,  entreating  the  patient  to  endure  to 
the  utmost,  as  this  was  her  only  hope.  This  she  did,  for  a  time^ 
but  soon  her  shrieks  and  groans  became  heart-rending.  Her  husband 
and  son  now  rushed  into  the  room,  and  commanded  me  to  desist 
from  further  attempts  to  relieve  the  patient ;  which  I  did  only  after 
at  least  two  quarts  had  been  injected.  The  friends  evidently  looked 
upon   me   as   a   personification   of  brutality."     &c. 

It  is  true,  after  this  the  bowels  moved,  but  the  real 
disease  evidently  remained  undisturbed  or  unchecked ;  and, 
as  a  consequence,  "  the  patient  was  not  destined  to  re- 
cover." "  She  died,  seemingly/'  says  he,  "  from  an  in- 
ability to  rally  from  the  extreme  prostration."  Then  in 
the  next  sentence,    again,   he   continues  :     "  Peritoneal  in- 


Brown. — A  Criticism.  147 

flammation  was,  doubtless,  the  cause  of  death'';  without, 
however,  having  adopted  a  treatment  scarcely,  if  any, 
more  appropriate,  or  rational,  for  this,  than  for  the 
imagined    "obstruction''    during   the   first   seven   days. 

Now,  is  there  not  great  incongruity  just  here  ?  If 
the  "  patient  died  from  an  inability  to  rally  from  the 
extreme  prostration"  caused  by  obstruction,  could  "perito- 
neal inflammation  have  been  the  cause  of  death "  ?  and 
vice  versa  ?  Again,  that  the  case  was  considered  only  as 
one  of  obstruction  to  the  end  of  his  efforts  (though  by 
no  means  in  our  estimation  treated  as  such  in  the  be- 
ginning), apart  from  the  title  of  his  article,  is  evident 
from  the  last  measure  adopted,  the  importance  of  which 
he  urged  upon  the  patient  and  friends  as  a  dernier  resort, 
without  even  intimating  the  presence  of  peritonitis ;  and 
whether  the  practice  was  inhuman,  as  is  more  than  in- 
timated the  friends  seemed  to  think,  or  not,  I  shall  not 
attempt  to  decide ;  but  will  venture  the  assertion  only, 
That  however  admissible  and  appropriate,  it  neither  reached 
nor  overcame  the  real  and,  as  it  turned  out,  fatal 
malady. 

Now,  in  conclusion,  I  would  say,  in  language  very 
nearly  like  that  which  closes  the  article  criticised,  and 
with  due  deference  to  its  author,  —  That  had  the  case 
been  clearly  understood,  and  copious  blood-letting  resorted 
to  in  the  very  out  -  set,  and  perhaps  repeated ;  then  a 
brisk,  reliable  cathartic  given,  followed  by  his  "  calomel 
and  opium"  (which  were  by  no  means  inappropriate,  had 
they  been  given  with  direct  reference  to  the  inflammation 
instead  of  obstruction),  with  the  topical  use  of  "hot  oil 
of  turpentine  to  the  abdomen,"  or,  what  would  have  been 
better,  large  linseed  cataplasms  saturated  freelj^  with  the 
oleum  terahinthence,  "  the  result,"  it  seems  to  us,  "  might 
have   been   diflerent." 

Kankakee   City,    III,    May  1st,  1855. 


148 


TIte  Pe7iinsalar  tuid  Indtptndtni. 


ART.  XIV.  — Meteorological  Register  for  Month  of  April,  1859. 

By  L.  S.  IIoRTON,  House  Physician  to  U.  S.  .Marine  Hospital. 


Altitude  of  Barometer  above  the  level  of  tlie  sea,  597  feet.     Latitude   4''®''4'N  •   and 
Longitude.  82"  58' W.  of  Gicenwicli.  >     -- 


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iibli^gra^Irial  |lu0rK 


FIVE  ESSAYS.  By  John  Kearsley  Mitchell,  M.  D.,  Late  Professor 
of  Practice  of  Medicine  in  Jefferson  Medical  College  of  Philadel- 
phia; Member  of  the  Academy  of  Natural  Sciences  of  Philadel- 
phia; Fellow  of  the  Philadelphia  College  of  Physicians,  &c.  Edited 
by  S.  Weih  Mitchell,  M.  D.,  Lecturer  on  Physiology  in  the 
Philadelphia  Association  for  Medical  Instruction.  Philadelphia:  J. 
B,   Lippincott   &    Co.     1859. 

The  collection  and  publication  of  these  Essays  is  the  result, 
undoubtedly,  of  a  laudable  desire,  arising  from  affection, 
to  perpetuate  the  memory  of  the  author.  We  make  this 
statement,  however,  with  no  disposition  to  disparage  the 
merits  of  the  book,  or  of  the  justly  celebrated  teacher  and 
practitioner  from  whose  pen  its  contents  emanated.  With 
a  single  exception,  the  editor  informs  us,  these  papers  had 
all  been  previously  given  to  the  public.  That  exception  is 
the  Essay  upon  Animal  Magnetism  —  a  subject,  which, 
though  badly  named,  is  full  of  interest,  and  in  the  consi- 
deration of  which,  if  our  author  is  not  fully  right,  he  forms 
no  exception  to  the  general  rule ;  indeed,  the  one  who 
should  be  so,  would  prove  the  exception.  The  other  papers 
are  not  yet  forgotten.  May  the  memory  of  the  author 
never  become  so  !  Gr. 


REPORT  ON  THE  NERVOUS  SYSTEM  IN  FEBRILE  DISEASES, 
AND  THE  CLASSIFICATION  OF  FEVERS  BY  THE  NERVOUS 
SYSTEM.  By  Henry  Frazek  Campbell,  A.  M.,  M.  D.,  Professor 
of  Anatomy  in  the  Medical  College  of  Georgia.  Extracted  from 
the  Transactions  of  the  American  Medical  Association.  Philadel- 
phia:   Collins.    1858. 

We    are   indebted  to  the  politeness  of  the    author  for  the 
above    named    pamphlet,    consisting    of   172    pages.       The 


150  The  Peninsular  and  Independent. 

readers  of  the  Independent^  and  of  the  consolidated  journal, 
know  full  well  our  views  upon  the  subject  of  Dr.  Camp- 
bell's Prize  Essay ;  these  views  are  closely  interwoven  with, 
and  distinctly  characterize,  the  subject  considered  in  the 
above  Keport.  For  these  views  we  sincerely  respect  and 
honor  the  author,  and  are  proud  to  be  conscious  of  the 
fact  they  were  clearly  taught  by  Dr.  Allen  in  the  Uni- 
versity of  Michigan  during  the  first  year  of  its  existence. 
Dr.  Campbell  is  following  up  the  subject  with  most  laud- 
able zeal,  and  with  untiring  industry,  as  evinced  in  the 
Keport  under  consideration.  He  is  upon  the  right  track, 
and  his  clear  conceptions  contend  most  favorably  with  the 
chaotic  results  which  arise  from  giving  full  credence  to  all 
of  Brown-Sequard's  manifold  and  multiform  experiments, 
and  the  adoption  of  all  his  conclusions.  G. 

THE  MICROSCOPIST'S  COMPANION;  A  Popular  Manual  of  Micros, 
copy.  By  Joun  King,  M.  D.  Cincinnati,  0. :  Robert  Clark  &  Co. 
Publishers. 

An  illustrated  directory  for  the  benefit  of  the  Microscopist 
—  showing  him  what  constitutes  the  principles  involved  in 
the  construction  of  the  Microscope,  the  methods  of  using  it, 
a  complete  descriptive  j^rice-list  and  catalogue  of  all  the 
various  instruments  made  by  American  manufacturers  of 
Microscopes,  together  with  a  glossary  of  terms,  and  a  com- 
pilation of  useful  matter  for  those  who  are  beginners  in 
the  use  of  the  Microscope. 

We  should  judge  it  to  be  of  value  to  students. 

F.  S. 


iMt0rial  §ti}uximtnl. 


The  Late  Medical  Teachers'  Convention. 

Since  the  organization  of  the  American  Medical  Asso- 
ciation, it  has  been  continually  exerting  itself  in  behalf 
of  medical  education.  The  meetings  of  the  dissociation 
have  been  mainly  made  up  of  representatives  from  the 
body  of  the  Profession,  changing  to  a  great  extent  from 
year  to  year.  This  persistent  effort,  therefore,  can  not  be 
without  cause ;  it  means  that  the  Profession  is  fully 
aware  of  the  fact  that  Medical  Education  is  not  what 
it  should  be ;  that  men  are  yearly  graduated  in  large 
numbers,  who,  at  the  time  of  their  graduation,  are  en- 
tirely unfit  to  assume  the  responsibilities  of  the  medical 
man  ;  that  human  life  is  thus  trifled  with ;  and  that, 
as  a  profession,  it  has  duties   to   perform  in   the  premises. 

Without  legislative  authority,  the  action  of  the  Asso- 
ciation has  exerted  only  a  moral  influence  over  the  schools, 
and  this  influence  has  not  been  as  powerful  as  could  be 
wished.  The  reason  of  this  lies  in  the  fact  that  medical 
schools  are  generally  commercial  rather  than  educational 
institutions.  Profit  to  the  Professors  is  the  main  con- 
sideration in  their  organization  and  existence.  Such  being 
the  case,  schools  are  slow  to  inaugurate  any  course  which 
will  have  a  tendency  to  diminish  the  yearly  number  of 
students.  The  present  avenue  to  the  privileges  of  the 
Profession   is   broad,  and  the   gate   is   wide,  and  many  are 


152  The  Peninsular  and  Independent. 

they  which  go  in  thereat.  A  narrower  gate,  and  a  more 
rugged  way,  would  lessen  the  numbers  of  those  who  find 
it ;  and  would  also  diminish  the  golden  stream  which 
flows  into  the  pockets  of  those  who  pilot  the  passage. 
It  is  not  strange,  then,  that  the  most  prosperous  schools 
are  backward  in  adopting  reformatory  measures.  We  are 
not  surprised,  therefore,  that,  at  the  late  Teachers'  Con- 
vention, Philadelphia  and  New  York  were  not  represented. 
We  are  not  surprised  that  those  schools  have  virtually 
said,  We  want  no  improvement ;  we  are  not  anxious  to 
make  better  students ;  we  are  not  anxious  to  elevate 
the  standard  of  education  ;  we  are  not  desirous  of  alter- 
ing the  present  condition  of  educational  affairs,  which, 
as  is  well  known,  is  such  that  students  who  fear  re- 
jection at  other  schools,  or  who  have  actually  received 
such  treatment,  repair  without  hesitation  to  us,  and  re- 
ceive their  degrees.  On  the  contrary,  we  desire  that  this 
impression  should  continue  to  prevail,  in  order  that  we 
may  still  reap  the  golden  fruits  thereof  We  repeat,  that 
we  are  not  surprised  at  this  course  of  the  schools  of 
the  two  great  medical  centres  of  the  Union.  We  confess, 
however,  that  we  were  surprised  that  the  University  of 
Nashville,  whose  representatives  were  jDresent,  did  not 
participate  in  the  Convention.  We  were  surprised  because 
we  had  regarded  that  school  as  an  advocate  of  improve- 
ment in  educational  matters  ;  and  we  are  sincere  in  our 
reluctance  to  class  her  with  the  Philadelphia  and  New 
York   schools. 

But,  although  the  Convention  did  not  accomplish  any- 
thing immediately  tangible,  it  was  not  without  its  bene- 
ficial influence.  It  appointed  a  committee  to  confer  with 
the  different  schools  in  the  Union  upon  the  subject  under 
consideration ;  and  adjourned,  to  meet  in  New  Haven  on 
the  day  previous  to  the  next  annual  meeting  of  Asso- 
ciation.     The   Association   also   appointed   a  committee  of 


Editorial  Department.  153: 

conference  with  the  committee  of  the  Teachers'  Conven- 
tion ;  and  we  are  confident  in  the  hope  that  this  com- 
mittee will  also  actively  exert  itself  during  the  interval, 
and  meet  with  the  Teachers'  Convention  at  its  next 
assembling.  We  would  also  express  the  hope  that  the 
Teachers'  Convention  will  prove  a  permanent  organization, 
and   that   it   will  be   productive   of  much   good. 

We   shall  recur  to  this  subject   again.  G. 

The  Meeting  at  Louisville. 

Another  (the  Twelfth)  Meeting  of  the  National  Asso- 
ciation has  just  taken  j)lace. 

In  one  respect,  at  least,  it  was  the  most  important 
meeting  which  has  convened  since  the  organization  of  the 
Association.  Entirely  without  legislative  authority,  the 
meetings  of  the  Association  have  hitherto  been  productive 
of  good,  principally  in  two  ways.  First,  in  the  production 
of  a  few  remarkably  good  Essays  and  Eeports ;  second,  in 
bringing  together  men  from  widely  -  separated  portions  of 
the  country,  and,  not  only  by  contact  in  convention,  but  by 
social  intercourse,  breaking  down  those  "middle  walls  of 
partition"  which  naturally  spring  from  location,  and  which 
thrive  upon  sectional  prejudice.  The  latter  we  regard  as 
certainly  not  second  to  the  first  in  professional  profit  and 
general  good ;  and  while  we  hail  with  genuine  joy  the 
adoption  of  the  plan  by  which  Eeports  and  Papers  are  to 
be  submitted  to  discussion  and  criticism  before  appropriate 
sections  of  the  Association,  believing  that  thereby  greater 
interest  will  attach  to  the  proceedings  and  greater  good 
result,  we  confess  that  we  have  a  real  love  for,  and  a  faith 
in,  the  social  intercourse  which  attends  these  meetings. 

In  this  connection,  too,  we  would  vindicate  the  Profes- 
sion in  reference  to  the  charge  of  quarrelsome  proclivities. 
However    justly   this   may  be    chargeable   upon    individual 


154  Tlie  Peninsular  and  Independent. 

members,  in  the  species  of  rivalry  which  naturally  occurs 
between  neighboring  practitioners,  the  great  body  of  the 
Profession  is  certainly  not  bellicose  in  character.  Com- 
pare the  meetings  of  the  National  Medical  Association 
with  those  of  the  National  Association  for  the  Advance- 
ment of  Science,  and  the  intercourse  of  the  doctors  ap- 
j)ears  in  the  comparison  like  billings  and  cooings  of  turtle 
doves.  But,  without  the  advantage  of  'such  comparison, 
the  meetings  of  the  Association  have  ever  been  charac- 
terized by  discussions  at  once  dignified  and  courteous. 
Its  members  are  remarkly  free  from  jealousy,  and  but 
for  those  jealousies  whicn  arise  from  the  representation 
of  rival  colleges,  the  word  would  hardly  have  a  meaning 
in   the   convention. 

The  meeting  at  Louisville,  as  to  number  in  attendance^ 
was  reasonably  good,  though  not  large.  The  Keports  of 
the  Committees  were  generally  wanting  ;  and  the  conven- 
tion expressed  its  dissatisfaction  at  the  delinquencies,  by 
refusing,  in  several  instances,  to  continue  the  committee. 
Several  volunteer  communications  were  received,  and  were 
read  by  title,  or  an  abstract  was  given.  Another  year, 
this,  we  trust,  will  all  be  different.  Keports  and  com- 
,  munications  will  be  read  at  length,  and  discussed  in  sec- 
tions of  the  Association.  These  discussions  will,  we  doubt 
not,  2:)rove  at  once  interesting  and  profitable ;  and,  by 
criticising  the  Reports  and  Essays,  the  value  of  the 
published    Transactions   will   be   enhanced. 

The  reception  of  the  Association  by  the  Profession 
and  citizens  of  Louisville  was  indicative  of  warm-hearted 
hospitality.  The  houses  of  several  of  the  citizens  (and 
among  them  that  of  Prentice  of  editorial  celebrity),  as 
well  as  those  of  the  Profession,  were  thrown  upon  to 
the  Association.  Princely  homes  and  cordial  hearts  greeted 
the  advent  and  sojourn  of  the  members  of  our  Profession 
with    a    tribute    of    respect.       Amid    the    hospitalities    of 


Editorial  Department.  155 

Louisville,  one  could  easily  forget  the  toils  and  perplexi- 
ties of  practical  medical  life,  and  rejoice,  for  once,  in  the 
title  of  Doctor.  Gr. 


Oar  Indigenous  Plants. 

The  American  Pharmaceutical  Association,  soliciting  the 
co-operation  of  the  Agricultural  Bureau  of  the  Patent 
Office  in  its  endeavors  to  amplify  and  develop  our  medical 
resources,  appointed  a  committee,  at  its  last  Session,  to  con- 
fer with  that  Bureau,  in  order  to  mutually  further  these 
objects  ;  and  we  gladly  notice  that  the  opportunities  and 
power  possessed  by  the  Government  have  been  recently  di- 
rected to  seeking  information,  though  the  Indian  Agents, 
concerning  these  indigenous  medicinal  plants  in  domestic 
use  among  the  various  Indian  tribes  in  our  territory.  The 
following  is  the  substance  of  a  circular  recently  sent  to  the 
ladian  Agents  by  the  Secretary  of  the  Interior: 

1.  What  medical  plants  are  used  by  the  different  Indian  tribes 
in   the   vicinity   of  the    Agency  ? 

2.  What  are  the  medical  virtues  ascribed  by  the  Indians  to 
them  —  whether  emetic,  cathartic,  diuretic,  diaphoretic,  expectorant, 
anthelmintic,  stimulant,  narcotic,  tonic,  astringent,  or  antispasmodic; 
and  the  diseases  said  to  be  cured  or  alleviated  by  the  respective 
plants  ? 

3.  In   what   latitude   are   they   to   be   found  ? 

4.  In   what   quantities   can   they   be   obtained? 

5.  How   near   to   navigable   streams    can   they   be   gathered? 

6.  What   facilities    can   be   had   for   sending   them   to   market? 
This   information   is   to   be   forwarded   to   the   Indian   Bureau. 

The  replies  elicited  from  these  queries  are  to  be  em- 
bodied in  a  Keport  to  be  made  to  the  American  Pharma- 
ceutical Association  at  its  next  meeting — 'One  which,  we 
trust,  will   form  a  valuable   feature  in  its  proceedings. 

F.  S. 


156  The  Peninsular  and  Independent. 

EDITORIAL    CORRESPO      DENCE. 


Steamship  Persia  —  Off  the  Coast  of  Ireland,  ) 
April  23d,  1859.  \ 

Bear  Readers  of  the  Peninsular  and  Independent : 

In  the  April  No.  of  the  Journal^  the  Editors  intimated  that 
as  one  of  their  number  was  to  be  abroad  for  several  of  the 
following  months,  he  would  furnish,  from  time  to  time,  com- 
munications presenting  some  of  the  results  of  his  observations. 
That  task  is  commenced  here,  and  now ;  and  in  order  that  you 
may  be  addressed  in  these  letters  in  the  most  direct  and  fa- 
miliar personal  style  —  a  style  which  it  is  presumed  will  be 
most  acceptable,  at  least  to  those  who  have  sustained  the  re- 
lation of  listeners  (as  not  a  few  of  our  readers  have)  to  the 
attempted  instructions  of  the  writer  —  the  first  person  singular 
will   be  adopted. 

I  left  Detroit  on  the  evening  of  the  6th  inst.  Witliout 
the  occurrence  of  any  event  worthy  of  record,  reached  Albany 
on  the  P.M.  of  the  next  day. 

Called  on  Dr.  A.  March,  the  venerable  and  still  enthusiastic 
Professor  of  Surgery  in  Albany  Medical  College.  The  school 
in  which  Prof  March  is,  perhaps,  the  most  prominent  attraction, 
has,  until  this  season,  held  two  Sessions  or  Courses  of  Lectures 
annually,  reckoning  each  as  a  full  Course,  and  granting  degrees 
at  the  close  of  the  Spring  Term  as  well  as  that  of  the  Fall  Term, 
which  closed  a  short  time  before  the  other  commenced.  By  at- 
tending these  two  Courses  in  succession,  a  student  who  could 
satisfy  the  Faculty  as  to  time  of  study  and  other  qualifications, 
might  graduate  within  eight  months  from  the  period  of  hearing 
his  first  lecture.  This  course  has  been  a  subject  of  complaint 
on  the  part  of  many  members  of  the  Profession,  for  some  time 
past;  and  the  expression  becoming  so  general  —  the  subject 
having  been  more  than  once  discussed  at  the  meetings  of  the 
American  Medical  Association — in  deference,  as  is  understood, 
to  that  sentiment,  the  second,  or  Spring  Course,  of  Lectures 
has  been  discontinued. 

The  voice  of  the  Profession,  through  the  Association,  is  thus 
being  heard  and  regarded;  and  if  that  Association  is  true  to 
itself  and  the  Profession — is  moderate,  consistent,  and  perse- 
vering in  its  expressions  and  acts,  the  time  is  not  distant 
when  no   School   claiming  regularity  and  respectability  will  be 


Editorial  Department.  157 

found  resisting  its  reasonable  requirements.  Time  is  required  for 
the  accomplishment  of  all  things  —  much  time  for  all  great  im- 
provements upon  established  customs  of  large  numbers,  and  con- 
trary to  the  opinion  of  some  high  in  the  Profession.  I  believe 
the  American  Medical  Association  has  already  accomplished  much 
good  in  relation  to  Medical  Education — as  much  as  could  rea- 
sonably have  been  expected  from  it  in  the  time  of  its  operations, 
and  that  greater  achievements  are  still  to  be  realised  by  this 
bodv. 

With  regard  to  the  general  condition  of  the  Albany  Medical 
College,  I  learned  that  the  number  of  students  in  attendance  is 
not  increasing,  and  that  one  of  the  Faculty  (Prof.  Hann),  who 
iias  very  acceptably  occupied  the  Chair  of  Physiology  and  Patho- 
ology,  has  resigned.  His  place  not  having  been  supplied,  ano- 
ther member  of  the  Faculty,  in  addition  to  his  regular  labors, 
will  deliver  the  Course  on  these  important  subjects. 

As  I  did  not  sail  until  the  13th  inst.  I  had  several  days  in 
Xew  York  City.  Since  the  unfortunate  "  Whitney  affair  " — un- 
fortunate for  all  parties  who  have  been  in  any  way  connected 
with  it  —  nothing  of  special  professional  interest  has  occurred  in 
this  great   metropolis  of  our  country. 

The  Schools  have  closed  their  sessions,  though  limited  courses 
of  lectures  are  being  delivered  to  such  new  students  as  remain 
in  the  city,  and  some  of  the  College  Clinics  are  still  kept  in 
operation.  The  instructions  in  Bellevue  Hospital,  instead  of 
being  systematized  and  rendered  more  specific  and  thorough,  now 
that  students  are  relieved  from  their  six  lectures  per  day  at  the 
colleges,  and  therefore  have  time  to  attend  to  them,  I  am  in- 
formed have  become  less  frequent  and  full  than  during  the  ses- 
sions of  the  colleges,  when  they  could  not  have  had  time  from 
their  other  studies  to  give  them  proper  attention.  This  is  a  state 
of  things  which  should  not  exist. 

I  do  not  designate  Bellevue  with  a  view  of  representing  this 
great  Institution  in  a  more  unfavorable  light  than  others,  here  or 
elsewhere  —  on  the  contrary,  I  believe  more  is  being  done  for 
clinical  instruction  in  this  than  in  any  other  institution  in  the 
country ;  but  I  wish  simply  to  show  that  nowhere  among  us  is 
this  most  important  part  of  medical  teaching  placed  upon  the 
proper  footing. 

There  can  be  no  doubt  that  the  great  need  of  Medical  Edu- 


158  The  Peninsular  and  Independent. 

cation  at  the  present  time,  is  a  system  of  thorough,  practical, 
Clinical  Instruction ;  and  this  can  only  be  carried  into  effect 
when  special  schools  of  Clinical  Teaching  are  established,  and 
when  students  are  in  attendance  upon  such  schools  and  such 
teaching  at  a  time  when  not  fully  occupied  with  elementary 
and  didactic  instruction  in  the  colleges.  Systematic  clinical 
instruction  should  be  chiefly  conducted  when  the  colleges 
are  not  in  session,  and  always  to  students  who  have  attended 
a  full  course  of  didactic  elementary  medical  teaching.  Such 
schools,  in  a  great  city,  would  in  no  way  interfere  with  the 
established  colleges,  but  would  rather  be  a  complement  to  them 
— together  completing  what  neither  could  do  alone  ;  and  besides 
they  would  attract  students  to  those  cities  in  wliich  they  were 
established,  and  retain  them  there  to  complete  their  medical 
pupilage. 

I  scarcely  need  add  that  New  York,  of  all  other  places 
on  our  continent,  is  the  best  ( not  but  that  others  may  be 
very  good)  for  such  schools  ,and  such  instruction.  Here,  ma- 
terials are  more  abundant,  of  greater  variety,  and  more  acces- 
sible than  anywhere  else.  It  is,  and  ever  will  be,  the  great 
Commercial  Emporium  of  the  New  World,  and  may  be  made 
the  great  Medical  Emporium  as  well.  This,  however,  can  only 
be  done  by  the  establishment,  under  proper  direction,  of  cli- 
nical schools  and  clinical  teaching,  such  as  has  been  suggested. 
Other  and  smaller  places  are  equally,  if  not  more,  capable 
of  producing  men  qualified  for  primary  and  elementary  me- 
dical teaching ;  but  no  place  furnishes  such  a  field  as  New 
York  for  teaching  clinical  medicine  and  surgery.  In  teaching 
elementary  and  didactic  medicine,  other  places  may  compete 
with  her,  and  outstrip  her,  but,  under  proper  management, 
in  clinical  instruction  it  is  impossible.  Some  members  of  the 
Profession  in  New  York,  capable  of  giving  them  realization, 
are  becoming  impressed  with  these  ideas,  and  the  time  may 
not  be  distant  when  their  importance  shall  be  more  fully 
appreciated  and   their   realization   entered   upon. 

As  already  stated,  our  good  ship  Persia  left  New  York 
on  the  1 3th  inst.  The  largest  steamer  of  the  Cunard,  or 
British  and  North  American,  line,  being  nearly  400  feet  in 
length,  she  is  filled  to  her  utmost  capacity  with  passengers, 
all   being  regarded   as   first-class  —  paying  8130  each.     Not   se- 


Editorial  Department.  159 

curing  my  passage  long  beforehand,  as  most  did,  I  was  among 
the  very  last  provided  for,  and  was  assigned  a  berth  in  the 
state-room  of  the  "  Doctor "  of  the  ship,  being  told  that  I 
would  find  it  very  comfortable  and  pleasant,  and  at  the  same 
time  assured  that  it  was  the  only  placej  left.  This  latter  state- 
ment decided  the  matter,  as  I  was  desirous  of  leaving  as  soon 
as  possible,  and  no  other  suitable  vessel  was  to  sail  under 
about   two   weeks. 

A  regular]  dissertation  on  "Life  at  Sea"  is,  I  believe,  per- 
petrated by  everybody  who  crosses  the  ocean,  and  writes 
letters  back ;  but  I  shall  save  you  this  infliction  —  (it  could 
scarcely  be  anything  else,  after  the  many  you  must  all  have 
read)  - —  and  especially  as  my  present  experience  would  not 
allow  me  to  write  in  a  very  pleasant  strain.  I  shall  confine 
myself  to  a  few  observations  upon  points  having  a  professional 
bearing. 

On  entering  the  state-room  assigned  me,  which  was  situ- 
ated on  deck,  and  so  far  having  a  promise  of  pure  air,  my 
olfiictories,  fortunately  not  very  acute,  were  assailed  with  the 
mingled  odors  of  medicines,  whiskey,  and  tobacco — the  latter 
decidedly  predominating;  and,  in  addition  to  these,  another 
odor  highly  composite  in  its  character,  and  very  peculiar, 
pervading  the  whole  vessel,  finding  its  greatest  concentration 
in  the  lower  cabins  and  state-rooms,  was  not  absent  from  this. 
This  was  by  no  means  an  agreeable  introduction  to  sea -life, 
and  was  a  pre-disposing  cause  to  that  general  condition  which 
causes  the  "  gorge  to  rise,"  and  which,  from  the  moment  I 
put    my  foot   on   the  planks,  I  felt   sure   would   come. 

Before  we  had  entirely  left  the  harbor,  swells  from  the 
ocean  began  to  roll  in,  not  very  perceptible  to  the  eye,  espe- 
cially w^hen  situated  so  far  above  the  waters  as  on  deck,  but 
still  they  were  sufiicient  to  cause  the  immense  structure  to 
undulate  —  to  cause  its  bow  and  stern  alternately  to  rise  and 
sink  with  a  sIoav  and  graceful,  yet  to  the  landsman  like  my- 
self,  an   unsettling   motion. 

As  we  got  fairly  to  sea,  pointed  our  bowsprit  to  the  east, 
and  after  halting  a  moment  to  discharge  our  pilot,  the  im- 
mense engine  a  perfect  marvel  of  mechanism,  commenced  its 
steady  and  untiring  movements ;  and,  like  the  seat  of  life  in 
the  human  frame,   pulsates  on,    and,   to  the  present    moment. 


160  The  Peninsular  and  Independent. 

as  we  now  approach  oin*  liarbor,  lias  not  coased  for  an  in- 
stant, bearing  us  steadily  onward  against  wind  and  wave  ; 
and  the  ship,  almost  as  constantly  as  she  has  plowed  througl) 
the  sea,  has  risen  and  fallen  as  the  great  swells  of  the  rest- 
less  ocean  have  swept   past   in   their  mighty   power. 

I  have  fiomewliere  heard  tlie  suggestion,  that  ships  would 
be  made  so  large  that  they  would  be  uninfluenced  by  the 
waves,  and  that  all  inconvenience  aiising  from  motion  would 
be  avoided.  My  present  observation  has  dispelled  this  illusion. 
It  is  true  that  by  the  size  of  a  vessel  the  motion  produced 
by  ordinary  waves  may  be  unperceived,  but  the  grand  ocean- 
swells,  measuring  such  distances  from  the  summit  of  one  to 
that  of  the  next,  as  they  do,  will  cause  the  largest  ship  is 
is  practicable  to  build  and  manage,  to  rock.  When  the  sea 
was  far  from  its  angriest  moods,  one  standing  near  the  stern 
of  our  sliij)  would  see  the  bow  so  pointing  towards  the  depths 
as  to  indicate  that  the  whole  vessel  would  plunge  beneath 
the  surface,  yet  the  next  moment  it  would  rise  again,  lifting 
itself  on  high  —  thus  the  great  ship  was  borne  like  a  feather 
over  the   rippling   bosom   of  a  stream. 

But  the  eifect  of  this  motion  upon  the  human  organism  is  tht* 
subject    most   interesting   to   a   medical    man. 

You  have  all  heard  and  read  of  sea-sickness,  though  not 
much  is  said  on  the  subject  in  medical  books.  Indeed,  little 
is  known  about  it  except  the  prominent  phenomena ;  and  they 
can  be  described  in  few  words.  Nausea  and  vomiting  are 
the  more  marked  symptoms,  but  they  by  no  means  consti- 
tute the  whole  of  tlic  mor1)id  phenomena  caused  by  a  vessel's 
motion.  There  are  others  wliich,  if  not  as  marked  and  de- 
monstrative, are  of  equal  ini])ortance.  The  primary  morbid 
impression  of  the  motion  is  doubtless  made  on  the  nervous 
system.  The  efl:ect  upon  the  stomach — the  vomiting  and  the 
persistent  nausea  which  accompanies  it — are  the  secondary,  and 
not  the  only  secondary,  effects  which  result.  The  secretions 
are  all  changed — perverted.  The  tongue  becomes  furred,  and 
a  most  unpleasant  taste  is  in  the  mouth.  The  actions  of  the 
intestines  are  disturbed.  There  may  be  at  first  an  increased 
peristaltic  action,  causing  uneasiness,  and  a  tendency  to  diarrhoea; 
but  decided  diarrhoea  is  seldom  developed — the  peristaltic  ac- 
tion   being  rather  reversed,   its  normal   character  at   any  rate 


Editorial  Department,  161 

suspended,  and  constipation  follows.  Though  feverishness,  as 
marked  by  heat  and  increase  of  pulse,  is  seldom  produced, 
yet  the  urine  is  loaded,  the  flesh  often  rapidly  wastes  away, 
and  the  general  perversion  of  secretions  and  other  organic 
actions  shows  a  condition  resembling  the  general  derangement 
of  a  fever.  The  mental  functions  are  not  unfrequently  dis- 
turbed in  much  the  same  manner  as  during  some  fevers,  and 
the   nights   are  restless   and   dreamy   in   the   same   way. 

My  experience  and  observations  during  this  voyage,  have 
enlarged  my  notions  of  the  character  and  importance  of  sea- 
sickness. It  is  a  much  more  general  disease  than  I  had  sup- 
posed. Its  bad  results,  it  is  true,  are  seldom  permanent  or  dan- 
gerous. It  is,  indeed,  popularly  regarded  as  a  beneficial  process, 
and  therefore  seldom  excites  either  alarm  or  sympathy.  It  is 
nevertheless  a  decided  disease,  and  has  more  than  once  proved 
fatal  in  constitutions  already  debilitated;  and  though,  by  the 
changes  it  effects  in  the  system,  it  may  operate  as  a  remedy  in 
one  laboring  under  previous  disorder,  as  any  other  disease  may 
supplant  a  previously  existing  one,  yet  it  is  essentially  a  morbid 
process,  and  no  person  in  previous  good  health  can  reasonably 
expect  to  be  benefited  by  it;  unless  as  a  severe  chastising  it 
works  a  moral  reform — which  I  fear  it  seldom  does. 

As  to  the  medical  treatment  of  sea -sickness  I  have  learned 
nothing  of  much  value.  I  have  been  sick — oh,  how  uncomforta- 
bly sick! — most  of  the  way.  I  took  one  dose,  by  the  advice  of 
the  ship's  "  Doctor,"  of  tiiict.  ginger,  aqua  ammonia,  and  chloric 
ether;  but  threw  it  up  in  a  few  minutes  after,  and  have  taken 
nothing  since  except  a  bottle  of  native  Seltzer  water  after  I  began 
to  get  better,  w^hieli  was  most  grateful  to  the  stomach,  and  gently 
removed  a  symptom  so  common,  before  referred  to.  At  this  pre- 
sent writing,  I  am  happy  to  say,  I  am  nearly  myself  again,  though 
the  thoughts  of  the  past,  mingled  with  some  of  the  odors  of  the 
present,  stirred  into  activity  by  an  occasional  extra  motion  of  the 
ship,  bring  back  some  of  those  same  sensations  I  w^ould  gladly 
forget. 

From  all  I  can  learn,  my  present  impression  of  medical  treat- 
ment is  that  it  is  of  little  avail.  Chloroform  has  been  recommend- 
ed by  high  authority,  but  the  testimony  I  get,  received  from  the 
experience  of  others,  is,  that  it  as  frequently  seems  to  do  harm  as 
good,  and  in  any  case  can  only  be  palliative  and  temporary.    The 

Vol.  II.  -  L. 


162  Tlie  Peninsular  and  Independent. 

best  preventive  coarse  is  to  take  food  moderately  and  regularly 
according  to  previous  habits,  exercise  on  deck  as  much  as  possible ; 
but  when  the  attack  has  actually  supervened,  the  recupibent  pos- 
ture must  be  taken,  and  kept  for  the  most  part,  though  occasional 
changes  to  the  sitting  or  erect  position,  even  at  the  expense  of  in- 
creased sickness  and  vomiting  at  the  time,  will  be  found  useful. 
After  taking  food,  the  patient  should,  if  inclined  to  vomit,  lie  per- 
fectly still  until  it  has  passed  out  of  the  stomach.  This,  for  sev- 
eral days  was  the  only  manner  in  which  I  could  retain  any 
food,  and  thus  prevent  the  greatest  prostration.  As  soon  as 
he  is  able  to  rise  without  vomiting,  the  patient  should  appear 
on  deck. 

Besides  the  motion  of  the  vessel,  the  special  causes  con- 
tributing to  sickness  on  ship-board,  are  impure  air  arising  from 
the  difficulty  of  eftecting  ventilation  beneath  the  surface  of 
the  water,  and  the  smallness  of  apartments  and  their  crowded 
condition:  and  on  these  steamers,  the  abominable  practice  of 
eating  five  times  a  day,  drinking  all  sorts  of  spirits,  wines, 
and  beers,    and  smoking  innumerable  segars. 

The  compensation  for  medical  services  on  board  these  ves- 
sels by  the  Company,  I  am  told,  is  small,  and  therefore  the 
best  class  of  men  can  not  be  expected  to  accept  of  the  situa- 
tions. Either  young  men,  before  having  established  a  reputa- 
tion or  secured  a  practice,  or  older  men  of  inferior  capacity 
or  character  must  be  taken.  In  some  cases,  I  am  told  that 
both  youth  and  inferiority  mark  the  men  that  serve  as  rej)- 
resentatives  of  our  Profession  on  these  instruments  of  commu- 
nication between  the  Old  and  the  New  World;  and  I  am  sorry 
to  believe  that  these  positions  are  not  those  in  which  the  in- 
cumbents are  most  likely  to  improve  in  general  or  profession- 
al character.  They  have  not  sufficient  duties  to  occupy  their 
time — their  state-rooms  are  small  and  uncomfortable  —  unsuit- 
ed  to  study  —  they  are  constantly  mingling  with  passengers 
who  have  little  else  than  eating,  drinking,  smoking,  and  gam- 
ing to  occupy  their  attention  for  the  voyage,  and  thus  bad 
habits  are  apt  to  be  formed.  These  conclusions  are  not  drawn 
from^  observations  on  this  ship  alone,  but  from  all  I  can  learn 
on  the  subject. 

The   "Doctor"    of  the   Persia,   with   whom   I   am    rooming 
for  the  voyage,  is  a  gentleman   of  the  "  Irish   persuasion,"  and 


Editorial  Department.  163 

•of  the  strictest  of  the  sect,  as  is  evinced  in  his  accent,  man- 
ners, and  particularly  in  his  face.  I  am  under  much  obliga- 
tion to  his  politeness  to  me;  for,  among  other  kind  things, 
<on  learning  that  tobacco  smoke  was  not  in  accordance  with 
my  tastes,  he  desisted  entirely  from  smoking  in  his  room, 
confining  his  indulgence,  which  was  nearly  constant  however, 
to  the  deck,  the  smoking-room,  and  other  places  about  the  ship. 
Liverpool  is  announced  as  not  far  distant;  the  bustle  pre 
paratory  to  landing  has  commenced;  and  I  must  bring  this 
long  letter  to  a  close. 

In  writing  only  respecting  subjects  having  a  bearing  upon 
the  subject  of  Medicine,  I  fear  I  have  given  too  unpleasant 
a  picture  of  the  voyage.  ^N'otwithstanding  my  almost  constant 
sickness,  there  has  been  much  of  pleasing  interest  to  me  since 
leaving  New  York.  I  have  formed  several  acquaintances  of 
a  very  agreeable,  and  I  hope  of  a  lasting  and  profitable  char- 
acter; and  the  perfect  order  and  regularity  of  the  ship's 
management,  and  the  feeling  of  perfect  safety  inspired  by  all 
its  appointments — not  to  mention  the  beauty,  the  grandeur, 
the  sublimity  of  the  illimitable  ocean — have  left  impressions 
worthy   of  being  cherished. 

When  you  shall  hear  from  me  again,  I  hope  it  will  be 
respecting  medical  men  and  medical  matters  on  this  side  of 
the   great  waters   which  now  separate   us. 

Yours   Truly,  A.  B.  P. 

Medical  Chronicle  (Moutreal). 

We  are  sincerely  regretful  to  see,  in  tbe  closing  ISTo.  of 
the  Sixtli  Volume  of  this  valuable  Monthly,  an  announce- 
ment of  its  discontinuance.  Like  a  majority  of  the  medi- 
cal journals  it  has  only  succeeded  in  paying  the  actual 
publishing  expenses  ;  and  now  that  a  new  postage  law  im- 
poses a  further  tax  upon  the  enterprize,  the  proprietors  are 
forced  to  abandon  it.  We  can  not  forbear  remarking,  that 
it  is  but  an  ill  commentary  upon  the  Canadian  Profession 
that  it  fails  to  support  its  only  medical  journal. 

AVe  part  with  the  Chrcniclej  and  its  accomplished  edi- 
tors, with   great   reluctance,  and  witb   the  hope  that   they 


164  The  Peninsular  and  Independent, 

will  be   yet   induced  to  renew  their  efforts  in  the  editorial 
section  of  the  great  medical  field.  G. 


Resignation. 

It  is  announced,  in  the  last  No.  of  the  Medical  News, 
that  Prof  L.  P.  Yandell,  long  identified  with  that  old 
and  meritorious  institution,  the  University  of  Louisville,  has 
resigned  his  professorial  chair. 

We  trust  that  the  name  Yandell  will  still  continue 
to  shed  its  lustre  over  the  University,  even  though  a  change 
of  initials  should  occur.  G. 

Erratum. 

On  page  150,  twelfth  line  from  top,  read  ^^contrasf 
for  "contend." 

Pre  -  Payment  of  tliis  Journal. 

Of  the  April  No.  of  this  journal  we  distributed,  through 
the  mail,  nearly  two  thousand  copies ;  of  the  May  No. 
we  sent  onhj  to  those  who  remitted  for  the  year  previous 
to  the  issue  of  that  No.,  and  to  those  who  had  j)aid  in 
full   for   Vol.    I. 

In  future,  while  we  propose  to  issue  a  large  edition 
each  month  above  our  regular  subscription  list,  we  shall 
not  send  it  regularly,  except  to  those  who  pay  in  ad- 
vance, reserving  to  ourselves  the  right  to  distribute  the 
balance  of  each  edition  among  such  non  -  subscribers  as 
we   please. 

It  will  be  seen  that  all  who  desire  a  full  set  for  the 
year  must  remit  to  us  in  advance,  for  we  shall  be  unable 
to   supply   back   Nos.   beyond   a   limited   extent. 

HIGBY   &   STEAKNS. 


Editorial  Department.  165 


CORRESPONDETfCE. 


THE  AMERICAN  MEDICAL  ASSOCIATION. 

The  last  meeting  of  this  Association  convened  at  Louisville,  Ky., 
the  city  of  the  glorious  State  of  Kentucky,  in  which  are  found  men 
of  science,  eminent  in  the  profession  of  medicine,  who  extended  the 
hospitalities  of  private  homes,  and  the  genial  welcome  of  the  whole 
city  to  the  members  of  our  profession ;  and  last,  not  least^  heautiful 
woman^  adorns  the  festivities  given  in  their  beautiful  city,  and  welcomes 
the  representative  of  scientific  medicine  to  their  homes,  adorned  with 
all  that  art,  science,  and  fancy  could  desire,  to  while  away  the  tedium 
of  the  hours,  which  otherwise  would  hang  as  a  dead  weight  upon  the 
stranger,  away  from  his  home  and  his  professional  avocations.  Thanks 
to  the  hospitality  and  kindness  of  the  Profession  of  Louisville,  and  for 
the  hospitalities  of  the  city ! 

But  the  American  Medical  Association  is  a  proper  subject  for  some 
reflections. 

Having  accomplished  much  good  for  the  Profession,  and  for  science, 
shall  it  go  on  its  career  of  usefulness  and  honor,  and  be  still  the  pride 
of  every  honest,  intelh'gcnt,  and  scientific  medical  man  in  the  Union. 
If  so,  it  must  be  composed  of  working  men,  and  moi^e  of  them.  The 
impression  of  a  member  who  had  never  attended  one  of  its  sessions, 
and  who  had  rather  an  exalted  opinion,  previously,  of  its  objects  and 
character,  has  not  been  improved  very  much  by  attending  its  late  ses- 
sion ;  and  there  are  several  reasons  why  new  members  expressed  them- 
selves disappointed  in  visiting  the  Association,  and  seeing  the  mode  of 
conducting  its  business. 

In  reference  to  the  observance  of  ^j>a7'Zi*«?72(S7ito?^2/  order,  there  is  just 
cause  of  criticism.  Though  a  semblance  of  observance  of  such  order, 
it  is  not  regarded  as  reaching  even  near  to  a  point  of  perfection ;  and 
a  criticism  in  one  of  the  daily  papers  of  Louisville  had  this  opinion: 
"That  the  members  of  the  Association  talked  much  about  order,  and 
yet  violated  the  rules  of  order,  and  discussed  questions  of  constitutional 
origin  (which  had  reference  to  the  organic  character  of  the  Association) 
with  as  much  gravity  as  if  they  were  legislating  for  the  world."  And, 
again,  in  reference  to  reports  and  reporters,  a  remark  of  this  kind 
was  common;  That,  much  of  the  interest  of  the  Association  was  lost, 
l)y  the  failure  to  report  of  those  committees  appointed,  upon  the  various 
topics  of  investigation.  So  it  seems  to  those  outside  of  the  Profession, 
that  there  is  too  much  want  of  energy  to  labor  in  the  cause  of  science 
in  too  many  members  of  this  highly  distinguished  body  of  men.  Men 
of  the  Profession  in  the  old  country  have  eulogized  the  character  of 
this  body,  and  shall  we  fold  our  arms  and  see  its  reputation  suffer 
because  individually  we  do  not  labor  ?    Never !     This  Association  does 


166  The  Peninsular  and  Independent. 

indeed  legislate  for  the  Profession,  but  let  its  sessions  possess  that 
dignity  and  gravity  becoming  its  high  position.  The  fault  is  not  with 
the  officers  but  with  its  members,  and  they  should  labor  to  harmonize 
the  conflicting  interests  of  the  Profession  in  the  various  parts  of  the 
country.  The  great  feature  of  strength  which  gives  the  National  Medi- 
cal Association  its  vitality  and  power,  is  bringing  together  the  medical 
men  of  the  country,  breaking  down  and  rooting  out  those  prejudices 
which  grow  out  of  varied  interest,  and  forming  ties  of  friendship  and 
good  feeling  which  will  leaven  the  whole  mass  into  a  combination  of 
power  and  strength  not  equaled  on  earth  among  medical  men.  But 
the  evidence,  drawn  from  its  late  session,  is  not  favorable  for  long  con- 
tinued vitality  or  strength  ;  in  fact  it  gave  vnmistalable  signs  of 
premature  age  and  decay.  And  one  or  more  worlcing  members  gave  his 
prognosis  upon  the  time  of  its  existence.  (I  hope  his  prognostications 
are  not  true.) 

Then  let  every  member  come  up  to  the  work,  and  labor  manfully 
and  w^hen  called  upon  for  a  Report  do  not  "beg  an  extension  of  time'* 
as  has  been  done,  and  I  fear  too  often,  merely  to  display  their  names 
as  reporters  upon  the  pages  of  the  Transactions. 

One  other  observation  I  shall  make,  and  leave  the  members  to 
ponder  it  well.  It  has  been  said  that  the  practice  of  the  Medical  Pro- 
fession requires  the  individual  possession,  by  its  members,  of  a  clear 
and  vigorous  mind,  a  practised  eye  and  steady  hand.  But  I  think  too 
many  of  the  members  of  the  American  Medical  Association  indulge  in 
libations,  and  particularly  on  the  occasions  of  these  meetings,  too  freely 
to  possess  the  requisites  here  mentioned,  and  who  discredit  themselves, 
the  Profession,  and  the  Association.  Ponder  well,  young  men  of  the 
Medical  Profession,  your  future  history,  if  you  sacrifice  to  Bacchus  as 
freely  as  some  of  you  have  done  while  legislating  for  the  Profession, 
and  while  you  are  filling  positions  of  honor  and  influence !  Do  you 
think  your  places  will  sustain  you  in  this  course  ?  On  the  other  hand 
you  must  sustain  honor,  character,  and  professional  reputation ;  if  you 
do  not,  you  will  fall  from  j^our  high  positions.  A  medical  man,  last  of 
all  men  in  the  world,  should  not  drink  anything  stronger  than  cold 
water.  At  the  bed  side,  his  vigorous  mind  should  not  be  beclouded 
with  the  paralyzing  influence  of  drink;  in  the  teacher'' s  cTiair^  his  mind 
should  grasp  his  subject,  and  make  it  plain  and  easy ;  in  the  associated 
capacity  of  our  National  Body,  let  reason,  judgment,  and  wisdom  sway 
their  sceptre ;  and  I  trust  as  a  Profession  we  will  accumulate  strength 
and  energy,  and  become  as  a  light  to  the  world,  which  can  not  be  hid^ 

H. 

EiCHiroND,  Ind. 


thtttl^i  ^xiith$,  Jibstrarts,  &t. 


TRANSLATIONS  from  FOREIGN  JOURNALS  for  the  PENINSULAR  AND  INDEPENDENT.. 


By  0.  D.  Palmer,  M.  D. 


(From  Gazette  Hebdomadaire  de  Medicine  et  de  Chirurgie,  Feb.  25,  1859.) 

IMPROVEMENTS  MADE  TO  THE  OPERATION  FOR  VESICO  -  VAGINAL  FIS- 
TULA BY  AMERICAN  SURGERY.  — Third  Article. 

Dr.  Marion  Sims'  Method. — No  one,  I  hope,  will  suspect  my  imparti- 
ality when  I  speak  of  foreign  surgeons,  from  whom  I  am,  and  ever 
expect  to  be,  separated  by  thousands  of  miles,  and  yet  I  can  not,  how- 
ever, conceal  the  embarrassment  I  experience,  in  appreciating  the  labors 
of  Dr.  Marion  Sims.  This  author  has,  in  fact,  written  two  articles  on 
Vesico- Vaginal  Fistulas — the  first  in  1852,  couched  in  the  most  suitable 
scientific  forms  ;  the  other  in  1858,  which  is  nothing  more  than  a  lengthy 
apology  for  metallic  sutures,  and  for  him,  at  the  same  time,  whom  he 
believes  to  be  the  inventor,  that  is  to  say,  for  Marion  Sims,  himself. 
It  is  with  as  much  astonishment  as  of  pain,  that  we  see  this  distin- 
guished practitioner  claim  for  himself,  in  the  most  exclusive  manner,  the 
operative  means  and  manoeuvres  which  have  belonged,  for  long  years,  to 
the  public  domain.  His  illusions  of  priority  are  otherwise  so  much  the 
more  injurious,  as  he  employs,  in  order  to  justify  them,  the  most  bitter 
words,  and  assertions  the  most  extravagant. 

A  singular  thing  is,  that,  in  1852,  Dr.  Sims  contented  himself  in 
making  public  the  method  which,  at  that  epoch,  he  had  adopted.  In 
1858,  he  insists,  particularly,  on  his  pretended  discoveries,  so  that  we 
must  seek  for  the  history  of  the  author's  first  attempts,  in  a  pamphlet 
published  six  years  after  the  dogmatic  publication  of  these  attempts. 
Then  in  1858,  Dr.  Sims  has  modified  his  method  of  1852,  so  that  we 
can  not  examine  his  labors  in  chronological  order. 

If  the  first  paper  of  Dr.  Sims  was  received  with  merited  favor  by 
his  countrymen,  the  second,  on  the  contrary,  has  called  forth,  in  both 
the  American  and  the  English  press,  criticisms  more  or  less  severe; 
which  we  shall  not  follow  farther  than  is  necessary  to  a  scientific  dis- 
cussion—  that  is,  in  pruning  them  of  personalities.      I  demand    pardon 


168  The  Peninsular  and  Lidej^endent. 

of  the  reader  for  this  long  preamble,  but  if  we  profess  the  greatest  re- 
spect for  persons,  we  esteem  the  rights  of  Science  and  of  History  as  not  less 
sacred.  Above  all  individual  pretensions  are  placed  the  irrecusable  au- 
thority of  facts,  of  dates,  and  of  records — veritable  archives  of  intellect- 
ual and  scientific  property.  It  is  not  unnecessary  to  recall  this  principle 
at  the  dehut  of  a  delicate  criticism  like  the  one  we  are  about  to  under- 
take. 

The  author,  himself,  teaches  us  that  in  1845  he  conceived  the  idea 
of  remedying  the  Fistula  V^sico -Vaginalis,  that  he  had  hitherto  be- 
lieved beyond  the  resources  of  Art.  By  accident,  at  that  time,  whilst 
attending  a  lady  affected  with  retroversio  nteri,  he  had  her  placed  upon 
her  knees  and  elbows,  the  pelvis  more  elevated  than  the  chest,  in  order 
to  reduce  the  displacement,  which  was  recent.  This  was  the  occasion 
of  his  first  discovery;  in  effect  he  makes  it  appear,  that,  whilst  in  this 
attitude,  the  uterus  elevated  itself  from  the  vulva,  and  that  the  supe- 
rior part  of  the  vagina  was  spontaneou-^l}''  dilated,  the  whole  produced 
by  the  pressure  of  the  atmosphere  on  ihe  internal  walls  of  the  vagina, 
and  enlarging  it  in  all  its  diameters.  Struck  by  this  fact,  Dr.  Sims  was 
anxious  to  examine,  in  the  attitude  above  described,  a  woman  affected 
with  Vesico -Vaginal  Fistula,  who  had  just  then  been  confided  to  his 
care.  lie  states  that  the  fistulous  opening  became  perfectly  accessible 
to  view,  and  also  that  he,  at  that  time,  had  a  glimpse  of  the  possibility 
of  a  happy  operation. 

An  appeal  made  to  his  neighboring  colleagues  enabled  Dr.  Sims  to 
assemble  seven  or  eight  cases  of  Fistulas,  abandoned  as  incurable.  The 
silversmiths,  blacksmiths,  dentists,  and  manuficturers  of  instruments, 
were  put  under  contribution  to  fashion  a  rough  surgical  arsenal,  and  at 
length  the  first  operation  was  performed  on  the  11th  of  Januar}-",  1846. 
It  is  not  inutile  to  say  that  Dr.  Sims  announced  having  read  all  the 
authors  he  could  find,  on  this  subject,  even  before  his  Jirst  operation, 
without  having  found  anything  but  ohscurity  and  confanon. 

The  case  was  very  simple,  the  fistula  being  transver.^1  and  situated 
at  the  base  of  the  vesica,  an  inch  and  a  quarter  broad.  There  was 
abundant  tissue.  The  opposition  was  very  exact,  and  still  he  was  un- 
successful. It  is  true  the  orifice  was  so  much  reduced  that  it  would 
not  admit  a  No.  4  bougie. 

Encouraged  by  this  first  result  he  repeated  the  operation  on  another 
woman,  but  without  success.  Then  he  made  new  and  various  trials, 
till  each  patient  had  submitted  to  numerous  operations,  but  all  in  vain. 
His  hopes  were  almost  annihilated,  and  he  was  advised  to  give  over  his 
attempts,  but  he  had  com'municated  his  enthusiasm  to  his  patients,  who, 
endowed  with  indomitable  courage,  insisted  upon  his  repeatedly  renewing 
his  trials. 

During  three  years  Dr.  Sims  made  use  of  what  he  called  damp 
sutures,  operated   by  a  complicated  machinery,  a  design  of  which   may 


Selected  Articles^  Abstracts^  c&c.  169 

be  found  on  page  56  of  his  second  pamphlet.  His  ill  success  appearing 
to  him  to  be  connected  with  this  apparatus,  he  abandoned  it.  He  then 
called  to  mind  that  when  a  boy  he  used  to  hammer  shots,  and  close 
them  around  his  fishing-line  with  his  teeth,  the  better  to  make  it  sink. 
This  reminiscence  came  to  him  on  the  night  of  the  14th  November,  1846! 
Thence  a  new  means  came  to  light  for  fixing  the  threads  of  the  suture, 
new  essays  were  made,  but  ever  fruitless.  The  clamps  intended  to  se- 
cure the  threads  were  too  voluminous.  They  were  at  first  diminished, 
and  then  afterwards  re -placed  with  bars  of  lead.  In  spite  of  all  these 
modifications,  failure  was  constant.  This  was  then  attributed  to  the 
catheter,  and  it  was  newly  fashioned.  At  this  epoch,  according  to  Dr. 
Sims,  the  mechanical  part  of  the  operation  was  perfect.  Why,  then,  did 
he  not  succeed?  The  idea  came  to  him  to  substitute  for  the  silk  thread 
leaden  wire,  for  making  ligatures,  and  often  used  by  Mettaueu  and  Dif- 
FENBAcn,  and  the  innocuousness  of  which  had  been  demonstrated  by 
Levert.  Two  cases  of  Vesico  -  Vaginal  Fistulas,  and  one  of  Recto-Vagi- 
nal Fistula,  were  treated  by  this  means,  and  which,  hrqyj^ih/,  says  the 
author,  misca-rried  like  the  others.  He  then  thought  of  gold,  of  silver, 
and  of  platina;  and  ordered  to  be  made  by  a  jeweler,  silver  wire  the  size 
of  ordinary  sewing  thread,  with  which  he  operated  on  the  21st  of  June,. 
1840. 

Case. — It  was  upon  a  young  negress,  who  had  never  murmured  at  the 
preceding  failures.  She  was  placed  upon  the  table  for  the  thirtieth 
time.  The  leaden  clamps,  the  silver  wire,  and  the  perforated  shot,  were 
put  in  use.  In  all  the  preceding  operations,  the  urethra,  at  the  end  of 
two  or  three  days,  became  red  and  painful,  the  urine  surcharged  with  a 
thick  tenacious  mucus,  evident  signs  of  inflammation,  which  prevented  the 
immediate  union.  In  this  case,  the  urine  remained  perfectly  limpid,  and 
on  the  eighth  day  the  parts  were  completely  healed.  The  suture  ap- 
paratus remained  in  place,  as  on  the  day  of  its  application ;  the  leaden 
cross-bars  that  supported  the  ligatures  were  merely  a  little  imbedded 
in  the  mucous  membrane  of  the  vagina. 

The  problem  was  at  length   solved,  and   but  a  few  days  after,  and' 
all  the    persons  on   whom   he   had   experimented  so   long  a  time   were 
cured. 

A  severe  disease  induced  Dr.  Sims  to  publish  to  the  world  his  first 
paper,  though  he  could  have  willingly  elucidated  still  further  some 
points.  Having  sent  it  to  Philadelphia,  the  memoir  was  published  in 
the  ''American  Journal  of  the  Medical  Sciences^''^  page  59,  of  the  Jan- 
uary No.  for  1852. 

It  is  this  work  that  we  are  now  about  to  examine.     It  is  true  it  was 
not  necessary  to  report  the  preceding  matter  ;  I  have  thought,  however 
it  would  be  interesting  to    know   to   what   anguish  —  to  what  pre -occu- 
pations—  an  ingenious  and    tenacious    spirit  is  submitted   that   seeks    to 
attain  its  aim  without  being  lieterred  by  obstacles  or  misfortunes.      We 


IVO  The  Peninsular  and  Independent. 

resume  briefly  the  recital  of  Dr.  Sims'  perplexities ;  they  at  least  fill  up 
fifteen  pages.  We  have  pruned  them  of  all  digressions  and  all  the  pas- 
sages in  which  "Providence,"  "Almighty  God,"  "Divine  Mission,"  &c., 
appear  here  to  play  a  very  inopportune  part.  At  the  very  first,  in  read- 
ing these  pages,  one  is  incited  to  raillery,  and  to  laugh  at  the  folly ; 
then,  he  can  not  hinder  himself  from  a  kind  of  admiration  for  the  double 
perseverance  of  the  operator,  and  for  those  operated  upon,  especially. 
We  can  not  doubt  that  during  four  years  the  cure  of  Finiulaa  Vesico- 
Vaginales,  had  been,  with  Dr.  Sims,  a  species  of  humanitary  monomania, 
very  rare  among  Surgeons,  and  which,  also,  is  not  destitute  of  greatness. 
Tlierc  is,  however,  a  useful  lesson  to  be  drawn  from  all  this.  Dr.  Sim3 
has  tortured  his  brain  for  four  years,  in  order  to  invent  methods,  which 
were  a  long  time  since  published,  and  which  had,  in  1849,  produced 
more  than  one  success.  Two  or  three  months  would  have  been  abundant- 
ly sufficient,  to  have  read  the  works  published  on  this  matter,  and  to 
have  realized  some  success;  for  in  18-iO,  I  repeat  it,  a  goodly  number 
of  Fistnhis  Vesico-  Vaginales  had  been  healed   by  the  suture. 

Accident,  perseverance,  ingenuity,  reasonning,  may  certainly  had  to 
great  therepeutic  discoveries,  but  the  surest  route  still  is  to  appeal  to 
the  experience  of  others,  ard  it  is  this  that  makes  the  sound  erudition 
the  way  that  still  conducts  the  most  certainly  to  progress. 

We  will  only  add  one  remark :  That  without  indicating  their  num- 
ber. Dr.  Sims  declares,  implicitly,  that  previous  to  his  first  success  ho 
had  operated  many  times,  since  one  patient  alone  come  to  the  amphi- 
theatre for  the  thirtieth  time.  In  supposing  that  our  surgeon  had  made 
the  fiftieth  trial,  we  can  not  well  explain  how  he  has  been  so  unfortu- 
nate, and,  at  the  same  time  so  persevering;  for  at  the  time  even  when 
manual  operation  was  verj^  defective,  some  one  succeeded  always,  from 
time  to  time ;  for  example,  Lallemand,  Dieffenbacii,  &c. 

Meiliod  of  Dr.  Sims  in  1852. — After  some  generalties  on  the  causes, 
diagnostics,  prognostics,  anatomical  varieties  of  Vesico- Vaginal  Fistula, 
followed  b}''  a  historical  summar}^  in  which  the  frequent  want  of  success 
of  the  suture  is  recounted,  the  author  claims,  by  right,  the  priority, — 

1st.  For  the  discovery  of  a  method  of  exploring  the  vagina  which 
permits  the  seeing  easily,  and  operating  with  facility  ; 

2d.  For  a  new  suture  apparatus  which  remains  imbedded  in  the 
tissue  for  an  indefinite  period  of  time  without  cutting  through  like  the  silk 
thread  ; 

3d.  For  the  invention  of  a  ''''  self -retaining''''  speculum  easily  sup- 
ported by  the  patient  during  treatment. 

We  will  also  divide,  on  our  part,  the  examination  of  this  method  into 
three  parts. 

1st.  By  the  eii:doration  of  tlie  Vagina. — We  have  seen  above  in  what 
this  innovation  consisted,  and  how  Dr.  Sims  arrived  at  the  discovery.  Here 
are   more   details.     The   patient   is  placed   on   a   table,   two   and  a  half 


Selected  Articles^  Abstracts^  dbc.  l'7l 

to  four  feet  high ;  she  is  to  support  herself  on  her  knees  and  elbows* 
the  haunches  elevated,  the  head  and  shoulders  depressed,  the  knees 
six  or  eight  inches  separated,  the  thighs  flexed  at  right  angles.  The 
dress,  any  way  capable  of  exerting  a  pressure  on  the  abdominal  paries, 
is  suppressed.  From  each  side,  an  assistant  places  one  hand  in  the 
fold  of  the  breech,  in  such  a  manner  as  to  be  able  to  touch  the 
lahia  majora  with  the  extremity  of  the  fingers.  If  the  nates  are  then 
drawn  upwards  and  outwards,  the  vulvar  orifice  is  opened,  the  p.elvic 
and  abdominal  viscera  gravitate  toward  the  epigastric  region,  and  the 
atmospheric  pressure  is  exerted  on  the  walls  of  the  vagina  (according  to 
Dr.  Sims  at  the  rate  of  fourteen  pounds  to  the  square  inch),  displaying 
this  canal  in  its  greatest  extent, — the  view  then  attains  very  easily 
to   the  fistula  to   the   os    tincw,  &c. 

In  order  to  facilitate  the  exploration  of  the  parts,  the  aid  situated 
on  the  right  introduces  into  the  vagina  the  level' -  speculum^  and  ele- 
vates the  cloison  recto -vaginal;  the  cavity  becomes  then  as  easily  to 
see   as   the   back   part  of  the  throat   when   the   mouth   is  widely  open. 

One  word  now,  in  regard  to  the  speculum  —  an  instrument  so 
precious   that   I    commend   with  all   my   heart. 

[Here  follows  a  description  of  the  speculum  —  a  translation  of  which, 
without   figuring,   would   be   unintelligible.] 

Dr.  BozEMAN  has  modified  this  speculum,  giving  to' it  greater  di- 
mensions, and  re -placing  the  terminal  hook  with  another  instrument, 
either  larger  or  smaller,  so  that  two  speculums  are  united  in  the  same 
instrument. 

The  position  requisite  to  be  given  to  the  patient  is  of  sufficient 
importance  to  legitimatize  some  observations ;  and,  to  begin  with,  we 
admit  that  Dr.  Makion  Sims  may  have  discovered  it,  on  his  part,  but 
as  to  j^rioritij  he  can   not  claim  it  for   an   instant. 

In  fact,  ScHKEGEK  published,  in  1817,  a  case,  in  which  he  obtained 
an  almost  complete  cure  after  the  applications  of  the  suture.  "The  pa- 
tient kneeled  on  the  edge  of  a  bed,  supporting  the  upper  part  of  the 
body  on  a  rolled  mattress,  so  as  to  form  by  it  and  the  thighs  a  right 
angle,  the  latter  separated  as  far  as  possible." 

In  1829,  J.  Pn.  Roux  attempted  the  cure  of  a  Vesico -Vaginal  Fis- 
tula by  a  suture.  "  The  patient  was  made  to  lie  on  her  belly,  the 
thighs  separated,  sustained  by  aids,  the  pelvis  more  elevated  than  the 
head,"  &c. 

In  1839,  M.  Velpeau  recommended  the  same  position:  An  assis- 
tant, he  says,  holds  the  vagina  dilated  by  means  of  a  large  grooved  in- 
strument of  metal,    horn,  or  wood,  &c. 

In  1834,  the  same  thing  had  been  accomplished  in  England  by 
Gasset,  in  a  very  remarkable  case,  to  which  we  may  return. 

About  1841,  WuTZER,  who  occupied  himself  successfully  in  Germany 
on  the  same  matter,  adopted  decubitus  in  pronatione  as  the  position. 


1*72  Tlie  Peninsular  and  Independent. 

It  would  be  superfluous  to  multiply  citations,  in  order  to  prove  that 
long  before  1845  many  surgeons  had  recognized  the  advantages  of  the 
above  attitude. 

[The  French  author,  M.  Veuneuil,  discusses  at  considerable  length 
the  relative  merits  of  different  positions.  It  seems  hardly  necessary  to 
follow  him  through  several  pages  devoted  to  this  suVyect.  His  conclu- 
sions appear  to  be  more  in  favor  of  decubitus  in  pronatione,  when  the 
operation  is  to  be  performed  without  anaesthesia  of  the  pati6nt,  but  when 
chloroform  is  to  be  administered,  he  prefers  the  patient  to  be  placed  on 
her  side.  Though  the  operation  is  not  attended  with  so  much  pain  as 
to  make  anaesthesia  desirable,  yet  when  it  is  judged  requisite  to  depress 
the  fistula  (by  the  use  of  an  instrument  of  whalebone  introduced  into 
the  urethra)  so  as  to  bring  it  into  view,  it  is  much  more  easy  to  ac- 
complish the '  depression,  with  the  patient  under  the  influence  of  chlo- 
roform.] 

Dr.  Sims  appears  to  have  been  himself  struck  with  the  inconvenien- 
cies  of  thcposition  in  jyronatione  which  he  had  at  first  so  much  vaunted. 
In  his  second  pamphlet  he  has  counselled  another,  applicable,  according 
to  him,  in  the  greatest  number  of  cases,  and  which  he  describes  in  the 
following  manner: 

"  The  patient  lies  on  her  left  side,  the  thighs  flexed  nearly  to  a 
right  angle  with  the  pelvis,  the  right  thigh  a  little  more  than  the  left. 
The  left  arm  is  thrown  backwards,  the  thorax  turned  downward  so  that 
the  sternum  is  applied  in  contact  with  the  bed.  The  vertebral  column 
is  in  complete  distension,  and  the  head  reposes  upon  the  left   parietal." 

We  will  continue  the  exposition  of  Dr.  Sims'  method  in  the  same 
order;  that  is,  in  making  his  description  march  in  front,  the  historical 
criticisms,  and  our  personal  appreciations  follow. 

Ah.  VERNEUIL. 


(From  the    ''  Oeslcrreichische  Zei/schrift  fiir  Praktische  JTeilkunde.^') 

EXCERPTS  from:  PROFESSOR  CHRASTINA'S   REPORT  OX  THE  RELATIVE 
NUMBER  OF  HEALTH  OFFICERS  IN  THE  CITY  AND  COUNTRY. 

No  one  can  exercise  the  calling  of  priest,  of  advocate,  of  notary,  or 
of  magistrate,  if  he  has  not  made  a  full  coarse  in  the  faculty  to 
which  he  intends  to  belong,  and  perfected  himself  in  his  own  spe- 
cial sciences.  Certainly,  men  who  have  charge  of  the  noblest  interests 
of  humanity  —  health  —  should  possess  all  the  knowledge  of  Medicine 
that  can  be  obtained  by  stud}'.  But  how  can  it  be  possible  for  a 
surgical  candidate,  a  j^oung  man  of  no  previous  cultivation  of  mind 
suitable,  to  master,  in  the  space  of  three  years,  such  weighty  matters 
as  anatomy,  phj^sic,  chemistry,  physiology,  surgery,  &c.,  in  a  manner 
worthy  of  claiming  the  confidence  of  the  public,  as  a  practitioner? 
Neither   his   previously  acquired   knowledge,  nor   the    grade  of  his  sub 


Selected  Articles^  Abstracts^  dbc,  173 

sequent  training,  are  such  as  well  enable  him  to  understand  these 
studies.  Besides,  the  course  is  run  over  in  such  a  cursory  manner 
that  the  best  scholars  even  would  not  be  able  to  comprehend  it  in 
this  interval.  Yet  the  student  of  Medicine  must  pursue,  as  a  pre- 
paratory study,  a  fundamental  training  of  eight  years,  and  then  still 
devote  Jive   more   years   to   professional   subjects. 

In  earlier  times,  when  the  medical  sciences  had  not  yet  extended 
far  beyond  their  primitive  bounds;  when  still  a  sparing  knowledge 
of  descriptive  anatomy,  physiology,  and  pathology  was  sufficient  to. 
procure  a  doctorate;  when  the  expulsion  of  a  tape-worm  was  esteemed 
half  a  miracle ;  when  organic  anatomy,  chemistry,  and  microscopy 
were  but  very  little,  or  not  at  all,  introduced  into  medicine,  — then, 
at  that  time,  the  institutes  of  sui-gery  were  established  —  transmitted 
from  the  same  original  fountain  of  medical  knowledge;  but,  at  the 
present,  when  the  mere  handling  and  overlooking  anatomy  with  un^ 
armed  eye  is  no  longer  sufficient ;  when  the  subject  is  dissected  to 
the  most  invisible  fibre  and  cell,  and  these  again  traced  in  the  em- 
bryonic state,  where  we  seek  to  fiithom  the  most  enigmatical  functions 
of  the  human  organism; — in  short,  in  a  time  when  medicine  has. 
undergone  a  complete  revolution,  and  neither  can,  nor  must,  remain 
in  the  rear  of  the  other  natural  sciences,  hastening  forward  as  they 
are  with  giant  strides,  —  in  such  a  time,  I  maintain  that  the  inferior 
chirurgical  institutions  are  no  longer  in  unison  with  the  remaining 
systems  of  mental  culture,  in  full  tide  of  successful  experiment,  and 
soaring  aloft   in   Austria 

It  is  really  wonderful  that  in  the  midst  of  these  troubles  —  these 
prospects  that  oppress  the  Medical  Profession,  like  a  leaden  weight  — 
the  Medical  Sciences  remain  in  such  splendor;  that  the  Medical  Fa- 
culties of  Vienna  and  Prague  belong  to  the  most  renowned,  and  are 
acknowledged  as  such,  in  the  whole  world.  The  outside  world  show 
this  appreciation,  by  sending,  yearly,  multitudes  of  young  men  to 
Vienna  and  Prague,  to  seek  out,  and  profit  by,  the  teachings  of  our 
high  schools.  But  in  order  not  to  paralyze,  in  the  end,  these  hitherto 
abundant  capabilities,  it  is  high  time  to  cast  about  for  ways  and 
means  that  may  be  suitable,  whereby  this  tedious  and  self- devoting 
study,  united  with  so  much  expense  of  time  and  money,  may  have 
opened  out  a  prospect  of  sufficient  exercise  and  remuneration,  and 
not   need   to   suffer   with   hunger,   or   starve   for   want   of  use. 

In  1838,  there  were  300  physicians  to  a  population  of  about 
400,000,  and  still  there  was  no  complaint  for  want  of  health  officers, 
nor  did  the  physicians  complain  of  being  overburthened  with  business 
—  much   less,  for   a   destitution   of  the  means   of  living. 

This  state  of  things  has  altered.  With  the  oversupply  of  me-, 
dical  men  still  increasing,  there  are  but  few  now  so  happy  as  to  be 
able,   by  practice   constantly,  to   support  their  families:    rari   nantes  in 


174  The  Peninsular  and  Independent. 

gurgito  vasto,.  Most  practitioners  having  no  other  source  of  income, 
Jiave  hard  work  to  cover  their  daily  expenses,  but  many  have  no 
sufficient   employment   to   that   end,    and  even   more    must   suffer 

It  may  be  the  case  that,  with  time,  the  ardor  of  scientific  zeal 
will  cool,  and  that  students  about  to  select  a  profession  will  turn 
their  backs  upon  the  thorny  path  of  Medicine,  well  persuaded  that 
the  deceptive  adage,  dat  Galenus  opes^  can  only  be  applied  in  rare 
cases,  and  that  the  future  generations  will  vote  it  a  myth  from  the 
hoary   times   of  antiquity. 

The  whole  number  of  civil  health  officers  in  Lower  Austria,  con- 
sists in  123  Doctors  of  Medicine,  and  630  Surgeons ;  the  population  being 
1,065,000.  On  an  average,  there  is  one  physician  to  every  800  in- 
habitants, and  one  surgeon  to  every  1500.  If  we  compare  the  me- 
tropolis, Vienna,  with  the  "rural  districts,"  there  we  find  the  dis- 
proportion of  doctors  to  inhabitants  as  ten  to  one  for  city  and 
country;  whilst  in  Vienna  there  is  one  DorAor  of  Medicine  to  every 
800   inhabitants,    and   in   the   country   one   to   every   8,000. 

The  very  natural  inquiry  arises :  What  hinders  the  graduated 
physician  from  settling  in  the  country?  Why,  for  example,  in  the 
near  vicinity  of  Vienna,  in  Hiittelburgh,  Purkersdorf,  Neulengbach,  and 
in  other  places,  the  seats  of  district  officers,  is  there  no  doctor?  I 
have  the  answer:  All  these  places  have  been  tried  by  doctors,  as  I 
could  substantiate  by  their  names,  but  they  could  not  succeed.  In 
every  place  there  is  a  surgeon,  that  lives  on  an  easy  footing  with 
the  community,  is  allied  or  related  with  many  of  the  families,  keeps 
a  house-apothecary,  carries  his  death-warrant  in  hand,  confided  in  by 
the  whole  population,  so  that  the  most  shilJfal  'pliy^ician  has  no  chance 
in  a  concurrence  with   him. 

The  higher  species  of  breeding  of  the  Medical  Practitioner  —  his 
manners,  his  mode  of  speech,  and  style  of  conversing  —  his  bearing, 
in  his  intercourse  with  the  people,  all  conspire  to  make  the  com- 
mon man  believe  that  such  a  gentleman  would  require  a  much 
larger  fee  than  the  surgeon,  living  with  him  in  fellowship,  and  fra- 
ternizing in  his  amusements  with  him,  and  who,  on  his  side,  lets  no 
occasion  or  opportunity  fail  to  cunningly  battle  for  his  aria  et  focis^ 
at  the  expense  of  his  more  learned  competitor,  and  to  conquer  a  sub- 
sistance;  whilst,  in  reality,  such  a  place  is  seldom  in  condition  to  sup- 
port two  practitioners. 

The  surgeon  charges  for  a  visit  to  a  patient,  from  10  to  20  kreu- 
zer  (^%  to  5  cts.) ;  but  at  the  same  time  he  has  30  kreuzer  for  his 
flask  of  mallows  tea,  30  for  his  salve,  30  for  cupping,  30  for  the  plas- 
ter, and  a  separate  charge  for  every  other  unavoidable  article  by  each 
patient,  but  which  the  counbyman,  who  thiwks  only  what  strikes  the 
eye  of  any  value,  finds  all  very  cheap,  because  the  visit  costs  so  little. 
But  the  doctor,  confident   in   the   advancement  of  the   medical  sciences 


Selected  Articles^  Abstracts,  €Jbc.  1T5 

and  not  willing  to  victimize   his   patient  with  an  extensive,  and  for  th 
most   part   useless,  trade  in  vesicatories,  cerates,    and  emplastrams,  and 
wishing   to   elevate  his    art  somewhat   higher,    is,    therefore  unwelcome 
to  the  countrymen. 


•  ♦  • 


ABSTRACTS  AND  SELECTIONS  for  the  PENINSULAR  AND  INDEPENDENT. 


By  M.  a.  Patterson,  M.  D.,  Tecumseh. 

TRAUMATIC  TETANUS  SUCCESSFULLY  TREATED  BY  ATROPIA. 

The  editors  of  the  Kentucky  Semi-MontMy  Medical  ISTews^  have  pub- 
lished the  successful  treatment  of  a  formidable  case  of  tetanus  by  free 
use  of  atropia.  The  patient  was  a  lad  aet.  14.  The  cause,  a  lacer- 
ated pistol  wound  of  left  hand,  received  27th  of  December  last.  On 
the  evening  of  January  12th,  convulsions  occurred;  the  spasms  for  a 
time  were  allayed  by  the  applications  of  chloroform,  but  fearing  its 
toxic  effects  upon  the  blood,  repeated  and  greatly  prolonged  anesthe- 
sia was  regarded  as  altogether  too  hazardous.  On  the  15th  of  Janu- 
ary, at  10  A.  M.,  he  took  1-20  gr.  of  atrophine;  similar  doses  were 
repeated  every  three  hours,  which  kept  him  fully  under  the  influence 
of  the  medicine,  with  the  effect  of  gradually  abating  the  force  and 
frequency  of  the  spasms.  On  the  15th,  the  atrophine  was  reduced 
to  1-40  grain  every  three  hours.  Spasms  and  delirium,  more  or  less 
severe,  continued  until  the  20th,  when  these  manifestations  were  so 
slight  the  atrophine  was  discontinued.  The  trismus  and  muscular  ri- 
gidity subsided  very  slowly.  During  the  progress  of  the  case,  other 
means  were  emploj'-ed  to  meet  temporary  symptoms ;  which  will  be 
readily  suggested  to  the  mind  of  any  intelligent  physician  who  may 
chance   to   have   a  case   of  this    fearful   nature    under   his    charge. 

The  following  remarks  are  so  judicious  we  can  not  resist  the 
inclination   to   present   them   to   the  readers   of  this  Journal: 

Chloroform,  without  doubt,  is  the  most  efficient  agent  for  the  control 
of  the  spasms,  but  unfortunately  its  toxic  effects  upon  the  blood  unfit  it 
for  cases  where  long  persistency  of  influence  is  required.  And  all  authors 
who  have  observed  and  written  much  in  regard  to  tetanus,  teach  us  to 
place  our  principal  reliance  for  success  in  the  safe  conduct  of  our  patient 
through  the  first  four  or  five  days,  after  which  the  disease  is  spoken  of  as 
"chronic"  and  manifesting  a  tendency  towards  spontaneous  subsidence. 
Our  measures  of  treatment  were  from  the  first  directed  towairds  the  attain- 
ment of  this  end.  One  of  the  most  strongly  urged  points  of  tieatment  in 
this  case,  and,  as  we  conceive  one  of  the  most  important,  was,  that  our 
patient  should  be  kept  absolutely  free  from  all  needless  sources  of  excitation. 
Strange  flices  were  prohibited  from  his  room  —  noises  were  interdicted  — 
his  nurses  were  admonished  to  be  gentle,  calm,  and  quiet  in  their  atten- 


176  The  Peninsular  and  Independent. 

tions;  sudden  currents  of  cold  air,  and  all  unnecessary  contacts  with  his 
bed,  or  touching  his  person  without  previously  apprising  him  were  avoided. 
.  ,  .  .  Then,  if  pjactitioncrs  would  content  themselves  with  simply 
moderaiiny  the  violence  of  the  convulsive  paioxysms  of  tetanus,  by  euch 
agents  as  may  be  found  best  suited  to  each  individual  case,  and,  sup- 
porting their  patient's  strength,  look  to  the  ultimate  spontaneous  ces- 
sation of  the  disease,  we  sincerely  believe  that  its  mortality  would  be 
materially  lessened,  although  it  may  long  continue  to  be  classed  as  one  of 
the  opprobria  of  our  Profession. 


APPLICATION  OF  GLYCERINE  IN  VARIOLA. 

Dr.  PosNEK,  editor  of  the  Medical  Central  Zeitung^  in  the  January 
No.,  1859,  of  his  journal,  recommends  the  application  of  Glycerine  in 
Variola,  affirming  that  it  protects  and  secures  the  patient  against  the 
Variola  deformity. 

lie  was  led  to  the  use  of  Glycerine,  in  consequence  of  the  entreaties 
of  his  patients  for  some  application  that  would  relieve  the  distressing 
pain  in  the  pustules;  for  this  purpose  he  directed  the  anointing  of  the 
painful  parts  every  two  hours,  with  pure  Glycerine.  His  anticipations 
were  answered  —  the  pain  and  tension  being  overcome. 

It  chanced  that  the  first  two  patients  upon  whom  the  remedy  was 
tested,  were  completely  coveied  with  pustules,  which,  upon  the  face, 
were  confluent.  Great  deformity  was  expected ;  but  when  the  scales 
fell  off,  contrary  to  every  anticipation,  the  scars  that  remained  were 
small  and  on  a  level  with  the  skin  —  they  were,  however  of  such  a  dark 
color  that  the  patients  looked  like  mulattoes. 

Out  of  instinct,  not  in  obedience  to  direction,  the  convalescents 
continued  the  application  of  the  Glycerine,  and  after  six  weeks,  the 
discoloration  had  disappeared  and  the  scars  were  scarcely  visible.  Since 
then  a  number  of  patients  have  been  thus  protected. 

Great  care  must  be  taken  that  the  Glycerine  is  perfectly  pure. 

[Med.  cC  Surg.  Reporter. 


ERGOT  IN  PHTHISIS  PULMONALIS. 

Ergot,  originally  recommended  by  a  French  physician  for  Phthisis, 
has  recently  been  tried  by  Dr.  Staats,  of  Albany,  N.  Y.,  with  decided 
benefit,  as  he  supposes,  in  three  well  marked  cases  of  consumption. 
From  the  New  York  American  Medical  Monthly^  for  May  last,  we  learn 
that  he  prescribed,  4  gr.  of  powdered  ergot,  \  gr.  of  ipecac,  with  1-10  gr. 
of  sulph.  of  morphia  ever}'-  six  hours;  a  strong  liniment  of  acetic  acid 
and  spirits  of  turpentine  to  the  chest,  and  a  full  animal  diet." 

With  such  important  adjuvants,  the  therapeutic  agency  attributed  to 
the  ergot  may  well  be  questioned.  The  asserted  object  of  his  communi- 
cation is  to  call  attention  to  the  remedy,  that  it  may  be  fairly  tested,  and 
with  this  view  we  notice  his  remarks. 


Selected  Articles^  Abstracts^  dbc.  177 

TARTRATE  OF  IRON  AND  POTASH  IN  PHAGENDIC  ULCER. 

M.  RicoRD,  of  Paris,  recommends  this  salt  very  highly  in  certain 
forms  of  syphilis.  AYe  have  used  it  frequently,  with  truly  surprising 
results.  We  now  recall  to  mind  a  case  in  which  a  very  large  ulcer 
threatened  to  destroy  the  glans  penis.  The  young  man  was  brought 
very  low  by  exhausting  haemorrhages,  and  the  ulcer  was  rapidly  pro- 
gressing. In  consultation  with  his  attending  physician,  -we  advised  from 
5  to  10  grains  tartrate  of  iron  and  potash,  three  times  a  day,  with  a 
strong  solution  of  the  same  constantly  applied  to  the  affected  part  on 
lint.  The  bleeding  was  soon  arrested,  and  the  deep  ulcer  filled  up  with 
wonderful  rapidity.  TVe  have  used  the  remedy  many  times  since,  and 
are  always  pleased  with  its  effects  in  similar  cases. 

[Southern  Med.  and  Surg.  Journal. 

NEW  METHOD  OF  CURING  HYDROCELE. 

In  the  Edinburgh  Medical  Journal  for  December,  1858,  is  a  state- 
ment that  Dr.  Simpson  reported  to  the  Medico -Chirurgical  Society,  the 
complete  cure  of  a  case  of  Hydrocele  by  the  following  method : 

A  slender  wire,  or  metallic  seton,  "  was  passed  through  the  sac,  by 
first  traversing  the  sac  from  below  upwards  with  a  long -handled  surgical 
needle,  such  as  is  used  in  transfixing  and  tying  haemorrhoids,  threading 
the  eye  of  the  needle  after  it  was  projected  through  the  scrotum  above 
with  three  or  four  slender  iron  threads,  pulling  the  needle  then  back- 
wards through  the  sac  and  out,  and  thus  leaving  the  metallic  seton  in 
its  place.  The  liquid  drained  off  in  an  hour  or  two ;  adhesive  inflam- 
mation set  in,  and  progressed  for  two  days,  when  it  began  to  subside. 
The  wires  were  removed  on  the  third  day,  and  the  cure  had  remained 
apparently  quite  complete,  with   the  vaginal   sac  firm  and  consolidated. 

This  method  of  treating  Hydrocele  was.  Dr.  S.  held,  much  simpler 
in  its  performance  than  tapping  and  injecting;  not  by  any  means  so 
painful  to  the  patient ;  less  likely  to  produce  a  suppuration  or  danger- 
ous amount  of  inflammation  ;  and,  perhaps,  experience  would  show  also, 
betimes,  that  it  was  surer  and  more  certain  in  its  results. 

In  connection  with  this  subject,  we  notice  in  the  Lancet^  a  case  at 
the  Westminster  Hospital,  in   which 

Mr.  HoLTHOUSE  passed  a  needle  with  a  silk  ligature  through  the  most 
depending  parts  of  the  hydrocele,  squeezed  out  the  serous  contents,  and 
tied  the  two  ends  together. 

Sufficient  time  had  not  elapsed  to  determine  the  result,  although  it 
js  probable  from  the  known  effect  of  metallic  wires  on  living  tissues  that 
the  iron  seton  will  be  found  preferable  to  silk. 

The  same  authority  states  that 

M.  Chassaignac,  of  Paris,  introduced  one  of  his  drainage  tubes  to  effect 
the  same  purpose,  by  means  of  a  trochar,  upon  which  the  tube  is  intro- 

VoL.  II. -M. 


178  TliQ  Peninsular  and  Independent. 

duced   completely   through   the  hydrocele,    thus   acting   the   part    of   a 
canula." 


OZCENA. 

Occasionally  we  meet  with  cases  of  Ozoena  which  are  very  distress- 
ing to  the  patients  and  perplexing  to  the  physician.  Hitherto  our  most 
successful  treatment  consisted  in  the  introduction  of  a  seton  in  the  nape 
of  the  neck;  injections  into  the  nostrils  of  nitrate  of  silver,  or  sulp.  zinc, 
and  the  internal  use  of  Fowler's  arsenical  solution ;  the  latter  changed 
for  special  anti  -  scrofulous  medication  when  indicated.  The  cure  of  an 
obstinate  case  is  related  by  Dr.  H.  F.  Campbell  {Southern  Medical  and 
Surgical  Journal^  March,  1859).  He  applied  to  the  diseased  Schneidarian 
Membrano,  three  or  four  times  a  day,  a  solution  made  by  dissolving  two 
grains  of  iodine  in  one  ounce  of  glycerine.  At  the  same  time  a  mixture 
composed  of  Huxam's  tincture  of  bark  |  viij.,  iodide  of  potassium  3  ij., 
was  administered  in  doses  of  a  tablespoonful,  mixed  with  sweetened  water, 
three  times  a  day. 


UTERINE  DISEASE  THE  MAIN  CAUSE  OF  NURSING  SORE   MOUTH. 

Dr.  M.  M.  Fallen  ( St.  Louis  Med.  &  Surg.  Journal )  remarks : 

From  the  uniformity  with  which  I  have  met  with  disease  of  the 
uterus  in  stomatitis  matcrna  I  have  concluded  that  it  plays  an  important 
part  in  the  production  of  the  disease.  I  suppose  that  the  affection  exists 
prior  to  the  sore-mouth,  and  pregnancy  or  lactation,  as  the  case  may  be, 
increases  it  to  such  an  extent  that  gastric  derangement  results,  and  this  is 
followed  by  the  trouble  in  the  mouth. 

This  hint  is  simply  valuable  to  direct  attention  to  the  condition  of  the 
womb  when  symptoms  of  stomatitis  materna  occur.  There  is,  however, 
more  danger  of  needless  interference  with,  than  neglect  of,  this  organ  in 
this  age  of  speculums  and  Bennetisms. 


VOMITING  DURING  PREGNANCY. 

In  some  obstinate,  and  rather  alarming,  cases  of  vomiting  continued 
to  advanced  pregnancy,  until  the  stomach  itself  became  seriously  affected, 
as  proved  by  altered  secretion,  Dr.  Gros  {Bui.  Genl.  de  Thera2oeutique) 
speaks  of  prompt  relief  being  afforded  by  the  administration  of  pepsine. 


ADDITIONAL  TESTIMONY  OF  THE  VALUE  OF  IRON  IN  THE  TREATMENT 
OF  SCARLATINA. 

Dr.  Bishop,  of  Davenport,  reports,  in  the  February,  1859,  No.  of  the 
Lancet^  fifty -one  cases,  some  of  them  quite  malignant,  of  scarlatina, 
recently  treated  by  himself,  with  the  loss  of  but  one  patient.  He  attributes 
this  exemption  from  the  usual  fatality  of  the  disease  in  Davenport,  to  the 
employment  of  tonics  from  the  first:  "either  citrate  of  iron  or  the  tincture 


Selected  Articles^  Abstracts^  <&c.  179 

•of  the  sesqui  -  chloride  in  the  usual  full  doses."  He  applied  no  caustics  to 
the  throat  or  tonsils,  but  used  external  applications  of  vol.  camph.  liniment, 
or  turpentine  sprinkled  on  a  strip  of  flannel  previously  wrung  out  of 
hot  water,  and  applied  around  the  neck  several  times  in  twenty -four 
hours. 


TREATMENT  OF  ERYSIPELAS  OF  THE  LIMBS  BY  ELEVATION 

A  plan  of  treatment  practiced  at  the  Middlesex  Hospital,  England,  for 
erysipelas  of  the  limbs,  is  merely  the  practical  application  of  a  general 
principle  which  is  too  often  neglected. 

It  consists  in  elevating  the  affected  leg  or  arm  in  a  vertical  position 
above  the  horizontal  plane  of  the  body.  This  causes  a  subsidence  of 
the  swelling,  and  removes  the  pain;  the  circulation  in  the  veins  is  ac- 
celerated towards  the  heart,  and  the  hitherto  inflamed  and  red  skin  as- 
sumes a  pallid  aspect.  [Lancet,  Fed.  1859. 


OBSTINATE  VOMITING. 

Dr.  H.  Buss,  of  Shoreditch,  in  the  report  of  a  case,  incidentally 
remarks : 

I  put  in  practice  Dr.  Steggol's  plan  of  arresting  obstinate  vomiting ; 
ten  -  grain  doses  of  sulph.  of  magnesia  in  half  an  ounce  of  water  every 
half  hour  —  a  dernier  resort  which  has  never  yet  failed  me. 

[lUd, 

ATROPIA  IN   EPILEPSY. 

Dr.  Max  Maresch  (  Wienerzeitschrieft),  Physician  to  the  Vienne 
Hospital  for  the  Insane,  prescribed  the  Atropia  in  eighteen  cases  of 
Epilepsy;  three   were   completely  cured,    and   thirteen  much  improved. 

The  one-fiftieth  of  a  grain  was  given  every  morning  before 
breakfast  for  a  period  of  from  sixty  to  ninety  days — an  intermission 
of  thirty  to  forty-five  days  allowed  to  the  patient,  and  then  the 
medicine  again  prescribed.  It  is  important  that  the  patient  use 
neither  coffee  nor  cocoa,  as  the  active  principles  of  these  counteract 
the   physiologial   effects  of  the  Atropia. 

In  the  above  dose,  the  usual  symptoms  of  balladonna  were 
produced. 

[Med.  &  Surg.  Reporter,  trans,  ly  Dr.  Demme. 


OF  THE   TREATMENT   OF  ORGANIC  STRICTURES   OF  THE   URETHRA  BY 
IODIDE   OP  POTASSIUM. 

Dr.  Thielmann,  surgeon  of  one  of  the  hospitals  of  St.  Petersburgh, 
has  utterly  relinquished,  the  last  thirteen  years,  the  use  of  mechan- 
ical  means   habitually   employed  for   organic  strictures   of  the  urethra, 


180  The  Peninsular  and  Independent. 

which  he  treats  exclusively  by  iodide  of  potassium.  This  medicatiorr 
has  perfectly  succeeded  in  twenty -seven  cases  of  stricture,  presenting 
a  great  ■  diversity  with  respect  to  seat,  extent,  structure,  etc.  With 
the  greater  part  of  the  patients  a  more  a  less  copious  gonorrhoeal 
discharge  was  present  at  the  same  time.  The  oldest  strictures  were 
of  two   years'   standing,    the  most  recent   of  eight    months'. 

Dr.   TiiiELMANN    exhibited    to  each    of   his    patients    three    table- 
spoonfuls   a   day    of   the  following  solution : 

Vf..     Potassa  lodidi 2  dr. 

Aqua    destill. Sj  oz. 

He  prescribed  a  rigid  milk  diet,  permitting  amjdaceous  food.  .  . 
It  was  sometimes  requisite  momentarily  to  suspend  the  use  of  the 
iodide  in  order  to  avoid  the  accidents  that  might  be  superinduced 
by  its  protracted  uses.  The  duration  of  the  treatment  varied  from 
a  fortnight  to  two  months,  when  the  inodular  tissue  of  the  strictures 
was  felt  externally.  Dr.  T.  ordered,  in  addition,  frictions  along  the 
part  of  the  penis  corresponding  to  the  urethra,  with  an  ointment 
composed   of 

% .     Potassa  iodid 1  dr. 

Adipis 1  oz. 

The  gonprrhoeal  discharge  for  the  most  part  ceased  spontaneously. 
When   it  was  persistent,    it   was    treated  by   the    ordinary  means. 

\JSIed.  Zeit.  Russlands,  and  Journ.  Tract.  Med.  &  Surg. 

VEGETABLE  PARASITES  OF  THE  HUMAN  SKIN. 

Mr.  Jabez  Hogg,  read  an  interesting  paper  on  this  subject  before  the 
medical  societ}''  of  London  (January  24,  1859),  the  object  of  which  was  to 
show  the  fallacy  of  the  theory  prepounded  by  certain  physicians,  who  at- 
tributed certain  special  diseases  of  the  skin  to  a  vegeta'ble  parasite  peculiar 
to  disease  in  question ;  thus,  that  the  porrigo  favosa  (the  cupped  or  honey- 
comed  ringworm  of  \Villan)  is  caused  by  a  parasitic  fungi  called  acliorion 
Sclwnleinii ;  that  the  porrigo  scutulata  of  Willan  II  due  to  the  parasite 
tricoi^liy ton  tonsurans  ;  that  the  porrigo  decalvans  is  ^wo,  io  iha  microspo- 
ron  Audouini ;  that  sycosis  or  mentagra  is  due  to  the  microsi^oron  menta- 
gropliitcs  ;  and  that  the  pityriasis  versicolor  is  due  to  the  onicrosj^oron  fur- 
fur. The  author  combated  this  hypothesis  by  exhibiting  the  microscopfc 
appearances  of  the  fungi  which  were  found  in  the  products  of  these  dis- 
eases, and  showed  that  the  same  fungi  were  common  to  all,  as  also  to 
other  skin  diseases  not  included  in  the  category  of  other  authors ;  and 
summed  up  his  arguments  as  follows  :  Fungi  are  well  characterized  through- 
out nature  by  feeding  on  effete  or  decayed  matter  ;  the  fungi  supposed  to 
be  peculiar  to  certain  diseases  of  the  skin  were  also  found  in  many  other 
diseases  of  the  cutaneous  surface  ;  competent  observers  had  not  been  able 
to  find  them  in  those  peculiar  diseases  ;  sporules  and  filaments,  described 
as  the  cause  of  one  definite  disease,  had  been  found  in  the  products  of 
another  definite  disease,  supposed  to  have  a  parasite  of  its  own,  dif- 
ering  from  this  and  peculiar  to  itself;  and,  lastly,  attempts  had  been 
made  in  vain  to  implant  these  parasites  in  the  healthy  skin ;  hence  one 
could   not   but   conclude  that  the  whole  theory  was  erroneous,  and  that 


r 

Selected  Articles^  Abstracts^  (&c.  181 

special  parasites  peculiar  to  and  productive  of  special  diseases  did  not  exist. 
It  was  the  author's  conviction  that  the  fungi  found  on  the  skin  and  hair 
were  not  primarily  the  cause,  but  rather  the  result,  of  disease. 

[Brit.  Med.  Journal,  Feb.  1859. 
PERSULPHATE   OF  IRON"  IK"  EPISTAXIS, 

Dr.  HiBBARD,  of  Richmond,  Ind.,  promptly  arrested  a  profuse  and 
alarming  nasal  hsemorrhage  by  injecting  into  the  nostril  "  3  ss.  of  a  mix- 
ture consisting  of  a  solution  of  persulphate  of  iron  one  part,  rain- 
water ten  parts."     He  remarks  : 

The  points  of  this  case  worthy  of  notice  are  —  1.  The  hsemorrhage, 
after  resisting  all  ordinar}^  measures,  was  arrested  at  once  upon  the 
application  of  a  diluted  solution  of  the  persulphate  of  iron;  2.  The 
application  was  convenient  and  without  pain  to  the  patient;  3.  The  nostril 
was  left  clear  of  clots,  irritation,  or  other  unpleasant  consequence  of  either 

the  lesion  or  the  medication The  preparation  I  used 'was  a  solution 

of  the  salt  as  made  and  used  as  a  ferruginous  tonic  by  J.  T.  Plummer,  M.D. 
of  this  city ;  and  as  the  process  appears  to  me  much  more  simple  than 
that  of  M.  MoNSEL,  I  subjoin  it  with  Dr.  Plummer's  approbation: 

R.     Sulphate  of  Iron    .         .         .         .         .         .  1  ijss. 

Nitric  Acid     .......  |  iij. 

Water    ........  |  xss. 

Triturate  the  salt  and  the  acid  together  for  fifteen  minutes ;  then  add 
the  water  and  filter  through  paper.  [  Lancet  &  OMerver. 

PROLAPSUS  UTERL 

W.  E.  Nourse,  a  Brighton  Surgeon,  relates  in  the  March  No.  of  the 
London  Lancet,  tlie  successful  treatment  of  a  very  bad  case  of  this  malady, 
of  three  years  standing,  by  a  simple  application  of  the  ])rinci;ple  upon 
which  the  success  of  the  surgical  operation  for  prolapsus  uteri  depends, 
viz.  :  partial  occlusion  of  the  vagina.  The  favorable  termination  of  the 
case  affords  a  striking  illustration  of  the  importance  of  decided  and  pre- 
cise directions,  and  of  the  efficacy  of  continued  unremitting  mechanical 
support.  '  After  replacing  the  womb,  he  directed  that  it  should  never  again 
be  allowed  to  descend  externally — "That  a  sort  of  thick  pad  or  cushion, 
of  a  length  and  breadth  sufficient  to  cover  the  external  parts,  should  be 
applied  and  kept  in  its  place  by  a  broad  and  firm  T  bandage  before  she 
again  rose  from  the  recumbent  posture  ;  that  she  should  always  put  one 
on  before  rising  from  her  bed  in  the  morning,  just  as  a  ruptured  person 
puts  on  a  truss,  and  should  never  go  abroad  without  one  ;  and  lastly,  that  she 
should  introduce  every  night  into  the  vagina,  a  few  grains  of  tannic  acid 
made  up  into  a  sort  of  soft  pill." 

On  the  same  subject,  according  to  the  Medical  Journal  of  North  Car- 
olina., Dr.  Bonordon  observes,  that  as  a  prolapsus  uteri  usually  arises  from 
hypertrophy  of  the  organ  and  a  relaxed  state  of  the  round  and  broad  liga- 
ments, the  indications  are  to  remove  the  hypertrophied  condition,  and  to 


182  The  Peninsular  and  Independent. 

strengthen  the  ligaments.  In  two  cases  he  has  been  enabled  to  completely 
fulfill  them  by  internal  remedies.  lie  administered  twenty  drops  of  tr, 
ferri.  mur.  morning  and  evening,  giving  with  the  evening  dose  also  three 
gr.  secale  cornut,  and  ten  gr.  of  gum  galhanum,  the  external  parts  of  gen- 
eration being  well  rubbed  several  times  a  day  with  Hoffman's  halsamum 
vitce.  At  night,  the  patients  were  directed  to  lay  with  the  pelvis  some- 
what raised.  The  secale  was  continued  for  fourteen  nights,  next  alternate 
nights,  then  a  while  at  longer  periods. 


RE-INTERMENT  OF  THE  REMAINS  OF  JOHN  HUNTER. 

The  following  rare  bit  for  the  medical  antiquary  the  iV!  Y.  Journal 
credits  to  the  London  Times  &  Gazette.  'As  public  notice  had  been  given 
that  the  re-interment  would  take  place  in  the  xVbbcy  on  ^Monday  after  the 
afternoon  service,  and  that  an  appropriate  anthem  would  be  given,  an 
unusually  large  congregation  had  assembled,  and  great  numbers  of  medical 
men  attended  in  addition  to  those  who  had  obtained  tickets  at  the  College. 
There  was  no  funeral  service,  but  the  words  of  the  anthem  were  peculiarly 
appropriate :  '  "When  the  ear  heard  him,  then  it  blessed  him ;  when  the 
eye  saw  him,  it  gave  witness  to  him ;  he  delivered  the  poor  that  crieth, 
the  fatherless,  and  him  that  hath  none  to  help  him.  .  .  .  His  body 
is  buried  in  peace;  his  name  liveth  evermore.'  While  the  service  was 
proceeding,  the  Council  of  the  College  and  many  gentlemen  invited  to 
join  in  the  ceremony,  assembled  in  the  Jerusalem  Chamber,  the  room  in 
which  Henry  the  Fourth  died,  after  having  been  brought  there  from  the 
Confessor's  Shrine  in  |the  Abbey  in  a  fit  of  apoplexy.  There  were  those 
present  who  recalled  the  words  of  the  djnng  king,  as  embalmed  by 
Shakspearc  in  his  historical  play,  and  of  Congreve  and  Addison  Ij'ing  in 
state  in  the  same  room  before  their  interment  in  the  Abbey,  so  well 
described  by  Goldsmith  as  '  the  place  of  sepulture  for  the  philosophers, 
heroes,  and  kings  of  England'  and  there  was  a  general  feeling  of  pride 
on  the  occasion  of  adding  the  remains  of  one  of  England's  greatest  medical 
philosophers  to  the  dust  of  his  fellows ;  especially  as  our  profession  is 
not  rich  in  associations  with  Westminster  Abbey.  Mead,  Friend,  and 
Baillie — with  the  exception  of  Buchan,  of  '  Domestic  Medicine '  renown — 
were  the  only  medical  men,  before  Hunter,  entombed  within  its  pre- 
cincts. When  the  service  was  over  the  procession  was  thus,  arranged, 
following  the  coffin,  which  was  carried  on  a  high  bier :  The  Dean  of 
Westminster ;  Mr.  Baillie,  a  grand  nephew  of  Hunter ;  the  Earl  of  Ducie 
and  Dr.  Clarke,  of  Cambridge,  as  trustees  of  the  Hunterian  Museum ; 
Mr.  Buckland  and  Professor  Owen  ;  the  Presidents  of  the  Colleges  of 
Physicians  and  Surgeons,  the  Council  and  Professors  of  the  College  of 
Surgeons,  the  Censors  of  the  College  of  Physicians,  the  Master  and 
Warden  of  the  Apothecaries'  Company,  the  Presidents  of  several  of  the 
learned  Societies,  the  Medical  Officers  of  London  and  Provincial  Hospitals, 
and  many  visitors.  While  the  Dead  March  in  Saul  resounded  from  the 
organ,  the  procession  proceeded  round  the  Abbey,  through  lines  of  spec- 
tators, and  returned  to  a  grave  opened  on  the  north  side  of  the  nave, 
near  the  western  end.  Here  the  coffin  was  lowered  amid  a  great  con- 
course, and  many  present  obtained  their  first  glimpse  of  it.  It  was  ex- 
tremely well  preserved.  On  a  brass  plate,  with  the  family  arms,  was 
inscribed  'John  Hunter,  Esq.,  died  16th  October,  1793,  aged  64  years.' 
Beneath   this   plate   the  College   had  had  another   affixed,   with   the   in- 


Selected  Articles^  Abstracts^  c&c.  183 

scription,  '  These  remains  were  removed  from  the  Church  of  St.  Martin- 
in-the-Fields,  by  the  Royal  College  of  Surgeons  of  England,  March  21st, 
1859.'  On  opening  the  grave  for  Hunter,  the  bones  of  Ben  Jonson  were 
exposed,  and  a  skull  was  freely  handled  about,  said  to  be  that  of  '  Rare 
Be« ';  but  we  did  not  learn  that  the  truth  of  the  story  of  the  poet  being 
buried  standing  on  his  feet  was  confirmed.  However  this  may  be,  the 
Poet  and  the  great  Surgeon,  Physiologist,  and  Naturalist  rest  at  last 
side  by  side,  close  to  Gifford,  who  rescued  Jonson's  memory  from  un- 
merited obloquy,  and  another  is  added  to  the  rich  associations  of  our 
National  Mausoleum.  In  its  aisle  and  chapels  sleep  our  kings  aud 
queens.  Elizabeth  in  the  same  sepulchre  with  her  victim,  the  Scottish 
Mary ;  the  descendants  of  Robert  Bruce  by  the  side  of  the  first  Edward ;. 
Pitt  within  a  yard  of  Fox.  ^      • 

'  "  How  peaceful  and  how  powerful  is  the  grave 
Which  hushes  all !  "  ' 


MEDICAL  TEACHERS'  COMENTIOIf. 


Louisville,  May  2,  1859. 

The  Convention  of  Medical  Teachers  was  called  under  the  following 
resolution,  adopted  at  the  Eleventh  Annual  Meeting  of  the  American 
Medical  Association,  held  at  Washington  city  last  year : 

Resolved,  That  we  recommend  to  all  the  Medical  Colleges  entitled  to  a  represent- 
ation in  this  body,  that  they  appoint  delegates,  especially  instructed  to  represent  them 
in  a  meeting  to  be  held  at  Louisville,  on  Monday,  the  day  immediately  preceding  the 
Convention  of  the  American  Medical  Association  for  the  year  1859,  at  10  o'clock  in  the 
morning,  at  such  place  as  the  Committee  of  Arrangements  shall  delegate. 

In  pursuance  of  this  resolution  the  committee  selected  Mozart  Hall  for 
the  place  of  meeting,  and  they  made  every  provision  for  the  comfort  of  the 
delegates  and  the  gentlemen  of  the  press,  each  of  the  latter  having  a  con- 
venient table,  with  the  requisite  stationery  and  a  most  luxurious  arm  chair, 
prescribed  for  his  accommodation.  This  evidence  of  attention  deserves  our 
warmest  acknowledgements. 

At  the  hour  of  10  the  Convention  was  called  to  order,  and  Prof.  Dixi 
Crosby,  of  Dartmouth  College,  Hanover,  N.  H.,  was  selected  as  chairman, 
and  Prof  George  C.  Blackman,  of  Ohio  Medical  College,  at  Cincinnati,  as 
secretary.  Prof  Crosby,  on  assuming  the  chair  said  that,  like  all  his  pre- 
decessors called  upon  to  preside  over  deliberative  bodies,  he  had  been  taken 
wholly  by  surprise,  and  should  have  declined  had  not  Dr.  Frost,  of  S.  C, 
and  Dr.  Davis,  previously  excused  themselves  from  serving.  He  could 
bring  the  Convention  no  qualification  for  the  position  except  an  earnest 
desire  to  serve  them  ;  but  this,  and  the  support  of  the  members,  he  hoped 
would  enable  him  to  meet  their  approval  and  conduct  the  important  deli- 
berations satisfactorily. 

Rev.  J.  H.  Haywood  was  then  introduced,  and  invoked  the  Divine 
supervision  over  the  proceedings  of  the  body,  in  an  earnest  and  eloquent 
prayer. 

Some  discussion  then  ensued  as  to  the  mode  of  organization,  some 
wishing  all  medical  professors  present  to  act  as  delegates,  and  others  de- 
siring that  each  college  should  have  a  unit  representation.  The  following 
resolution  was  submitted  by  Dr.  David  F.  Wright,  of  Shelby  Medical 
College : 


184  The  Peninsular  and  Independent. 

Resolved,  That  all  members  of  the  Faculties  of  Medical  Colleges  now  present 
shall  be  considered  members  of  this  Convention,  but  that  where  more  than  one  belong 
to  the  same  College  one  of  them  alone  shall  vote  in  behalf  of  that  institution. 

After  some  further  interchange  of  views  —  all  tending  to  the  same 
wish  of  full  representation  —  on  motion  of  Dr.  A.  II.  Baker,  of  Cincinnati, 
the  following  substitute  was  offered  and  adopted : 

Resolved,    That  a  committee  of  three  on  credentials  be  appointed  by  the  Chair. 

Under  this  resolution,  Prof  Crosby  selected  Drs.  Baker,  Shattuck,  and 
Haskins  the  Committee  on  Credentials,  and  the  Convention  took  half  an 
hour's  recess  for  the  registration  of  the  names  of  delegates. 

Let  us  take  advantage  of  this  syncope  in  the  proceedings  to  look 
around  upon  the  descendants  of  Galen  and  Hippocrates  now  assembled 
here.  It  is  an  important  convc^ation,  its  members  exercising  the  most 
delicate  relations  to  the  whole  humafi  family  and  being  the  custodians  of 
the  life  and  health  of  the  entire  community.  A  grave,  intelligent  body  of 
men,  apparently  proudly  conscious  of  their  high  position,  the  delegates 
represent  some  of  the  most  noted  sources  of  medical  knowledge  in  the 
country.  As  they  rise  to  address  the  Chair,  we  hear  their  names  enunciated 
by  the  clear  voice  of  the  President,  and  fmd  them  to  have  been  written 
down  in  the  book  of  professional  fame,  and  associated  with  the  prosperity 
of  the  medical  colleges  to  which  they  belong,  and  in  many  instances  add- 
ing largely  to  the  reputation  of  those  institutions.  But  few  of  them  wear 
glasses;  hardly  a  wig  or  a  toupee  is  visible  upon  a  rapid  scrutiny  of  the 
heads  of  the  Professors,  and  it  seems  to  us  that,  generallj^,  they  look  more 
hale  and  heart}''  than  practicing  physicians  usually  do.  It  may  be  that 
the  professorial  duties,  which  do  not  "  murder  sleep  "  by  unreasonable 
midnight  calls,  and  the  quiet  dignity  of  the  chairs  of  Pharmacy,  Surgery, 
Chemistry,  Obstetrics,  &c.,  are  more  congenial  to  the  physical  develop- 
ment of  phj^sicians,  than  the  hard  work,  long  rides,  tedious  walks,  and 
harrassing  cares  of  the  Doctor  of  Medicine  who  has  his  round  of  patients 
to  attend.  Be  this  as  it  may,  these  teachers  of  medicine  are  a  very  fine 
looking  body  of  men,  their  heads  show  great  intellectual  development,  and 
their  eyes  are  peculiarly  keen  and  sparkling. 

But  the  Committee  on  Credentials  have  discharged  their  duty ;  the 
Convention  is  called  to  order  again,  and  the  following  delegates  are  an- 
nounced as  in  attendance,  with  the  institutions  to  which  they  belong : 

Dartmouth  College,  New  Hampshire  —  Professor  Dixi  Crosby. 

Shelby  Medical  College.  Tenn.  —  Professor  E.  B.  Haskins,  Prof.  D.  F.  Wright. 

Missouri  Medical  College —  Professor  J.  N.  McDowell. 

St.  Louis  Medical  College  —  Professor  M.  L.  Linton. 

Medical  College  of  South  Carolina —  Professor  Henry  K.  Frost. 

Medical  College  of  Georgia,  at  Augusta  —  Prof.  H.  F.  Campbell,  Prof.  Joseph  Jones. 

Medical  Department,  University  of  ]\Iichigan  —  Prof.  Moses  Gunn. 

University  of  Louisville  —  Prof.  L.  P.  Yandell,  Prof.  L.  Powell. 

Cincinnati  College  of  Medicine  —  Professor  A.  H.  Baker. 

Lind  University,  Chicago  —  Prof.  X.  S.  Davis. 

Oglethorpe  Medical  College,  Georgia  —  Prof.  A.  G.  Thomas. 

Medical  College  of  Ohio  —  Professor  George  C.  Blackman. 

Western  Reserve  Medical  College,  Cleveland,  0.  — Prof.  G.  C  C.  Weber. 

Kentucky  School  of  Medicine  —  Prof.  M.  Goldsmith,  Prof.  G.  W.  Bayless. 

Iowa  University —  Prof.  Mcgugin. 

Medical  College  of  Memphis,  Tenn.  —  Prof.  H.  R.  Robards. 

Medical  College  of  Richmond,  Ya.  —  Prof.  B.  R.  Welford,  Prof.  L.  L.  Joynes. 

Atlanta  Medical  College,  Ga.  —  Prof.  J.  G.  Westmoreland,  Prof.  John  W.  Jones. 

Medical  Faculty  of  Harvard  University,  Boston,  Mass.  —  Prof.  Geo.  C.  Shattuck. 

Rush  Medical  College,  Chicago,  111. —  Prof.  Dan'l  Brainard,  Prof.  Joseph  W.  Freer. 

The  Convention  was  then  permanently  organised  by  the  re-election  of 
the  temporary  officers,  Prof  Crosby  humorously  remarking  that  the  dele- 


Medical  Teachers'  Conveyition.  185 

gates  were  fortunate  in  this  action,  inasmuch  as  they  would  have  no  fur- 
ther speech  in  reference  to  the  honor  conferred,  &c.  He  said  that,  until 
the  Convention  should  adopt  rules  for  its  government,  he  should  limit 
speeches  to  ten  minutes,  and  allow  no  one  to  speak  more  than  twice  on  the 
same  subject  without  permission. 

Dr.  Wright's  resolution  that  members  from  Medical  Colleges  who  are 
now  present  be  permitted  to  take  part  in  the  debates,  but  that  each  college 
have  but  one  vote,  was  again  taken  up,  considered,  and  passed. 

Dr.  N.  S.  Davis  offered  the  following,  which  was  adopted : 

Resolved,  That  a  Easiness  Committee  of  five  be  appointed  by  the  Chair  to  report 
propositions  for  the  action  of  the  Convention. 

The  Chair  appointed  Drs.  N.  S.  Davis,  Gunn,  Frost,  Shattuck,  and 
Yandell.  After  a  short  recess  to  enable  this  committee  to  report,  they 
submitted  the  following  through  Dr.  Davis,  the  chairman  : 

1.  Resolved,  That  this  Convention  recognises  the  great  advantages  to  be  derived 
from  the  action  of  the  American  Medical  Association,  in  prescribing  the  terms  and  con- 
ditions on  which  medical  degrees  shall  be  conferred  and  licenses  to  practice  medicine 
shall  be  granted  ;  and  that  an  expression  of  opinion  as  to  methods  or  j)eriods  of  instruc- 
tion from  the  American  Medical  Association  should  be  received  with  deference  and  re- 
spect, and  that  all  pains  should  be  taken  to  enforce  any  rules  and  regulations  recommended 
by  that  body. 

2.  Resolved,  That  this  Convention  earnestly  recommend  the  American  Medical  As- 
sociation to  adopt  such  measures  as  will  secure  the  efficient  practical  enforcement  of  the 
standard  of  premninary  education  adopted  at  its  organization  in  May,  1847  ;  and  that  the 
medical  colleges  will  cheerfully  receive  and  record  the  certificates  alluded  to  in  said 
standard  whenever  the  profession  generally  and  the  preceptors  will  see  that  students  aro 
properly  supplied  with  them. 

3.  Resolved,  That  no  medical  college  should  allow  any  term  of  practice  to  be  a 
substitute  for  one  course  of  lectures  in  the  requisitions  for  graduation. 

4.  Resolved,  That  Hospital  Clinical  Instruction  constitutes  a  necessary  part  of 
medical  education;  and  that  every  candidate  for  the  degree  of  Doctor  of  Medicine 
should  be  required  to  have  attended  such  instruction  regularly  for  a  period  of  not  less 
than  five  months  during  the  last  year  of  his  period  of  medical  pupilage. 

5.  Resolved,  That  every  Medical  College  should  rigidly  enforce  the  rule  requiring 
three,  full  years  of  medical  study  before  graduation,  and  that  the  diploma  of  no  Medical 
College  shall  be  recognized  which  is  known  to  violate  this  rule. 

Prof  Wright,  of  Nashville,  moved  that  the  resolutions  of  the  report 
be  considered  seriatum,  and  the  first  being  taken  up  he  spoke  at  length  in 
opposition  to  it,  giving  a  history  of  the  previous  difficulties  between  the 
American  Medical  Association  and  the  Medical  Colleges.  He  could  neither 
vote  for  such  a  resolution  nor  could  he  take  any  future  part  in  the  proceed- 
ings of  a  Convention  which  should  adopt  it. 

Prof  Brainard,  of  Chicago,  thought  this  Convention  was  asked  to  take 
a  step  fraught  with  peril  to  the  harmony  of  the  profession  and  its  best  in- 
terests ;  it  should  be  met  on  the  threshold,  and  a  solemn  protest  entered 
against  it.  This  body  did  not  represent  the  medical  colleges  of  the  country 
with  unanimity ;  New  York,  Philadelphia,  and  New  Orleans  were  not  repre- 
sented here,  and  he  must  consider  their  absence  as  a  protest  against  the  as- 
sumption of  any  power  on  the  part  of  this  body,  or  the  American  Medical 
Association,  to  dictate  the  terms  on  which  the  colleges  should  confer  their 
degree  or  receive  their  students.  The  admission  of  such  a  resolution  would 
produce  hostile  factions  both  in  the^profession  and  in  the  colleges,  and  could 
never  receive  the  sanction  of  those  who  had  independent,  chartered  rights 
to  fall  back  upon.  He  was  opposed  to  no  true  improvement  in  the  medical 
profession,  but  he  did  object  to  shutting  that  door  upon  young  men  desi- 
rous of  entering  the  profession  through  which  we  ourselves  all  had 
entered. 

Without  definite  action  on  the  resolution,  the  Convention  adjourned 
until  3  o'clock  p.  m. 


186  The  Peninsular  and  Independent. 

Afteenoon  Session. 

When  the  Convention  re-assembled,  Dr.  Bayless  offered  the  following 
amendments  to  the  first  resolution : 

1.  To  substitute  in  the  third  line  the  word  "recommending"  for 
"  prescribing." 

2.  To  strike  out  all  after  the  words  "deference  and  respect." 

A  long  discussion  ensued  on  the  resolution,  which  was  participated  in 
by  Doctors  Bayless,  Yandell,  Palmer,  McDowell,  Davis,  Brainard,  Shat- 
tuck.  Baker,  and  Wright.  The  differences  of  opinion  seemed  almost  as 
various  as  the  number  of  speeches,  and  the  Convention  was  tying  itself 
into  an  apparently  inextricable  entanglement,  when  an  Alexander  sprung 
up  in  the  person  of  Prof  L.  L.  Joynes,  of  the  Medical  College  of  Rich- 
mond, Va.,  who  offered  the  following  preamble  and  resolutions  as  a  substi- 
tute for  the  resolutions  from  the  Business  Committee: 

Whereas,  It  appears  that  a  large  proportion  of  the  Medical  Colleges  of  the 
United  States  are  unrepresented  in  this  Convention,  and  no  changes  in  the  present  system 
of  education  can  be  effectual  unless  adopted  by  the  schools  generally : 

Resolved,  That  it  is  inexpedient  at  this  time  to  take  any  action  upon  the  proposi- 
tion contained  in  the  report  presented  by  the  Special  Committee  en  Medical  Education, 
at  the  last  meeting  of  the  American  Medical  Association. 

Resolved,  That  with  the  view  of  obtaining  a  moro  general  union  in  counsel  and  in 
action,  upon  this  important  subject,  this  Convention  do  now  adjoUrn  to  meet  again  on  the 
day  preceding  the  next  annual  meeting  of  the  American  Medical  -.Association,  at  the 
place  which  may  be  agreed  upon  for  said  meeting,  and  that  the  several  Medical  Colleges 
in  the  United  States  be  requested  to  appoint  each  one  delegate  to  such  adjourned  meeting 
of  this  Convention. 

These  resolutions  were  amended,  at  the  suggestion  of  Dr.  Wright,  to 
include  the  appointment  of  a  committee  of  five,  to  take  into  consideration 
during  the  recess  the  various  matters  referred  to  in  the  resolutions,  and 
report  thereon  at  the  adjourned  meeting. 

The  vote  was  demanded  on  this  by  colleges,  and  resulted  as  follows  : 

Yeas  —  Shelby  Medical  College,  Missouri  Medical  College,  St.  Louis  Medical  Col- 
lege, Oglethorpe  Medical  College,  Ohio  Medical  College,  Western  Reserve  Medical  Col- 
lege, Kentucky  School  of  Medicine,  Medical  CoUege,  Richmond ;  Atlanta  Medical  College, 
Rush  Medical  College  —  10. 

Nays  —  Medical  College,  S.C,  Medical  College,  Ga.,  Medical  Department  Univer- 
sity, Mich.,  University  of  Louisville,  Cincinnati  College  of  Medicine,  Lind  University, 
Iowa  University,  Medical  College,  Memphis  ;  Harvard  University— 9. 

The  substitute  was  declared  adopted,  yeas  10,  nays  9,  and  so  the  Con- 
vention stood  adjourned  until  the  day  preceding  the  next  annual  meeting 
of  the  American  Medical  Association. 

The  Chairman  appointed  the  following  committee  under  the  above 
resolution :  Drs.  Yandell,  Shattuck,  Blackman,  Campbell,  and  Gunn. 


Ilarm^tnttital  i^prtm^nt* 


New  Therapeutieal  Uses  for  some  of  our  Indigenous  Plants. 

We  note  the  following  new  uses  for  some  of  our  most  valued  plants, 
which  it  may  be  worth  while  to  preserve : 

Apocynum  AndroscEmifolium  (commonly  called  Dogsbane  or  Bitter 
Root)  has  been  used  with  success  in  dyspepsia  and  kindred  diseases. 
In  small  doses  the  root  is  laxative;   in  larger  ones,  cathartic. 

Atropa  Belladonna^  in  the  form  of  a  watery  solution  of  its  extract, 
is  recommended  for  arresting  the  secretion  of  milk,  by  applying  it  to 
the  areola. 

Plantago  Major.  The  fresh  juice  of  this  plant  (Yard  Plantain)  is 
stated  to  be  a  remedy  for  the  bite  of  the  venomous  spider.  It  is  ad- 
ministered in  doses  of  from  three  to  four  ounces,  with  immediate  relief. 

AcMllcB  MillifoUum  (Common  Yarrow)  is  proposed  as  an  emmena- 
gogue. 

Lycoperdon  Giganteum.  The  smoke  of  the  burning  PufF-ball  is  stated 
to  possess  decided  ansssthetic  properties,  without  evil  results  arising 
therefrom. 

Gelseminum  Sempenirius  (tincture  of  Yellow  Jessamine)  is  used  with 
success  in  treatment  of  Gonorrhoea. 

Trillium  Penditlum  (Bethroot),  combined  with  Scutellaria  laterifolia 
(Sculcap),  in  infusion,  is  recommended  in  treatment  of  Menorrhagia. 

Oentiana  quinquiflora  (under  the  name  of  Indian  quinia).  An 
infusion  of  this  plant  is  largely  used  in  the  west,  as  an  antiperiodic,  in 
domestic  practice. 

Asclepias  tuberosa  (Pleurisy  or  White  Root)  is  highly  spoken  of  as 
a  diaphoretic,  without  causing  cerebral  disturbance  or  checking  the  se- 
cretion of  the  kidneys.     '  ^ 

Sanguinaria.  This  has  recently  been  recommended  by  Dr.  Edward 
H.  Sholl,  M.  D.,  of  Warsaw,  Alabama,  in  a  communication  to  the  Phil- 
adelphia Medical  Reporter^  as  an  application  in  treatment  of  carbuncle 
and  of  pneumonia.     He  states : 

Premising,  at  first,  the  deep  incisions,  and  the  free  use  of  the  caustic 
potash,  I  have  been  in  the  habit  of  mixing  with  the  powdered  root  a  suflS- 


188  The  Peninsular  and  Independent. 

cient  quantity  of  honey  to  make  a  semi-fluid  mass.  This  is  to  be  spread 
on  lint  or  soft  musHn,  and  applied  twice  daily  to  the  diseased  part,  proper 
care  being  used  in  removing  the  discharge.  For  the  first  few  da5^s,  morn- 
ing and  night,  a  tablespoonful  of  the  Tinct.  Sang,  should  be  given,  as  an 
alterative — an  eflPect  I  am  convinced  alwa3^s  to  be  desired  in  the  earlier 
stages  of  this  disease.  This  simple  treatment  possesses  an  undeniable  snj)e- 
riority  over  any  method  I  am  cognizant  of,  in  that  it  much  abbreviates  the 
duration  of  the  disease,  and  that  from  the  first  dressing  the  improvement 
progresses  steadily  and  rapidly  to  a  cure.  This  has  been  the  uniform  ex- 
perience of  my  own  trials  with  it,  and  of  those  to  whom  I  have  suggested 
its  use,  and  I  cordially  commend  it  to  the  Profession,  hoping  they  will  give 
it  a  careful  trial,  and  note  its  merits. 

In  its  adaptation  to  the  treatment  of  pneumonia,  which,  in  our  south- 
western country,  is  prone  to  assume  a  tj^phoid  form,  gleaning  from  a  wide 
range  of  cases,  the  treatment  of  which  has  thus  far  been  uniformly  success- 
ful, in  its  curative  agency  as  alterative,  sedative,  and  nauseant,  it  has  few 
equals,  especially  when  aided  with  the  properly-timed  administration  of 
quinine.  I  speak  of  the  disease  as  it  prevails  in  our  section  of  the  country, 
and  do  not  intend  to  embrace  the  pneumonia  of  every  latitude — simply 
that  modified  by  existing  local  causes.  In  all  cases  ushered  in  with  a 
decided  chill,  experience  has  proved  that  mercury  is  positively  injurious, 
and  here  come  into  play  the  admirable  virtues  of  Sanguinaria  as  an  alte- 
rative. The  following  formula  was  obtained  from  Dr.  Cocke,  of  Missis- 
sippi, who,  during  an  extensive  practice  of  twelve  years,  I  am  told,  was 
successful  in  his  management  of  every  case  of  pneumonia : 
R.  Tinct.  Sanguinaria,  f  3  V. 
Tinct.  opii  camph,,  f3vi. 
*  Spirit  pyroxil.,  f5ss. 

Potass,  nit.  3  i. 
Aquae,  f  3  iii. 
M.  Sig.     A  teaspoonful  every  two  hours. 

Using  it  in  this  way,  coupled  with  such  other  remedies  as  the  varia- 
tions of  the  disease  may  suggest,  I  have  been  more  than  gratified  in  its 
power  of  controlling  a  dangerous  disease.  In  spasmodic  croup,  whooping 
cough,  and  chronic  diseases  of  the  liver,  I  can,  from  experience,  recom- 
mend it  to  the  Profession  as  a  useful  and  desirable  remedy. 


New  Process  for  obtaining  Scammony  Resin. 

Prof.  Williamson,  of  University  College,  England,  has  recently  pa- 
tented a  process  for  obtaining  the  pure  resinous  extractive  matter  from 
the  imported  dried  root  of  the  plant,  which  yields  a  uniform  per- 
centage of  the  article,  and  enables  him  to  supply  it  to  the  trade, 
through  the  workers  of  the  patent,  at  a  rate  much  less  than  that 
for   which   the   best   virgin   Scammony   can  be   obtained. 

The  idea  was  suggested  by  a  manufacturer  of  Extract  of  Liquorice, 
in  Turkey  in  Asia,  who  thought  that  if  the  root  of  the  plant  was  col- 
lected at  the  proper  season,  and  dried,  that  a  suitable  process  could  be 
devised  by  which  to  extract  the  resin,  rendering  the  product  more  abun- 
dant, uniform,  and  cheaper. 

Prof  "Williamson's  process  consists  of  boiling  the  roots  first  with 
water,  and   afterwards    with    diluted   acid,  by   which    means   they  were 


Pharmaceutical  Department.  18& 

deprived  of  all  matter  soluble  in  those  menstruse,  while  the  resin  was 
left  undissolved.  The  roots  are  then  digested  with  spirit,  which  dis- 
solves out  the  resin,  and  from  this  the  spirit  is  separated  by  distilla- 
tion. 

The  physical  qualities  of  the  Scammony  thus  produced  differ  from 
that  met  with  in  commerce,  and  from  pure  virgin  Scammony.  It  is 
non- porous,  not  producing  a  lather  with  water,  and  instead  of  having 
a  musty,  or  sour,  cheese -like  odor,  possesses  an  aromatic  and  fruity 
smell,  exactly  like  the  dried,  untapped  root.  In  appearance,  when  in 
thin  layers,  it  much  resembles  the  Scammony  which  is  occasionally  seen 
in  the  small  shells  (and  regarded  as  the  purest  form  of  Scammony)^ 
being  transparent  and  of  a  yellow  color.  In  composition  it  is  very  rich 
in  resin,  being  almost  entirely  composed  of  this  matter  in  the  state 
of  a  resinous  acid. 

Dr.  A.  B.  Garrod,  of  University  College,  as  the  result  of  experi- 
ments, one  hundred  and  twenty  in  number,  is  of  opinion  that  this 
new  form  of  Scammony  is  equal  to  the  best  specimens  of  virgin  Scam- 
mony, and  to  the  resin  which  is  extracted  by  ether  from  commercial 
Scammony. 


Citrate  of  Iron  and  Strychnia. 

At  the  request  of  one  of  our  subscribers,  we  call  attention  to  this 
new  therapeutic  agent,  which  has  been  used  with  considerable  success, 
^n  some  of  the  Hospitals  of  Great  Britain,  in  cases  of  dyspepsia  of  an 
atonic  character.  It  has  been  found  of  great  benefit  in  similar  con- 
ditions, depending  upon  functional  derangement  of  the  uterus  ;  acting  in 
such  cases  as  an  emmenagogue  when  all  other  remedies  have  failed, 
and  it  has  a  powerful  effect  in  tranquilizing  the  excitement  of  the  nervous 
system.  Mr.  Charles  A.  Heinitsch,  pharmaceutist,  of  Lancaster,  Penn., 
who  has  prepared  considerable  quantities  of  this  salt,  reports  that  in  the 
hands  of  the  medical  gentlemen  of  his  place  it  has  proved  a  great  sue, 
cess  in  treatment  of  chlorosis,  especially  when  dependent  upon  mental 
emotions,  or  when  there  has  been  a  total  suppression  of  the  menses 
from  any  excitement. 

This  salt,  as  found  in  market,  usually  contains  one  part  of  Strych- 
nia to  forty-eight  parts  of  Citrate  of  Iron ;  the  dose  being  three  grains, 
which  would  give  one-sixteenth  of  a  grain  of  Strychnia  with  each. 

It  is  prescribed  with  tincture  chiretta  or  tincture  chiretta  and  fluid 
ext.  valerian.  F.  S. 


Hydrate  of  Magnesia,  an  Antidote  to  tbe  Poisonous  Effects  of  Arsenlous  Acid. 

Mr.   G.    GuERiN   proposes   to    substitute   the   hydrated  peroxide   of 
iron  by  hydrate  of  magnesia,  in  arsenical  poisoning.     This  can  be  quickly 


190  The  Peninsular  and  Independent. 

prepared  by  any  one,  and  consists  of  precipitating  the  hydrate  from  a 
solution  of  sulphate  magnesia  (Epsom  salts)  by  means  of  liquor  ammonia. 
The  hydrate  of  magnesia  is  then  washed  with  several  waters,  and  admi- 
nistered in  a  state  of  suspension  in  water. 


Pepsin  WlKC. 

Our  Philadelphia  friends  in  the  Pharmaceutical  Profession,  ever  anx- 

ous  to  take  and  keep  the  lead  in  introducing  novelties  in  Medicine,   have 

gotten  up,  recently,  a  Pepsin  Wine.     We  wonder  if  it  is  like  the  following ! 

Take  of  Starchy  Pepsin,  prepared  according  to  Messrs.  Coyisart  & 
Bourdault's  formula,  one  drachm  and  a  half ;  Distilled  Water,  six  fluid 
drachms;  y^hH^y^mQ^  fifteen  fluid  drachms;  White  Sugar,  one  ounce; 
Spirits  of  Wine  (33*^),  three  fluid  drachms.  Mix,  dissolve,  and  filter.  One 
tablespoonful  of  this  wine  contains  about  fifteen  grains  of  Pepsin,  and  may 
be  given  after  every  meal. 

[D  Union  Medicate. 

We  doubt  whether  thus  dissolving  and  masking  a  Pepsin,  assists  its 
therapeutical  powers,  and  believe  the  form  recommended  by  Berthe  (in 
pastiies),  to  be  the  best  for  its  administration.  F.  S. 


Chromic  Acid  in  Syphilitic  Vegetalions. 

Mr.  Hairon,  after  describing  the  advantages  derivable  from  the  chromic 
acid  in  certain  forms  of  the  granular  eyelid  (a  disease  of  common  occur- 
rence in  the  Belgian  army),  observes  that  the  trials  he  has  made  of  the 
acid,  as  recommended  by  Marshall  and  Heller  in  syphilitic  vegetation, 
have  been  attended  with  the  most  complete  and  rapid  success.  Moreover, 
its  application,  whether  to  these  syphilitic  vegetations  or  to  the  fungus 
granulations  of  the  conjunctiva,  is  never  attended  with  pain  or  reaction, 
notwithstanding  the  rapid  destruction  of  tissue  that  takes  place. 

Annates  d?  Occulisiigue. 


Betectioa  of  Pregnancy,  by  Ergot. 

A  correspondent  of  the  Boston  Medical  and  Surgical  Journal  recom- 
mends Ergot  for  the  above  purpose,  and  states : 

For  many  years  I  have  been  in  the  habit  of  administering  small  doses 
of  this  drLig  for  this  purpose,  and  in  my  hands  it  has  seldom  failed  of 
furnishing  the  evidence  sought.  The  specific  action  of  the  medicine  is  not 
felt  by  an  unimpregnated  womb,  while  the  gravid  uterus,  I  believe,  almost 
invariably  responds  to  its  action  by  some  uneasiness  in  the  back,  but  more 
particularly  by  pain  in  the  upper  part  of  the  thighs,  sufficiently,  to  enable 
you  to  diagnosticate  the  case  with  great  certainty.  I  have  in  many  doubt- 
ful cases  trusted  to  this  test,  and  have  very  seldom  been  disappointed  in  my 
diagnosis.  I  will  only  add  that  the  Ergot  can  be  given  with  entire  safety 
in  sufficient  quantity  to  accomplish  the  object  sought. 


CompoiiKd  Confection  of  Culiefes  and  Copaifea  with  Nitrate  of  Bismuth. 

M.   Caby,  in  the   Bulletin   Genh-al  de    Ihera'peutique.,   recommends 
the   addition   of  the  Nitrate  of  Bismuth  tp  combinations  of  Copaiba  and 


Pharmaceutical  Departinent.  191 

Cubebs,  as  it  possesses  the  power  of  neutralizing  the  irritating  efiPects 
produced  by  those  medicines  upon  the  digestive  canal. 

The  formula  employed  at  the  Hospital  of  St.  Lazare,  Paris,  consists 
of  equal  parts,  by  weight,  of  balsam  copaiba,  powdered  cubebs,  and 
subnitrate  bismuth,  flavored  with  some  aromatic  essence. 

It  is  stated  that  the  confection  is  acceptable  to  the  most  delicate 
stomach;  there  following  no  excitement,  epigastric  heat  or  diarrhoea. 
Its  medical  action  being  entirely  concentrated  upon  the  genito  -  urinary 
passages,  it  follows  that  the  desired  results  are  more  rapidly  and  easily 
obtained. 


Hypophospbate  of  Qwiuia. 

Is  proposed  as  a  new  remedy,  by  Prof  J.  Lawrence  Smith,  and  sug- 
gested by  him  as  useful  in  hectic  fever  of  phthisis,  as  a  tonic  in  the  same 
disease ;  also  in  the  various  forms  of  cachexy,  where  quinia  is  used. 

Its  solubility  in  cold  water  also  recommends  its  use  in  place  of  the  less 
soluble  salts  of  quinia,  where  the  presence  of  acids  in  extemporaneous 
solutions  is  objectionable. 

The  H3^pophosphate  of  Quinia  may  be  made,  in  a  small  way,  by  adding 
an  excess  of  recently  precipitated  Quinia  to  a  hot  solution  of  Hy|)ophos- 
phorus  acid.  Upon  cooling,  the  salt  crystallizes  in  beautiful  silky  tufts, 
resembling,  when  dry,  asbestos  in  appearance. 

It  is  very  soluble  in  hot  water,  and  in  water  at  60°  Fahr.  in  the  pro- 
portion of  one  part  to  sixty. 

\_Semi- Monthly  Medical  News. 


The  Einpioyment  of  Altealles  iu  tlie  Extriictioa  of  the  Active  Principles  of  Plants. 

DANNEgy  noticed,  in  the  treatment  of  fevers  contracted  in  the  depart- 
ments of  Landes  and  Gironde  —  those  called  paludal  or  marsh  fevers  —  that 
while  sulphate  of  quinine  failed  so  frequently,  on  the  contrary,  success 
attended  a  host  of  so-called  empirical  recipes,  in  which  cinchona  was  com- 
bined with  carbonate  of  potassa.  This  clinical  result  induced  Danne9y  to 
investigate  the  nature  of  the  action  of  the  alkaline  carbonate,  and  brought 
him  to  the  conclusion  that  the  alkalies  (potassa  or  soda)  were  the  most 
powerful  adjuvants  in  the  extraction  of  the  active  principles  contained  in 
plants.  Thus,  he  does  not  hesitate  to  propose  the  addition  of  a  small 
quantity  of  these  substances  to  water,  as  the  best  means  of  obtaining  good 
pharmaceutical  preparations. 

Cinchona  bark,  treated  by  tiiis  process,  furnishes  extracts  with  little 
taste ;  and  Dannecy  believes  that  they  will  be  preferred,  on  this  account, 
to  the  ordinary  preparations,  especially  in  the  treatment  of  children. 

The  employment  of  an  alkali  in  the  exhaustion  of  plants,  for  those 
which  contain  astringent  principles  among  their  proximate  elements,  has 
another  very  important  advantage ;  it  prevents,  during  the  evaporation  of 
the  liquid,  the  formation  of  the  substance  called  apoth&me,  which  has  been 
considered,  by  pharmacologists,  as  a  result  of  the  oxidation  of  the  ex- 
tractive principle.  The  preparation  of  the  extract  of  Kramer ia,  which 
presents  this  phenomenon  in  a  very  great  degree,  is  completely  protected 
Irom  it  by  the  addition  of  a  small  quantity  of  alkali  to  the  water  used  in  its 
preparation.     Evaporation,   then,   in  the  open  air,  does  not  furnish  the 


192  The  Peninsular  and  Independent. 

slightest  quantity  of  this  insoluble  principle,  which,  in  the  preparation  of 
the  extract  by  the  ordinary  method,  diminishes  so  notaVjly  the  proportion 
and  quality  of  the  extract  made  with  cold  water. 

After  some  experiments  made  on  nux  vomica  and  cinchona,  Danne9y 
was  induced  to  conclude  that  the  process  of  extraction  by  alkalies  furnishes 
a  ready  and  economical  method  for  the  procuring,  not  only  of  strychnia 
and  quinine,  but  also  of  other  immediate  principles,  not  yet  isolated. 

[Journal  of  Maryland  College  of  Pharmacy. 


Honey  of  Roses. 

The  following  is  from  the  pen  of  Prof  Grahame,  of  the  Maryland 
College   of  Pharmacy,    in   a   paper   read   before   the   College: 

Take  of  Red  Rose  leaves,  in  powder  (No.  50  sieve)  2  ounces. 

Clarified  Honey         .....         20  fluid  ounces. 

Diluted  Alcohol    .         .         .     '    .         .         .     sufficient  quantity. 

Oil  of  Roses 4  drops. 

Dampen  the  powder  with  the  diluted  alcohol,  and  pack  moderately  firmly 
in  a  glass  funnel  displacer;  place  over  the  surftice  a  piece  of  perforated 
filtering  paper,  and  pour  on  the  menstruum ;  set  aside  the  first  six  fluid 
drachms  of  liquid  which  pass;  continue  the  percolation  to  exhaustion 
(about  6  fluid  ounces) ;  reduce  this  bj'' water  -  bath  at  a  temperature  not 
exceeding  IGO''  F.  to  ten  fluid  drachms,  and  having  mixed  this  with  the 
portion  first  obtained,  add  the  oil  of  roses  and  mix  the  fluid  extract  thus 
made  with  the  clarified  honey. 

As  thus  prepared  Honey  of  Roses  is  highly  astringent,  and  possesses 
much  richness  of  color  and  flavor. 

Thus  formed,  it  is  an  agreeable  and  valuable  astringent  addition 
to  the  gargles  employed  in  inflammation  and  ulceration  of  the  mouth 
and  throat. 


Itcli  Ointments. 

M.  BiETT  has  made  a  series  of  experiments  at  the  St.  Louis  Hospital, 
Paris,  to  determine  what  will  cure  itch  in  the  shortest  time.     Forty-one 
different  preparations  were  employed.     Of  these  he  found  the  following  ^ 
ointment  cured  in  the  smallest  number  of  days : 

15 .    Sublimated  sulphur     ......  |j. 

Subcarbonate  of  potash      .         .         .         .         .  f  ss. 

Adeps  simplex 3  iv. 

Apply  morning  and  evening. 
Seven  days  are  required  to  destroy  the  acarus  scabei,   by  which  it  is 
produced. 

I^ .    Recent  grains  delphinium  staphisagria         .         .  §  v. 

Adeps  simplex  bul.     ......  |  viij. 

M.     Digest  twenty-four  hours  at  the  temperature  of  a  lOC^  in  a  sand 
bath,  and  strain. 

Friction  for  four  days  with  this  ointment  not  only  destroys  both  the 
insects  and  their  eggs,  but  also  completely  cures  the  eruption. 


THE 

PENINSULAR  and  INDEPENDENT 

MEDICAL  JOURNAL. 

Vol.  II.  DETROIT,  JULY,  1859.  I^o,  4. 

Original  C0mmiinirati0ns. 


ART.  XV.— Luxations  of  Hip  and  Shoulder  Joints. 

[Re  -  published  from  the  Peninsular  Journal  of  Medicine,  for  July,  1855,  with  additional 

experiments  and  observations.] 


By  Moses  Gunn,  M.  D.,  Prof,  of  Surgery  in  the  University  of  MiclL 

The  object  of  the  present  paper  is  to  elucidate  more 
fully  certain  views  relative  to  luxations  of  the  hip  and 
shoulder  joints,  which  were  contained  in  a  short  article 
originally  read  before  the  Detroit  Medical  Society,-  and 
subsequently  published  in  the  Peninsular  Journal  of 
Medicine.  An  article  on  dislocations  of  the  hip,  by  Dr. 
Markoe,  of  New  York,  published  in  the  January  No.  of 
the  Neio  York  Journal  of  Medicine,  induced  me  to  re- 
peruse  the  article  by  Dr.  Reid,  of  Rochester,  published 
in  the  Transactions  of  the  State  Medical  Society  of  New 
York;  and  I  was  pleased  to  see  how  illustrative  of  the 
views  contained  in  my  former  article  were  two  experiments, 
one  made  by  each  of  these  gentlemen.  These,  together  with 
further  experiment  on  my  own  part,  led  to  '  the  prepara- 
tion  of  the   present   paper;  in   the  construction   of  which 

Vol.  II.  -  K. 


194  The  Peninsular  and  Independent. 

I  shall  here  introduce  my  former  article,  published  in  Sep- 
tember, 1853 : 

\ 

The  views  here  advanced  I  have  taught  for  the  past  two  years 
to  the  gentlemen  composing  the  Medical  Class  in  the  University;  and 
I  shall  offer  no  apology  for  calling  the  attention  of  the  Society  for  a 
few  moments  this  evening  to  the  subject  of  Dislocations  of  the  Hip 
and  Shoulder,  and  more  particularly  to  that  form  of  the  accident,  which, 
from  the  anatomical  peculiarities  of  the  joint,  is  one  exceedingly  diffi- 
cult to  reduce  ;  and  for  the  reduction  of  which  Dr.  Reid  has  recently 
proposed  a  novel  and  efficient  mode. 

It  is  not  my  intention  to  discuss  the  question  of  priority  which 
has  been  raised  in  reference  to  this  subject,  for  there  can  be  no  doubt 
that  Dr.  Reid  arrived  at  his  conclusions  by  a  course  of  reasoning  and 
experiment,  and  that  those  conclusions  were  most  essentially  novel  to 
a  large  majority  of  the  Profession.  I  propose,  rather,  briefly  to  consider 
the  prominent  peculiarities  of  the  joint,  and  the  relation  of  the  parts  in 
a  state  of  dislocation ;  the  structures  which  oppose  the  return  of  the 
head  of  the  femur  to  the  acetabulum ;  the  manner  in  which  Dr.  Reid's 
manipulations  overcome  this  opposition ;  and,  lastly,  the  application  of 
the  principles  involved,  to  the  reduction  of  some  other  dislocations. 

The  encircling  ridge  which  gives  depth  to  the  cotyloid  cavity, 
presents  upon  its  outer  slope  a  plane,  the  inclination  of  which  varies  in 
different  parts.  At  its  posterior  portion  this  inclination  is  very  great, 
and  it  would  seem,  in  dislocation  in  this  direction,  impossible  to  return 
the  head  of  the  bone  to  the  cavity  without  lifting  it  completely  over 
the  ridge :  upwards  and  backwards  it  is  more  gradual,  and  would  seem 
to  afford  a  much  more  easily  surmountable  obstacle ;  yet  when  we  exa- 
mine the  relation  of  the  parts  in  a  dislocation  in  this  direction,  we  find 
that  applied  to  this  surface,  we  have  the  anterior  and  inferior  surface  of 
the  head  and  neck  of  the  femur,  the  rotundity  of  the  head  corresponding 
with  the  curvature  of  the  slope,  while  the  edge  of  the  acetabulum  cor- 
responds with  the  curvature  described  by  the  anterior  and  inferior  sur- 
face of  the  neck.  Although  thus  seemingly  locked  together,  compa- 
ratively slight  extension  in  the  line  of  dislocation  would  cause  the  head 
to  ride  over  the  edge  of  the  cavity,  were  it  not  bound  down  in  this 
position  by  the  surrounding  tissues.  Which  particular  tissue  constitutes 
these  bonds  is  an  important  question  to  him  who  seeks  to  relax  them. 
Dr.  Reid,  in  common  with  the  Profession  generally,  considers  the  muscles 
the  agents  which  thus  oppose  our  efforts  at  reduction,  and  his  manipu- 
lations are  conducted  with  a  view  to  relax  them,  while  the  femur,  acting 
as  a  lever,  raises  the  head  of  the  bone  clear  of  the  edge  of  the  cavity. 
With  this  same  view  we  have  the  directions  of  the  books  and  public 
teachers  to  apply  extension  and  counter -extension  slowly  and  uniformly^ 
in  order  to  tire  out  the  rebellious  muscles.      Blood-letting,    antimony. 


GuNN"  on  Jjuxations  of  Hip  and  Shoulder  Joints,       195 

^nd  the  hot  bath  are  also  called  in  to  aid  in  this  laudable  crusade  against 
these  wicked  organs. 

In  this  view,  I  would  respectfully  differ  with  Dr.  Reid,  the  teachers, 
books,  and  Profession,  and  state  my  honest  belief  that  the  muscles  oppose 
our  efforts  very  little  more  than  they  do  the  progress  of  our  earth  in  its 
'orbit.  This  belief  I  have  repeatedly  verified  by  experiments  upon  the 
dead  subject,  and  the  members  of  the  Medical  Class  of  1851-2  in  the 
University  will  remember  those  conducted  before  them.  A  subject  was 
placed  upon  the  table,  the  lower  border  of  the  gluteus  maximus  was 
taised,  and  a  scalpel  carried  through  the  subjacent  muscles,  and  an  open- 
ing made  in  the  posterior  and  superior  portion  of  the  capsular  ligament. 
The  round  ligament  was  then  divided,  and  the  head  of  the  femur  lux- 
ated upon  the  dorsum  of  the  ilium.  The  usual  indications  of  this  dis- 
location were  present.  The  subject  was  placed  in  the  proper  position,  a 
tjounter  -  extending  band  applied  to  the  perinseum,  and  fixed ;  the  strength 
of  two  men  exerted  now  upon  the  extending  band,  while  endeavor  was 
inade  to  raise  the  head  of  the  bone  clear  of  the  acetabulum  with  a  jack 
towel  was  insufficient  to  reduce  the  luxation.  Reid's  method  of  manipu- 
lation readily  replaced  the  bone.  This  experiment  was  repeated  many 
times,  and  uniformly  with  the  same  result. 

As  muscular  action  could  not  have  opposed  our  efforts  and  prevented 
success  in  this  case,  the  question  naturally  presents  itself.  What  structure 
stood  between  effort  and  success  ?  *  I  answer,  The  untorn  portion  of  the 
capsular  ligament.  In  support  of  this  view,  let  us  consider  for  a  moment 
the  position  of  the  limb  at  the  instant  of  the  escape  of  the  head  from  the 
socket  during  the  process  of  dislocation.  To  do  this,  we  must  bear  in 
mind  that  force  applied  to  the  knee  or  foot  while  the  limb  is  in  a  state 
of  adduction,  constitutes  the  most  frequent  cause  of  this  dislocation. 
Force  thus  applied  adducts  the  limb  still  more  powerfully  before  disloca- 
tion takes  place,  and  at  the  moment  of  the  escape  of  the  head  of  the 
bone  from  the  socket,  the  limb  is  in  a  direction  which  crosses  the  thigh 
of  the  opposite  side.  Immediately  that  the  head  of  the  bone  has  cleared 
the  edge  of  the  acetabulum,  it  settles  into  its  position  upon  the  dorsum 
of  the  ilium,  and  the  limb  assumes  the  position  and  direction  indicative 
of  the  accident.  During  the  dislodgement  of  the  bone,  the  superior 
and  posterior  portion  of  the  capsular  ligament  is  ruptured,  through  which 
the  head  protrudes ;  while  from  the  position  of  the  limb  at  the  instant 
of  protrusion,  the  anterior  and  inferior  portion  is  very  much  relaxed, 
thus  allowing  the  head  to  rise  easily  over  the  acetabulum.  As  soon 
as  the  head  settles  into  its  position  upon  the  dorsum  of  the  ilium,  the 
direction  of  the  limb  is  changed,  and  the  untorn  portion  of  the  ligament 
becomes  more  tense,  and  for  this  reason  the  head  of  the  bone  can  not 
be  readily  returned  to  its  place  till  the  limb  is  again  placed  in  a  position 

*  Dr.  Reid  would  answer,  passive  muscular  j&bres. 


196  The  Peninsular  and  Independent. 

to  relax  it.  Dr.  Reid's  method  does  this  most  efiPectually;  and  I  conceive 
that  any  other  plan  which  does  not  accomplish  this,  as  for  instance 
extension  and  counter  -  extension  by  the  pully,  or  Jarvis's  apparatus, 
in  the  usual  direction,  succeeds  only  by  lacerating  much  more  exten- 
sively, if  not  by  actually  tearing  the  ligament  completely  asunder,  be- 
fore the  head  of  the  bone  will  ride  over  the  edge  of  the  cavity. 

The  principle,  then,  I  would  seek  to  establish,  is  this — That  in 
luxations  of  the  Tiip  and  shoulder  the  untorn  2^ortion  of  the  capsular 
ligament,  dy  tinding  down  the  head  of  the  dislocated  l)07ie,  prevents  its 
ready  return  over  the  edge  of  the  cavity  to  its  pjlace  in  the  socJcet;  and 
that  this  return  can  he  easily  effected  dy  putting  the  limb  in  such  a 
position  as  will  effectually  approximate  the  two  points  of  attachment 
of  that  p)ortion  of  the  ligament  which  remains  untorn. 

This  principle  can  be  successfully  applied  to  the  reduction  of  the 
backward  luxation  of  the  femur  into  the  ischiatic  notch,  and  also  to  the 
several  luxations  of  the  shoulder.  It  has  several  times  been  my  guide 
in  the  reduction  of  the  downward  dislocation  of  the  humerus  into  the 
axilla.  The  patient  is  seated  upon  the  floor ;  an  assistant  slowly  raises 
the  arm  to  an  angle  of  forty -five  degrees  to  the  plane  upon  which 
the  patient  is  sitting ;  and  now  while  the  assistant  makes  extension  in 
this  direction,  the  surgeon  makes  pressure  with  the  hand  upon  the  top 
of  the  shoulder,  the  bone  readily  returns  to  its  place,  and  the  arm  i& 
dropped  to   the   side   and  secured  in  a  sling. 

White's  method  of  reducing  this  luxation,  which  is  figured  in 
"Druitt,"  is  essentially  the  same,  the  only  difference  being  in  the 
position  of  the  patient.  According  to  his  plan,  the  patient  lies  upon  his 
back,  the  scapula  is  fixed  by  a  counter -extending  band  applied  to  the 
top  of  the  shoulder,  or  by  the  hand  of  an  assistant,  while  "the  arm 
is  raised  from  the  side,  and  drawn  straight  up  by  the  head,  till  the 
bone  is  thus  elevated  into  the  socket."  In  either  method  it  will  be 
seen  that  the  upper  and  untorn  portion  of  the  capsular  ligament,  by 
the  elevation  of  the  arm,  is  very  much  relaxed,  thus  giving  a  latitude 
of  motion  to  the  head  which  greatly  facilitates  its  return,  and  which 
could  not  be  obtained  by  any  manipulation  in  which  this  relaxation  was 
less  perfect.  Nine -tenths  of  the  force  spent  in  extension  and  counter- 
extension  may  be  spared,  in  the  reduction  of  all  those  dislocations  in 
which,  by  alteration  of  the  position  of  the  limb,  such  relaxation  is  effected ; 
and  in  the  several  luxations  above  specified,  this  end  is  undoubtedly 
attainable. 

Further  tliought  and  experiment  upon  this  subject  have 
convinced  me  that  dislocations  of  the  hip  joint  can  not 
occur,  except  in  certain  positions,  and  these  are  positions 
of  very   great  distortion.     In  support  of  this  view,  I  would 


Gtjnn  on  Luxations  of  Hip  and  Shoulder  Joints.      197 

call  attention  to  the  great  security  against  this  accident 
provided  by  nature  in  the  anatomy  of  the  joint.  The 
great  depth  of  the  acetabulum,  surrounding  on  all  sides 
the  head  of  the  femur,  renders  its  escape  nearly,  if  not 
absolutely,  a  physical  impossibility,  so  long  as  the  legs 
are  parallel  to  each  other,  and  on  a  line  with  the  body. 
Fracture  of  some  of  the  bony  structures  of  the  joint  would 
be  the  result  of  great  violence,  in  this  position  of  the  limbs, 
but  dislocation  without  fracture,  I  apprehend,  never.  Be- 
fore dislocation  can  take  place,  the  limb  must  be  so  dis- 
torted that  the  walls  of  the  acetabulum  will  afford  no 
longer  protection  against  the  escape  of  the  head  of  the 
femur,  the  dislocating  force  throwing  the  head,  in  this 
changed  direction,  against  some  portion  of  the  capsule  of 
the  joint,  which  gives  way  before  it,  permitting  the  rup- 
ture of  the  round  ligament,  and  the  escape  of  the  bone. 
It  is  evident  that  while  the  changed  direction  of  the 
limb  throws  the  head  wholly  against  some  portion  of  the 
capsule,  the  opposite  side  of  this  capsule  must  be  re- 
laxed, and  by  its  relaxation  facilitate  the  riding  of  the 
head  over  the  edge  of  the  cotyloid  cavity.  Taking,  for 
example,  the  upward  and  backward  form  of  luxation,  in 
my  experiments,  I  have  found  it  impossible,  by  my  own 
strength,  to  produce  luxation,  even  when  the  direction 
of  the  limb  was  changed  to  that  which  distinguishes  this 
form  of  the  accident  after  it  has  occurred,  although  the 
upper  and  posterior  portion  of  the  capsule,  and  the  round 
ligament,    were   divided. 

In  the  course  of  my  instruction  during  the  last  winter, 
I  introduced  the  following  experiment :  A  fresh,  whole,  and 
muscular  subject  was  selected,  and  a  circular  incision  was 
made  around  the  middle  of  the  thigh  and  down  to  the 
bone ;  another,  from  the  tuberosity  of  the  ischium,  around 
the  inner  aspect  of  the  thigh,  and  over  the  dorsum 
of   the    ilium    to    the    point    of  commencement,    and    all 


198  The  Peninsular  and  Indepeyident. 

the  tissues  were  cleanly  removed  from  the  bone  and  capsule 
of  the  joint.  The  upper  and  posterior  half  of  the  capsule 
was  then  cut  away,  leaving  the  anterior  and  inferior  half 
whole,  and  the  round  ligament  was  divided.  In  this 
state  it  will  be  seen  that  all  tissues  were  entirely  out  of 
the  way  (and  could  neither  afPord  protection  against  dis- 
location, or  impediment  to  reduction),  except  the  ante- 
rior and  inferior  half  of  the  capsular  ligament.  I  now 
placed  the  limb  in  the  position  which  characterizes  the 
dislocation  upon  the  dorsum,  viz.,  the  knee  in  advance  of 
the  other,  and  the  foot  inverted ;  and  the  pelvis  being 
fixed,  I  attempted  to  produce  dislocation,  but  failed  to 
do  so;  and  I  believe  that  no  force,  however  great,- ap-. 
applied  to  the  knee,  would  be  sufficient  to  accomplish  the 
escape  of  the  head  of  the  bone  without  fracture  of  the 
acetabular  walls,  so  long  as  the  limb  remains  in  this  di-- 
rection ;  for  in  this  position,  the  head  presses  perpendi-^ 
cularly  against  the  superior  and  posterior  portions  of  the 
acetabular  walls.  But  on  carrying  the  limb  to  a  position 
in  which  the  thigh  crossed  that  of  the  opposite  side,  at 
a  point  just  above  its  middle,  slight  pressure  was  sufficient 
to  dislocate  the  bone ;  for  the  acetabular  walls,  in  this  po-. 
sition,  presented  to  the  head  of  the  bone  an  inclined 
plane,  while,  from  the  same  reason  of  position,  the  undi- 
vided portion  of  the  capsule  was  relaxed,  thus  permitting 
the  head  to  slide  easily  up  this  inclined  plane  and  ride 
over  the  acetabular  edge.  At  the  moment,  however,  du- 
ring which  the  head  rested  upon  the  edge  of  the  cavity, 
this  undivided  portion  of  the  cajDsule  became  tense,  re- 
laxed again  as  the  head  settled  down  upon  the  outside 
of  the  cavity,  and  upon  dropping  the  limb  down  to  the 
position  which  characterizes  this  dislocation,  it  became  again 
tense.  Efforts  at  reduction  by  extension  and  counter-ex-- 
tension  in  this  direction  were  now  made,  but  were  unsuc-. 
cessful,   for  this^  tense,    undivided    portion   of  the   cajDSula 


GuNN  on  Luxations  of  Hip  and  8houlder  Joints.      199 

bound  down  the  head  so  that  it  could  not  ride  back 
over  the  edge  of  the  acetabulum;  but,  on  carrying  the 
limb  across  the  other,  to  the  position  in  which  it  was 
at  the  moment  of  escape,  the  reduction  was  easily  ac- 
complished. 

Upon  the  limb  of  the  opposite  side,  the  experiment 
detailed  in  my  former  article  was  repeated,  and  with  the 
same  result. 

The  following  case  illustrates  also  the  practical  bearing 
of  the  principle  under  consideration :  In  February  of  the 
present  year  (1855)  I  was  called  into  the  interior  of  the  State 
to  reduce  a  dislocation  of  the  hip  of  four  days'  standing, 
which  had  resisted  the  efforts  of  two  very  efficient  profes- 
sional gentlemen.  They  had  extended  with  Jarvis's  ad- 
juster, and  practiced  Eeid's  manipulations,  but  without 
success.  Keid's  method,  they  informed  me,  only  altered 
the  form  of  luxation,  carrying  the  head  downward  and 
forward  upon  the  obturator  ligament.  The  luxation  had 
been  primarily  upon  the  dorsum,  but  upon  examination 
I  found  the  head  of  the  bone  in  the  ischiatic  notch.  I 
placed  the  patient  upon  his  back,  and  attempted  reduc- 
tion after  Eeid's  plan,  but  with  the  same  result  that  had 
attended  the  efforts  of  the  gentlemen  in  attendance.  By 
inverting  the  foot,  I  slipped  the  head  back  to  its  position 
in  the  notch,  and  repeated  my  efforts,  but  with  like  re- 
sults. I  thus  four  times  essayed  reduction,  but  succeeded 
only  in  making  the  head  travel  from  one  position  to  the 
other.  I  adopted  this  plan  with  confidence,  from  the  fact 
that  the  luxation  had  originally  been  upon  the  dorsum, 
but  failing  to  replace  the  bone,  I  applied  Jarvis's  adjus- 
ter, and  made  extension  after  the  usual  method,  and 
carried  it  to  the  extent  of  bending  the  extending  bar  to 
the  form  of  a  very  considerable  curve,  but  was  not  able 
to  reduce  the  luxation.  Opposed,  as  I  was  before,  to  vio- 
lence,   I    removed   the    instrument,    and   straightening   the 


^00  The  Peninsular  and  Independent. 

extending  bar,  resolved  to  adopt  Blundell's  obstetric 
mottOy  arte  non  vi.  After  some  deliberation,  I  armed 
the  adjuster  with  the  shoulder  fork,  flexed  the  thigh  at 
right  angles  with  the  body,  and  adducted  it ;  and  ap- 
plying the  shoulder  fork  to  the  pubis  and  ilium,  and  at- 
taching the  extending  bar  to  the  knee,  a  fcAv  turns  of  the 
instrument   elevated  the  head  into  the   socket. 

Although  Doct.  Keid  attributes  to  the  muscles  all  the 
difficulties  of  reduction,  he  is  explicit  upon  the  fact  that 
it  is  not  muscular  activity  which  opposes  our  efforts,  and 
points  triumphantly  to  the  ease  with  which  muscular  con- 
traction is  overcome  in  fractures  of  the  neck  and  shaft 
of  the  femur.  He  conceives  that  the  muscular  tissues 
immediately  surrounding  the  joint,  are  the  means  of  bind- 
ing down  the  head  of  the  bone  in  its  new  jDosition,  thus 
preventing   reduction.     He   says : 

*'  The  true  condition  of  the  muscles  is  this :  the  six  rotator,  adduc- 
tor, and  abductor  muscles,  viz. :  the  obturator  externus,  anteriorly  ;  the 
pyriformis,  obturator  internus,  gemelli,  and  quadratus,  posteriorly;  are 
all  in  a  state  of  extreme  tension,  while  the  other  eleven  muscles,  larger 
and  smaller,  are  shortened,  and,  in  one  sense,  contracted,  but  in  another, 
and  in  fact,  they  are  relaxed  —  that  is,  in  a  recent  dislocation.  Now  it  is 
®vident,  on  the  slightest  inspection,  that  the  six  muscles  that  are  put 
upon  the  stretch,  being  in  antagonism  to  each  other  —  that  is,  the  short, 
strong  obturator  externus  anteriorly,  being  opposed  by  the  other  j&ve 
posteriorly  —  and  all  acting  at  nearly  right  angles  to  the  axis  of  the  femur, 
must  hug,  with  great  power,  the  head  of  the  bone  upon  the  dorsum, 
and  by  the  same  force,  oppose  its  ascent  over  the  brim  of  the  acetabulum, 
in  any  direct  attempt  to  replace  it  by  traction  towards  its  socket.  These 
six  muscles,  then,  so  violently  stretched,  constitute  the  real  and  only  im- 
pediments to  the  reduction  by  the  usual  mode,  and  not  the  shortened  and 
contracted  triceps  and  glutei,  as  has  always  been  believed  and  taught 
by  all  authors  and  professors  of  surgery." 

So  forcibly  impressed  is  Dr.  W.  with  the  idea  that 
^' these  six  onuscles  constitute  the  real  and  only  impedi- 
ment," that  even  in  an  experiment  of  his  own,  which  he 
details   in    his   paper,    he   fails   to   see    the   fact   which   he 


GuNN  on  Luxations  of  Hip  and  Shoulder  Joints.      201 

actually  relates,  that  there  is  another  structure  which 
forms  an  impediment.  His  experiment  was  upon  a  sub- 
ject considerably  advanced  in  decompositioUj  and  in  the 
course    of   its   relation   he    holds   the   following    language : 

"After  carefully  noting  the  relative  position  of  bone  and  muscles, 
we  made  traction  on  the  femur  downward  and  inward  over  the  sound 
limb,  as  we  are  direct^ed  by  most  authors ;  but  the  moment  the  attempt 
was  made,  the  muscles  already  named  as  being  in  a  state  of  tension 
became  more  tense,  although  all  the  muscles  about  the  joint  were  sepa- 
rated from  each  other  —  were  loose,  without  vitality,  and  almost  in  a 
state  of  decomposition,  yet  it  was  with  great  difiBculty  that  we  could 
bring  down  the  head  into  its  socket;  and  when  we  did  so,  we  carried 
away  a  part  of  the  capsular  ligament." 

It  seems  hardly  probable  that  muscles  "almost  in  a 
state  of  decomposition/'  could  form  the  "real  and  only 
impediment,"  particularly,  when  in  accomplishing  reduc- 
tion, he  '^carried  aivay  a  part  of  the  capsular  ligament." 
In   this   connection,    I   quote   from   my   first   article : 

Extension  and  counter -extension  by  the  pully,  or  Jar  vis's  appara- 
tus, in  the  usual  direction,  succeeds,  only  by  lacerating  much  more 
extensively,  if  not  actually  tearing  the  ligament  completely  asunder, 
before  the  head  of  the  bone  will  ride  over  the  edge  of  the  cavity. 

Dr.  Markoe,  who  adopts  Dr.  Eeid's  views  relative 
to  the  nature  of  the  impediment,  seems  to  have  had  a 
similar  illustration  in  one  of  his  experiments,  and,  like 
Dr.  K.,  fails  to  see  that  the  untorn  portion  of  the  cap- 
sular ligament  forms  an  "impediment."  His  experiment 
is   as  follows: 

"  I  removed  all  the  muscles,  leaving  the  capsular  ligament  only,  and 
then  endeavored  to  dislocate  the  head  of  the  bone.  I  first  tried  adduc- 
tion, and  carried  the  limb  so  forcibly  over  the  abdomen  that  the  knee 
touched  the  anterior  surface  of  the  thorax,  but  without  producing  luxa- 
tion. In  making  more  violent  efforts  in  the  same  direction,  the  cervix 
fractured,  or  rather  cracked  across  within  the  capsule,  and  soon  after  the 
ligament  itself  tore  across  at  its  superior  and  posterior  part,  just  oppo- 
site the  point  of  yielding  of  the  cervix.  The  laceration  was  directly 
across  the  ligament,  and  occupied  about  one -half  of  its  circumference. 


202  The  Peninsular  and  Independent. 

As  soon  as  this  took  place  the  dislocation  was  easily  effected.  The 
neck  of  the  femur  and  the  trochanteric  portion  of  it  were  now  seen 
to  be  kept  in  their  place  by  the  untorn  portion  of  the  capsular  liga- 
ment, which  acted  as  a  sort  of  fulcrum,  upon  which,  by  using  the 
limb  as  the  long  arm,  we  could  make  the  head,  as  the  short  arm,  move 
about  in  any  direction  upon  the  surface  of  the  dorsum  of  the  ilium." 

Does  the  untorn  portion  of  the  capsular  ligament  form 
an  impediment?  My  own  views  are,  that  it  constitutes 
the  cMef^  if  not  the  only  opposition  to  our  efforts  at 
reduction.  If  it  is  urged  that,  in  this  view,  I  am  ex- 
clusive and  ultra,  I  ask  only  that  before  such  judgment 
is  passed,  the  experiment  of  removing  all  the  tissues  about 
the  joint,    in   the   manner   detailed   above,    may   be   made. 

Thus  much  was  published  in  the  Peninsular  Journal; 
I  now  would  add  — 

That  the  practical  rule  to  be  drawn  from  the  doctrines 
here  laid  down,  is  one  which  will  apply  to  all  disloca- 
tions; but  in  those  of  the  shoulder,  and  particularly  those 
of  the  hip,  it  is  of  almost  imperative  importance.  It  is 
this:  For  the  easy  reduction  of  a  dislocation,  the  dislo- 
cated limh  should  he  placed  in  exactly  that  position  ivhich 
characterized  it  at  the  moment  of  the  escape  of  the  joint 
end  from  its  normal  position  in  the  joint.  For  instance, 
in  the  upward  and  backward  dislocation  of  the  head  of 
the  femur  upon  the  dorsum  of  the  ilium — which  almost 
invariably  occurs  from  force  applied  either  to  the  foot  or 
knee  when  the  limb  is  in  an  adducted  position,  whereby 
it  is  more  powerfully  adducted  and  carried  across  its  fel- 
low, until  the  head  forced  up  the  inclined  plane  which 
is  presented  to  it  by  the  upperward  and  backward  portion 
of  the  acetabular  walls,  and  against  the  now  tense  upper- 
ward  and  backward  portion  of  the  capsular  ligament, 
rupturing  that  ligament,  and  escaping  from  the  acetabu- 
lum, while  the  limb  is  in  this  greatly  distorted  position, — 
the  indication  is  to  carry  the  limb  across  its  fellow  until 
it   attains   the   position   in   which  it   was   at   the   moment 


GuNN  on  Luxations  of  Hip  and  Shoulder  Joints.      203 

of  escape;  the  pelvis  being  now  firmly  held  by  an  assist- 
ant, the  limb,  with  a  decided  rotation  inward,  is  easily 
lifted  into  its  place. 

This  internal  rotation,  at  the  moment  of  lifting  the 
limb  into  its  place,  is  of  great  importance,  and  is  illus- 
trated by  a  more  recent  experiment  than  those  previously 
detailed.  This  experiment  also  shows  that  though  the 
untorn  portion  of  the  ligament  constitutes,  perhaps,  the 
most  important,  it  is  not  (as  I  formerly  supposed),  the 
only  obstacle  which  we  have  to  overcome  in  reducing  this 
dislocation.  The  dense  outer  portion  of  the  fascia  lata,  in 
this  distorted  position  of  the  limb,  is  put  also  greatly  upon 
the  stretch,  thereby  pressing  firmly  down  upon  the  tro- 
chanter major,  and  causing  the  head  of  the  bone  to  hook 
closely  against  the  acetabular  walls.  Internal  rotation,  by 
depressing  the  trochanter,  relieves  this  pressure,  and  thus 
eludes  the   last  opposing  agent  to  our  efforts  at  reduction. 

The  first  experiment  illustrating  this  fact  was  made  in 
the  dissecting  rooms  of  the  University  during  the  winter 
of  1857-8,  by  a  young  gentleman  who  was  then  a  candi- 
date for  graduation,  and  is  now  Dr.  William  Bovie.  The 
experiment,  which  was  original  with  him,  does  credit  to 
his  investigating  ability  and  disposition,  and  was  as  fol- 
lows :  A  dissection  was  made,  removing  the  integument 
and  superficial  fascia,  preserving,  however,  as  far  as  pos- 
sible, the  fascia  lata  and  all  the  muscles  about  the  hip. 
The  capsular  ligament  was  completely  removed,  and  the 
round  ligament  was  divided.  A  dislocation  was  now  easily 
efi*ected  by  carrying  the  limb  across  the  other,  and  push- 
ing against  the  knee.  A  far  less  degree  of  distortion,  how- 
ever, characterized  the  mal- position  of  the  joint  than  when 
the  anterior  and  inferior  portion  of  the  ligament  is  left 
attached  to  the  bones.  Extreme  efi'orts,  by  extension  and 
counter -extension,  in  the  old  way,  failed  to  efiect  reduc- 
tion;  but  both  Keid's  method^  and  that  practiced  by  my- 


,204  The  Peninsular  and  Independent. 

self^  readily  replaced  the  dislocated  bone.  Observation 
during  the  several  steps  of  both  methods  of  procedure, 
detected  the  fact  above  stated,  that  the  pressure  of  the 
outer  portion  of  the  fascia  lata  upon  the  trochanter  major, 
by  forcing  the  head  of  the  femur  down,  and  causing  it 
to  hook  against  the  ascetabular  walls,  prevented  reduction. 
Internal  rotation  completely  relieved  this  pressure,  and 
eluded  this  opposing  agent. 

During  the  past  winter,  my  prosector.  Dr.  William 
Lewitt,  made  the  following  dissections  for  me,  to  use  in 
my  class  experiments:  The  dissection  used  in  former  ex- 
periments— viz.  removing  all  the  tissues  about  the  joint, 
and  also  the  upper  and  outer  portion  of  the  capsular 
ligament,  and  severing  the  round  ligament  —  was  made 
upon  one  side;  upon  the  other,  an  incision  was  carried 
through  the  integument  and  superficial  fascia  along  the 
inferior  border  of  the  gluteus  maximus,  and  an  inter- 
muscular passage  to  the  joint  was  effected,  through  which 
all  the  capsular  ligament  was  cut  away,  and  the  round 
ligament  severed.  The  wound  was  then  closed  with  a 
continued  suture.  Here,  as  in  Dr.  Bovie's  experiments, 
there  was  no  capsular  or  round  ligament  uj)on  one  side, 
all  other  tissues  remaining  intact;  while,  upon  the  other, 
all  tissues,  except  the  anterior  and  inferior  portion  of  that 
ligament,  were  removed.  Owing  to  a  mal- formation  of 
the  joint  in  the  subject  upon  which  this  dissection  was 
made,  our  experiments  were  not  usually  satisfactory,  yet 
they  were  confirmatory  of  the  doctrines  which  are  above 
expressed.  Dislocation  could  not  be  effected  upon  either 
side,  without  very  marked  adduction,  though,  owing  to 
the  peculiar  mal -formation  of  the  joint,  less  than  the 
usual  amount  of  distortion  was  required  to  produce  dis- 
location; and  also  in  effecting  reduction,  it  was  not  neces- 
sary to  carry  the  limb  across  its  fellow  at  so  high  a  point 
as   usual.     It   was   necessary,    however,    in   order   to   effect 


GuNN  on  iMxations  of  Hip  and  Shoulder  Joints.      205 

the  reduction  witli  facility,  to  place  the  limb  in  the  same 
position  which  it  occupied  at  the  moment  of  the  escape 
of  the  head  of  the  hone  from  the  socket,  thus  confirming 
the   general   principle   above   laid   down. 

Both  limbs  were  also  luxated,  and  an  attempt  made 
to  place  them  parallel  to  one  another,  on  a  line  with  the 
trunk.  The  limb  upon  which  the  capsular  ligament  was 
dissected,  was  easily  placed  on  a  line  with  the  body,  owing 
to  the  yielding  of  the  muscular  tissue;  the  other,  upon 
which  only  the  anterior  and  inferior  portion  of  the  cap- 
sular ligament  remained,  was  brought  to  a  line  with  the 
trunk    only    by   tearing   the   ligament   completely   asunder. 

From  these  experiments  we  learn.  That  if  all  other 
tissues  are  removed,  the  undissected  portion  of  the  capsular 
ligament  will  cause  the  limb,  in  the  luxation  upon  the 
dorsum  ilii,  to  assume  the  direction  and  position  so  char- 
acteristic of  that  accident;  that  if  now  an  attempt  be 
made  to  place  the  limb  parallel  with  its  fellow,  on  a  line 
with  the  trunk,  that  attempt  will  be  unsuccessful  until 
complete  rupture  of  the  remaining  untorn  portion  of  the 
ligament  takes  place;  that  an  attempt  to  reduce  by  the 
old  method  of  extension  and  counter -extension  will  prove 
ineffectual  without  the  exercise  of  a  terrible  power,  and 
the  complete  laceration  of  the  capsular  ligament;  that  by 
placing  the  limb  in  the  position  which  it  occupied  at  the 
instant  of  escape,  reduction  is  readily  effected. 

We  learn  further,  that  if  the  ligaments  be  cut  away, 
leaving  all  other  tissues,  and  the  head  of  the  bone  be  dis- 
located upon  the  dorsum  ilii,  and  reduction  be  attempted 
by  either  Eeid's  method  or  my  own,  that  the  outer  por- 
tion of  the  facia  lata  will,  by  its  pressure  on  the  trochanter 
major,  prevent  success  until,  by  internal  rotation,  that  dif- 
ficulty is  avoided.  Hence,  we  establish  the  following  gen- 
eral rule: 

In   all  dislocations,  place   the  limb  in  just  the  position 


20G  The  Peninsular  and  Independent, 

which   characterized  it  at  the   moment  of  escape,  and   the 
reduction  will  then  be  easily  effected. 

We  further  lay  down  the   following  special  rules: 

In  the  luxation  upon  the  dorsum  ilii,  the  patient  lying 
on  his  back,  carry  the  limb  across  its  fellow  at  a  point 
corresponding  with  the  union  of  the  middle  with  the  upper 
third,  rotate  inwards,  and  the  pelvis  being  fixed  by  an 
assistant,  the  head  may  now  be  readily  be  drawn  into  its 
place. 

In  the  dislocation  into  the  obturator  foramen,  when 
extension  is  being  made  in  the  usual  way  at  the  upper 
part  of  the  thigh,  the  limb  should  be  abducted  instead  of 
adducted,  as  universally  directed;  abduction  conforms  to  the 
general  rule  laid  down  above,  and  relaxes  the  upper  and 
untorn   portion   of  the  ligament. 

In  the  forward  dislocation  upon  the  pubis,  while  exten- 
sion and  counter -extension  are  being  made  in  the  usual 
manner,  the  limb  should  be  rotated  externally;  this  relaxes 
the  posterior   and  untorn  ]3ortion  of  the   ligament. 

In  the  backward  luxation  into  the  sciatic  notch,  the 
limb  should  be  carried  across  the  opj^osite  groin,  and  ro- 
tated internally,  previous   to   any   extension  being  made. 

In  the  luxation  of  the  humeral  head  into  the  axilla, 
the  arm  should  be  drawn  upward  by  the  side  of  the 
head,  as   directed   in  my  first  article. 

In  the  forward  dislocation  upon  the  thorax,  the  arm 
should  be  rotated  externally  before  extension  is  attempted. 

In  the  luxation  backwards  upon  the  dorsum  scapulas, 
the  arm  should  be  rotated  internally  before  extension  is 
commenced. 

87  Shelby  St.,  June  10th,  1859. 


Potter  on  Feculiar  Death  of  Foetus  in  Utero.         207 


ART.  XY.  — Peculiar  Death  of  Foetus  in  Ftero. 


By  a.  0.  Potter,  M.  D. 


October  19th,  1858,  I  was  called  to  visit  Mrs.  M.  in  her 
third  confinement.  When  I  arrived  at  the  house,  the  child 
was  born.  I  found  a  retained  placenta,  which  was  readily  de- 
livered with  a  good  contraction  of  the  uterus.  The  child 
was  dead,  and,  upon  examination,  the  following  appearances 
were  presented. 

The  connections  between  the  bones  of  the  cranium  by  the 
different  sutures  were  wholly  destroyed ;  the  brain  was  softened 
and  only  needed  an  incision  through  the  integument]  for  the 
whole  contents  of  the  cranium  to  be  discharged ;  in  fact,  the 
whole  head  above  the  neck  was  in  a  state  of  perfect  decom- 
position, while  below  the  neck  the  body  presented  a  healthy 
appearance.  There  were  no  signs  or  marks  of  a  putrifactive 
process  having  been  commenced  in  either  the  hands  or  feet ; 
no  marks  of  a  change  having  been  set  up  at  the  finger  or  toe 
nails,  as  might  have  been  expected  from  the  appearance  of 
the  head  and  face. 

I  was  a  little  surprised  at  this  at  first,  and  unable  to  ac- 
count for  it,  but  when  told  the  cord  was  wound  four  times 
around  the  neck  of  the  child,  it  was  easily  accounted  for. 
The  traction  upon  the  umbilical  cord  had  cut  off  the  foetal 
circulation  in  the  brain  by  the  pressure  upon  the  jugular 
veins  and  carotid  arteries;  thus  actually  killing  the  head, 
and  leaving  it  to  soften  and  decay ;  while  the  circulation 
in  the  placenta,  umbilical  cord,  body  and  limbs  of  the  foetus 
was  kept  up,  and  carried  on  for  some  time,  in  nearly  or 
quite  a  normal  state. 

That  the  circulation  in  the  cord  and  body  of  the  foetus 
should  be  carried  on  while  there  was  pressure  and  traction 
sufficient  upon  the  cord  to  cut  off  the  circulation  to  and 
in  the  brain,  has  been  a  fact  of  no  little  interest   to  me, 


208  The  Peninsular  and  Independent. 

and  this  is  my  only  reason  for  reporting  the  case  to  the 
Journcd. 

The  child  was  one  of  nearly  or  quite  full  term,  and  no 
cause  of  its  death  can  he  given  except  the  pressure  and 
traction  of  the  cord  about  its  neck,  as  given  above. 

Mantorville,  Minn.  April  28th. 


Horton's  Meteorological  Register  for  May. 


209 


ART.  XVII.  ~  Meteorological  Register  for  Month  of  May,  1859. 

Br  L.  S.  HoRTON,  House  Physician  to  U.  S.  Marine  Hospital. 


Altitude  of  Barometer  above  the  level  of  the  sea,  697  feet.     Latitude,  42^24' N.:,  and 
Longitude,  82°58' W.  of  Greenwich. 


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Vol.  IL  — O. 


^ibliojgra^Htal  ^U0rl)f, 


A  PRACTICAL  TREATISE  ON  THE  DISEASES  OF  INFANCY 
AND  CHILDHOOD.  By  T.  H.  Tanner,  M.  D.,  F.  L.  S.,  Licentiate 
of  the  Ro3'al  College  of  Physicians ;  Late  Physician  to  the  Hos- 
pital for  Women,  etc.,  etc.  Philadelphia:  Lindsay  &  Blakiston. 
1859. 

We  don't  like  the  book.  Wc  have  no  love  for  the  class 
to  which  it  belongs  ;  and  this  is  an  example  ^^ar  excellence 
of  its  class.  The  day  has  past  when  superficial  books  are 
demanded,  or  appreciated  with  favor.  A  statement  of  the 
most  prominent  facts  of  a  subject,  even  though  it  should  be 
clear  and  concise,  no  longer  makes  up  an  acceptable  book 
in  any  dei}artment  of  science  ;  and  the  ''Practical  Treatise" 
of  Dr.  Tanner  is  nothing  more.  So  far  as  the  list  of 
diseases  of  which  it  treats  is  concerned,  it  is  very  full  and 
complete  ;  but  the  reader  can  judge  of  the  value  of  the 
"  Treatise "  when  he  is  aware  that  the  whole  subject  of 
Dentition,  including  ''disorders''  of  "first  and  second  den- 
tition "  is  disposed  of  in  eight  and  a  half  duodecimo  pages ! 
Diseases  of  the  eye  are  arranged  in  eight  sections,  as  fol- 
lows :  1.  Diseases  of  Eyelids  ;  2.  Do.  of  Conjunctivaa ;  3. 
Do.  of  Sclerotic  and  Cornea  ;  4.  Do.  of  Iris  ;  5.  Congenital 
Cataract ;  6.  Amaurosis  ;  7.  Encephaloid  Fungus  of  the  Eye- 
ball ;  8.  Strabismus.  This  little  job  is  dispatched  in  20 
pages!  "Very  mild  alterative  courses  of  mercury,  especially 
of  the  bichloride,"  are  recommended  in  encephaloid  fungus! 
This   is   the   second   production  of  its   kind  which   Dr. 


JSihlio graphical  Record.  211 

Tanner  has  furaished  us  (the  first  being  a  "Manual  of 
the  Practice  of  Medicine")  ;  and  we  repeat,  that  we  don't 
like  the  style  of  the  effort.  We  utterly  abhor  all  such 
diluted  abominations  in  medical  literature.  They  are  of 
good  use  to  no  one  :  they  are  of  absolute  injury  to  the 
student ;  and  a  properly  educated  practitioner  has  no  use 
for  them.  Let  authors  cultivate  less  ground,  and  till  it 
better ;  so  shall  our  harvests  be  more  abundant,  and  the 
quality  of  the  product  greatly  improved. 

Who  the  American  sponsor  for  the  little  candidate 
for  favor  is,  we  are  not  informed.  We  are  thankful  for  this 
at  least, — It  gives  us  some  hope  for  the  future,  to  see  that 
the  ambitious  editors  of  the  host  of  exotics  which  Phila- 
delphia produces,  are  beginning  to  show  a  better  care  as 
to  the  character  of  the  work  on  which  they  parade  their 
fair  names.  Let  this  care  increase,  until  none  but  truly 
meritorious   books   are   re-  produced   in   this   country. 

a. 


CONTRIBUTIONS  TO  OPERATIVE  SURGERY  AND  SURGICAL 
PATHOLOGY.  By  J.  M.  Carnocdan,  M.  D.,  Prof.  etc.  With 
Illustrations  drawn  from  Nature.  Part.  II.  Lindsay  &  Blakiston, 
1858. 

We  had  begun  to  apprehend  that  the  somewhat  severe 
criticisms  which  some  of  the  brethren  bestowed  upon  the  first 
number  of  the  above  named  enterprize  had  dampened  the 
ardor  which  characterized  its  incieption.  The  criticisms 
referred  to  were  natural  enough,  yet  the  title  of  the  work  is 
modest,  and  the  cases  are  interesting;  and  though  the  "get 
up "  of  the  book  is,  perhaps,  pretentious,  we  freely  con- 
fess that  we  had  much  rather  see  it  in  its  present  form 
than  in  one  less  elegant,  even  though  it  would  then  escape 
the  kind  of  criticism  which  it  has  received.  If  Prof.  Car« 
NOCHAN,  or  Prof  or  Dr.  Anybodyelse,  desires  to  lay  his 
novel,  important,  or  interesting  experience   before  the  Pro-« 


212  The  Peninsular  and  Independent. 

fession  and  the  "  rest  of  mankind/'  and  chooses  to  do  bo 
in  an  attractive  form,  is  is  certainly  his  privilege  to  do 
80 ;  and,  for  one,  we  admire  the  disposition  and  taste 
evinced.  If  Mr.  Editor  Grovtler,  or  Mr.  Reviewer  Cynic, 
curl  the  lip  and  shed  a  little  concentrated  wit,  or  even 
bitterness,  from  their  quill,  steel,  gold,  or  lead  points,  why 
that  is  their  privilege ;  and  Author,  Reviewer,  and  the 
World  are  alike  unharmed  —  perhaps  all  are  improved 
thereby.  All  such  things  go  to  make  uj)  the  sum  total  of 
affairs  human. 

The  present  number  contains  the  following  cases  : 

1.  Case   of  Exsection    of  the  entire    Una. 

2.  Remarks   on   Neuralgia   of  the  Face ;  with  a  case. 

3.  Exsection   of   the   Trunlv    of    the    Second   Branch    of    the    Fifth 

Pair   of   Nerves,    beyond   the   Ganglion    of   Meckel,    for    severe 
Neuralgia  of  the  Face;   with   three  cases. 

The  neuralgic  cases  are  of  great  interest ;  and  whatever 
difference  of  opinion  may  be  entertained  as  to  the  ex- 
pediency of  such  extreme  measures  as  those  j^racticed  by 
Prof.  Carnochan,  all  will  read  them  with  avidity,  and  not 
without  profit. 

As  a  surgeon,  we  are  glad  that  the  author  is  giving 
us  his  experience  in  just  the  manner  which  he  has  chosen, 

G. 


€trit0rial  §t^KXtmnt. 


Medical  Education  in  Chicago. 

The  leader  in  the  editorial  department  of  the  Chicago 
Journal  for  June,  is  devoted  to  a  review  of  the  "First 
Annual  Announcement  of  the  Medical  Department  of  the 
Lind  University,  at  Chicago,  111.,  1859-60/' 

As  was  easily  foreseen,  the  establishment  of  a  second 
college  in  Chicago  does  not  exert  a  harmonizing  influence ; 
and  whether  it  shall  really  tend  to  accomplish  anything  in 
the  elevation  of  the  standard  of  education,  is  yet  to  be  seen. 
The  Journal  reviews,  very  ably,  the  proposed  innovations, 
and  shows  very  conclusively  that  the  projectors  of  the  Med- 
ical Department  of  Lind  University  have  not,  in  their  pres- 
ent plan,  advanced  in  the  educational  cause.  We  do  not 
endorse  all  that  the  Journal  advances ;  for  he  assails  some 
principles  which  we  advocate,  and  which  the  New  School 
in  Chicago  fails  to  fully  carry  out. 

We  should  not  have  noticed,  however,  at  the  present 
time,  the  Chicago  struggle  for  students,  but  for  the  fact 
that  the  organ  of  the  Rush  Medical  College  takes  some 
pains  to  strike  at  the  University  of  Michigan,  while  it  deals 
a  blow  at  its  immediate  rival.  ISTor  would  we  even  then 
have  answered  the  insinuation,  had  it  been  a  candid  allu- 
sion to  a  fact ;  but  such  is  not  the  case.  The  Journal 
says : 

By  carefully  noting  this  plan,  it  will  be  seen  that  it  differs  from 
that  pursued  in  all  the  Colleges  in  the  United  States  (except  that  at  Ann 


214  The  Peninsular  and  Independent. 

Arbor,  Mich.),  in  that  it  proposes  to  make  a  fall  course  of  lectures  com- 
pose 430  lectures,  delivered  in  twenty  weeks,  instead  of  576  lectures, 
delivered  in  sixteen  weeks,  as  is  the  present  practice." 

Perhaps  the  editor  of  the  organ  of  the  Eush  Medical 
College  did  not  mean  as  much  as  the  ahove  exception 
would  indicate ;  for  he  must  have  known  that  the  University 
of  Michigan  never  held  a  less  than  six  months'  course  of 
four  lectures  per  diem;  and  that  the  six  working  days 
of  each  week  were  fully  consumed^  making  a  weekly  ag- 
gregate of  twenty-four  lectures.  The  lecture  term  is  twenty- 
six  weeks  long :  deduct  one  week  for  the  examinations,  and 
we  have  twenty- five  weeks  of  actual  lecturing,  which,  mul- 
tiplied by  the  weekly  aggregate,  twenty- four,  makes  the 
sum  of  six  hundred  lectures.  The  distinctive  features  of 
the  University  of  Michigan  are,  increased  length  of  lecture 
term  and  a  diminished  daily  number  of  lectures,  enhanced 
requirements  for  the  Doctor's  Degree,  and  free  education. 
This  is  the  policy  of  the  State  of  Michigan^  established 
by  her  Legislature  as  early  as  1836,  and  required  by  the 
organic  law  of  the  University. 

This  policy  we  have  no  disposition  to  obtrude  upon 
any  other  educational  institution.  It  works  well — excel- 
lently well — with  us  in  Michigan  ;  but  it  is  for  the  people 
of  the  other  States  to  determine  whether  it  shall  be  their 
policy  or  not.  As  an  educator,  we  have  no  disposition  to 
seek  to  establish  any  general  rule  or  law  for  other  colleges, 
as  to  length  of  term,  or  daily  number  of  lectures.  We 
sincerely  wish,  however,  that  all  colleges  could  unite  upon 
one  or  two  other  points  of  reform,  viz.,  enhanced  prelim- 
inary requirements,  and  hospital  instruction.  We  believe 
that  these  two  are  the  chief  points  to  be  considered  in 
the  proposed  reform.  Likening  medical  education  to  an 
architectural  column,  the  first  represents  the  base,  the  last 
the  capital.  The  shaft  is  represented  by  the  present  lecture 
system,   and,  we   believe,  combines   already  the   solidity  of 


Editorial  Department.  215 

the  Tuscan,  and  tlie  rich  ornaments  of  the  Corinthian  orders. 
Considered  as  a  whole,  in  this  country,  the  base  is  too 
often  defective,  and  capital  only  supplied  by  years  of  private 
practice^  Gr. 

Catawba  Brandy  as  a  Medicinal  Agent. 

The  writer,  in  a  paper  read  before  the  American  Phar- 
maceutical Association,  at  its  Seventh  Annual  Meeting  in 
September,  1858,  endeavored  to  show  that  the  product  of 
brandy  in  the  Ohio  valley  might  be  made,  by  proper  means,  a 
perfect  substitute — for  all  purposes  whatever — for  that  of 
French  manufacture. 

We  presume  it  is  admitted  by  all  that  the  only  important 
medicinal  principle  in  any  brandy  is  its  alcohol,  and  that  the 
differences  in  its  market  value  are  owing  to  equal  diiferences 
in  qualit}^  of  flavor  and  odor.  In  saying  the  above,  we  refer 
only  to  brandy  made  from  wine,  and  not  to  an  artificially 
made  article. 

With  this  preface,  we  desire  to  call  attention  to  some 
remarks  of  John  Zimmerman,  of  Cincinnati,  Ohio,  which 
are  taken  from  the  Journal  of  the  Mai^yland  College  of 
Pharmacy.  This  gentleman  having  been,  to  use  his  own 
words,  "practically  and  theoretically''  connected  with  the 
American  wine-growing  establishment  of  Nicholas  Long- 
worth  and  C.  Zimmerman,  of  Cincinnati,  for  several  years, 
any  report  from  him  upon  the  subject  is  entitled  to  credit 
and  respect.     He  states  : 

In  1851,  LoNGWOKTH  and  Zimmerman  proposed  to  buy,  from 
wine-growers,  grapes  instead  of  juice,  in  order  to  prevent  any  possible 
adulteration.  By  this  operation  two  things  were  gained,  —  first,  the 
pumice  of  the  grape,  frequently  called  the  skins  or  marc  of  the  grape ; 
and  secondly,  the  lees  or  sediment — the  latter  being  a  separated  part  of 
the  juice,  which  is  produced  during  the  fermentation.  These  two  things 
forming  the  most  necessary  materials  for  the  manufacture  of  Catawba 
brandy,  can  now  be  bought  cheap  from  the  growers. 

The  best  Catawba  brandy  will  be  produced   if  the  juice   with   the 


216  The  Peninsular  and  Independent. 

pumice  are  distilled  after  fermentation,  —  the  extractive  matter  and  the 
alcohol  produced  standing  in  a  natural  proportion  to  each  other.  But 
as  the  juice  possesses  a  high  value  for  wine,  and  even  in  the  best  years 
produces  not  more  than  from  eight  to  ten  per  cent,  of  alcohol,  brandy 
manufactured  in  this  manner  would  reach  a  price  of  ten  to  fifteen 
dollars  per  gallon.  In  order,  however,  to  do  anything  in  this  line  of 
business,  so  important  to  our  country,  cheapness  of  the  article  in 
question  was  to  be  aimed  at. 

A  trial  was  made  to  distill  the  pumice  and  lees  with  the  most 
inferior  wines:  but  this  also  did  not  give  the  desired  result;  the  raw 
material  not  producing  that  quantity  of  alcohol  which  the  rich  ex- 
tractive matter  required.  Another  difficult}'^  proved  to  be  an  obstacle 
to  this  way  of  fabrication :  the  pumice  and  lees  burning  fust  to  the 
inner  brim  of  the  still  and  giving  thus  to  the  brandy  a  fragrant  taste: 
an  observation  made  by  Professor  Wayne,  of  Cincinnati,  a  member  of 
the  American  Pharmaceutical  Association,  and  communicated  in  the 
proceedings  of  that  society  for  1855. 

Further  trials  were  made  by  mixing  pumice,  lees,  and  inferior 
kind  of  wine  in  certain  manner ;  to  which  was  added  diluted  alcohol, 
in  order  to  gain  more  alcohol  to  extract  the  pumice.  This  raw  mate- 
rial was  then  distilled  by  steam  in  a  water-bath,  and  the  result  was 
more  satisfactory.  However,  the  brandy  was  not  fi-ee  of  the  corn-fusel 
oil,  which  remained  in  consequence  of  the  fabrication  of  alcohol  from 
whisky.  This  lessens  the  value  of  the  brandy,  and  is  easily  discovered 
by  the  reagent  of  L.  Molnak,  published  it  the  Proceedings  of  the 
American  Pharmaceutical  Association  for  1858,  page  67. 

In  order  to  produce  a  price-worthy  native  grape  brandy,  and 
entirely  free  of  corn-fusel  oil,  a  great  improvement  was  made  by  adding 
to  pumice,  lees,  and  inferior  kind  of  wines,  so  much  sugar  and  water 
as  to  produce,  by  fermentation,  alcohol  in  proportion  to  the  extractive 
matter ;  by  which  process,  the  pumice  also  was  extracted.  This  alcohol 
is  indentical  to  that  contained  in  the  pumice  and  lees ;  and  distillation 
repeated  four  times  proved  entirely  successful. 

The  specimen  of  brandy  presented  on  the  occasion  of  the  last  meet- 
ing of  the  American  Pharmaceutical  Association,  in  September,  1858, 
was  manufactured  in  the   above-mentioned  way,  and  two  years  old. 

American  grape  brand}^,  if  so  manufactured,  is  equal  to  French 
grape  brandy  when  of  equal  manufacture  and  age,  possessing  the  same 
grape  oil,  —  a  produce  of  fermentation,  which  forms  by  slow  chemical 
process,  oenanthic  ether,  which  must  be  present  in  old  grape  brandy, 
and  in  which  consists  the  great  medical  value  of  this  brandy. 

Imitations  of  Catawba  brandy  are  frequently  offered  for  sale,  a 
product  of  diluted  alcohol,  essential  oil  made  from  the  pumice  of  the 
Catawba  grape,  and  coloring  matter.     Such  an  article  can  be  very  easily 


Editorial  Department.  217 

discovered  by  separating  the  corn-fusel  oil  from  the  alcohol  by  chemical 
reagents. 

The  undersigned,  therefore,  is  firmly  convinced  that  xlmerican  grape 
brand}^,  if  manufactured  as  stated  and  allowed  to  grow  old  enough,  can 
fully  be  substituted  in  the  American  Pharmacopoeia  for  the  ''^Spiritus 
Vini  Gallici.''' 

We  do  not  believe,  as  does  Mr.  Zimmerman,  that  the 
"oenanthic  ether"  of  brandy  embodies  its  great  medical 
value,  but  do  believe  that  the  distilled  product  from  Catawba 
is  capable,  under  a  thoroughly  carried  out  system  of  pro- 
gressive improvement,  of  becoming  equal,  and  indeed  supe- 
rior to  the  best  products  of  foreign  climes.  The  decided  and 
fine  boquet  of  the  Catawba  grape  promises  thus  much. 

We  were  informed  by  the  Messrs.  Zimmerman  that  for 
Pharmaceutical  ]3urposes  Catawba  brandy  can  be  furnished 
of  any  required  proof  (i.  e.  alcoholic  strength),  and  without 
color.  This  fact  renders  this  form  especially  applicable  in 
the  substitution  of  alcohol  by  it  in  the  nicer  class  of  pre- 
parations, in  which  its  superiority  of  flavor  and  odor,  over 
that  of  ordinary  alcohol,  is  desirable.  F.  S. 


EDITORIAL    COERESPOIDEIfCE. 

London,  May  26th,  1859, 
Dear  Readers  of  the  Peninsular  and  Independent : 

A  month  has  now  elapsed  since  my  arrival  in  London,  and 
within  that  time  I  have  been  so  constantly  receiving  impres- 
sions from  without,  that  I  have  had  very  little  time  for  reflection ; 
and,  excepting  the  rude  jottings  in  my  journal,  and  a  few 
letters  to  friends,  have  written  nothing.  Every  day  there  are 
some  new  objects  to  be  seen — some  new  Institution  to  visit 
—  some  new  man  to  be  heard — some  new  set  of  patients  to 
be  observed;  and  these  labors,  together  with  the  following  up 
of  the  medical  men  and  cases  I  most  wish  to  hear  and  study, 
bring  me  to  my  lodgings,  at  night,  weary  and  exhausted,  almost 
absolutely  incapable  of  anything  like   vigorous  and  consecutive 


218  The  Peninsular  and  Independent. 

thought  —  and  this  state  of  mind  becoming  now,  to  a  certain  ex- 
tent a  habit,  makes  the  task  of  writing  this  letter  for  you,  appear 
formidable,  and  causes  me  to  despair  of  its  being  well  performed. 
Indeed,  I  almost  regret  that  I  have  given  any  intimation  that  I 
would  write  for  the  Journal  until  after  returning  home,  and 
getting  into  my  accustomed  writing  -  chair,  with  my  usual  sur- 
roundings, and  then  I  might  hope  that  the  impressions  now, 
being  daily  received  would  take  some  form  of  order  — 
might  be  crystallized  upon  some  thread  of  thought,  and  not 
as  they  are  now  likely  to  be,  hastily  and  irregularly  scattered 
before   you   in   amorphous   fragments. 

It  would  be  in  vain  for  me  to  attempt,  in  a  few  pages  or 
articles,  to  give  you  my  full  impressions  of  this  great  intellectual 
and  commercial  centre  —  this  metropolis  of  the  civilized  world ; 
and  as  I  am  writing  to  medical  mea,  I  shall  attempt  to  give 
you  impressions  of  nothing  more  than  medical  matters,  and 
of  such  other  things  as  have  some  relation  to  them. 

The  geographical  situation  of  London,  and  its  general  topo- 
graphy, you  all  know.  The  names  of  many  of  its  divisions, 
squares,  streets,  public  buildings,  and  even  courts  and  lanes, 
you  are  familiar  with,  as  there  are  so  frequent  allusions  to 
them  in  the  rich  literature  which  we  enjoy,  are  proud  of,  and,  in 
its  older  portions,  in  every  sense  share  in  common  with  Eng- 
lishmen. 

The  extent  of  field  here  for  medical  observation  may  be  better 
understood  by  a  few  statements.  When  one  first  looks  about 
him  in  London,  its  busy  bustle  and  its  dingy  aspect  arrests, 
most  forcibly,  his  attention.  All  he  meets  are  intent  upon  their 
own  business,  —  not  indeed,  dashing  on  with  such  speed  as  is 
often  witnessed  in  New  York,  or  used  to  be  observed  in 
Chicago;  but  actively,  perseveringly,  unanimously,  pushing  on,  as 
though  some  Malakoft'  of  commerce  or  manufacture  was  to 
be  deliberately  stormed ;  and  he  is  at  once  convinced  that 
the  assailants  are  to  be  successful.  Whatever  may  be  the 
fate  of  individuals  in  this  rush — whoever  may  be  trodden 
down  and  crushed  out  of  existence,  —  he  sees  that  general 
success  is  inevitable.  The  moment  he  looks  up  from  the  hu- 
man tide  that  is  mingling  and  flowing  past  him,  the  sombre 
walls  seem  to  gather  around,  and  frown  down  upon  him,  as 
though  he  was   an   intruder.     The   air   is   dark    and   thick    and 


Editorial  Department.  219 

heavy.  Is  there  a  seige?  has  there  been  a  battle?  are  the 
walls  blackened  with  gunpowder,  or  only  with  coal  smoke?  Is 
he  a  prisoner  of  war?  These  are  questions  instinctively  and 
obscurely  hinted,  if  not  by  his  imagination  broadly  asked.  But 
he  soon  finds  he  is  at  liberty;  he  can  go  where  he  pleases 
' — no  hostility  is  manifested;  and  if ,  he  ventures  to  ask  a 
question  —  it  matters  not  of  whom — he  may  be  answered  in  a 
somewhat  hasty,  but  always  in  a  respectful  and  kindly  tone, 
and  he  at.  once  begins  to  hope  he  is  among  friends.  He  is 
soon  confident  they  are  not  enemies;  and  in  the  order  and 
regularity  which,  amidst  this  apparent  confusion,  he  soon  sees 
prevail,  he  feels  a  security  which  calms  all  his  fears.  He  may 
now  look  about  him  at  his  ease.  He  has  a  letter  to  deliver 
or  some  business  to  transact.  He  calls  a  "hack"  or  a  "Hansom" 
(the  latter  a  two  wheeled,  covered  vehicle,  the  driver  posted 
upon  a  high  seat  behind ),  and  rolls  av/ay,  he  knows  not 
whither,  but  along  thronging  thoroughfares,  and  between  walls 
still  dingy,  yet  perhaps  less  forbidding,  than  they  seemed  at  first. 
He  may  dash  by  a  little  "square"  filled  with  trees,  shrubs,  and 
flowers,  and  adorned  with  statues  of  some  of  those  great  men 
whom  their  country  is  proud  to  honor — or  pass  along  by  a 
spacious  "park,"  with  its  stately  trees  and  silvery  pools  and 
and  winding  paths — but  on,  on  he  goes,  again  plunging  be- 
tween the  same  dingy  walls,  and  seeing  mingle  the  same  busy 
crowd,  xlnd  now  the  most  striking  feature  of  Loudon  begins 
to  burst  upon  liim  —  viz.,  its  vastness.  He  begins  to  inquire 
is  this  interminable?  —  is  there  no  limit?  But  on  he  goes; 
and  still  he  is  surrounded  by  the  same  walls,  and  still  is  rush- 
ing on  the  same  crowd.  In  a  single  drive,  if  it  be  long  enough, 
one  may  get  some  impression  of  London's  greatness;  but  this 
impression  grows  upon  him  daily  as  he  traverses  its  many  great 
thoroughfares,  sails  upon  its  rivers,  crosses  its  bridges,  descends 
through  its  Tunnel,  penetrates  its  lanes  and  alleys,  and,  in  con- 
nection with  its  extent,  considers  the  crowded  condition  of  every 
locality — the  amount  of  property  and  business  and  life,  of  labor 
and  enjoyment,  of  crime  and  sufifering,  of  good  and  evil,  pressed 
into  every  cubic  perch  of  the  vast  area;— -I  say  cubic  perch, 
for  human  life  is  found  from  the  deepest  cellar  to  the  highest 
garret. 

Within    the    limits  of  the   Metropolis   are   embraced    about 


220  The  Peninsular  and  Independent. 

3,000,000  of  people,  consuming  daily  over  5,000  sheep,  about 
1,000  bullocks,  and  8,000  salmon,  besides  all  other  kinds  of  flesh 
and  fish.  There  are  daily  swallowed  130,000  gallons  of  malt 
liquors!  and  the  milk  of  14,000  cows.  Fifty  millions  of  gallons 
of  water  daily  flow  through  its  pipes.  A  fleet  of  more  than 
1,000  sail  is  employed  to  bring  it  coal  from  the  mines  upon 
the  island,  besides  what  is  brought  upon  the  numerous  railroads. 

Of  this  vast  population,  a  much  larger  proportion  are  in 
moderate  circumstances  than  even  in  our  large  cities;  and  more 
who  are  able  to  pay  for  medical  services  apply  to  public  insti- 
tutions for  aid,  than  among  us.  The  number  of  Hospitals  and 
Infirmaries  here  is  very  great,  and  access  is  not  difficult.  From 
these  statements  it  will  readily  be  seen  that  the  number  of  pa- 
tients obtaining  treatment  in  public  institutions  is  vast;  and  as 
all  these  institutions,  under  one  regulation  or  another,  are  open 
to  students  and  medical  men  seeking  information — all  the  cases 
being  used,  if  necessary,  for  purposes  of  instruction  —  it  will 
readily  be  understood  that  the  opportunity  of  seeing  disease  here 
must  be  commensurate  with  the  vastness  of  London  in  other 
respects.  The  physicians  and  surgeons  having  charge  of  these 
institutions  are  very  polite  to  strangers  —  certainly  to  Americans 
—  furnishing  them  every  opportunity  for  observation  they  could 
desire ;  and  yet  few  remain  here  for  any  length  of  time.  As  I 
have  not  yet  witnessed  the  opportunities  for  observation  in  Paris, 
Vienna,  Edinburgh,  and  elswhere,  where  so  many  more  resort 
for  purposes  of  study,  than  here,  it  would  be  premature  to  spec- 
ulate upon  the  cause  of  so  many  giving  such  a  brief  portion  of 
their  time  abroad  to  this  place  ;  but  certainly  it  is  not  because 
there  is  a  want  of  cases  of  interest,  or  opportunities  to  observe 
them. 

I  have  already  visited  about  twenty  hospitals  of  one  sort  or 
another — their  number  of  beds  ranging  from  100  to  700 —some 
of  the  Insane  Asylums  having  accommodations  for  many  more ; 
and  there  are  many  others  I  have  not  seen.  Connected  with  al- 
most every  hospital  is  a  department  for  out-patients,  and  in  these 
many  more  cases  are  prescribed  for  than  of  those  admitted  to 
beds.  These  patients  come  to  see  particular  physicians  or  sur- 
geons, on  certain  days  in  the  week,  are  examined  and  prescribed 
for,  and  cases  among  them  of  special  interest  are  selected  for  ope- 
rations or  other  treatment  in  the  wards.     From  these,  as  well  as 


Editor ial  Department.  221 

other  sources,  are  obtained  constant  supplies  of  cases  of  interest. 
The  leading  hospitals  have  schools  of  medicine  and  surgery  con- 
nected with  them,  the  physicians  and  surgeons  to  the  respective 
hospitals  being  professors  in  the  schools ;  such  a  thing  as  medical 
school  in  London,  without  a  hospital  attached  for  clinical  instruc- 
tion, being  unknown. 

A  few  of  the  London  hospitals  are  endowed,  supported  by 
funded  property ;  but  most  of  them  are  dependent  upon  voluntary 
subscriptions  from  benevolent  individuals;  and  appeals  through 
the  press,  and  from  the  pulpits  are  frequently  made  for  contribu- 
tions in  their  support.  With  some  of  them,  donations  of  a  certain 
amount  entitle  the  donor  to  send  into  hospital  a  patient  from 
time  to  time ;  in  other  cases,  the  governors  of  the  institution  re- 
commend patients ;  while  in  other  instances,  the  cases  to  be  ad- 
mitted are  determined  by  the  medical  officers.  Individuals  and 
governors  often  delegate  their  powers  to  the  physicians  and  sur- 
geons. 

Most  of  the  hospitals  are  general ;  i.  6.  they  [admit  different 
classes  of  cases — various  medical  and  surgical  diseases;  while 
others  are  devoted  to  specialties — such  as  diseases  of  the  chest, 
the  eye,  the  ear,  those  peculiar  to  women,  children,  &c.  The  Or- 
thopoedic  Hospital  is  established  for  the  treatment  of  deformities 
of  the  body  alone. 

Some  of  those  connected  with  the  hospitals  devote  themselves 
to  specialities,  both  in  the  wards  and  with  the  out-patients, — hav- 
ing special  days  for  seeing  a  particular  class  of  cases  ;  and  patients 
are  sent  from  one  to  another,  according  as  they  are  affected  with 
one  or  another  form  of  disease.  In  some  cases,  the  clinical  teach- 
ing is  done  by  those  engaged  in  didactic  instruction  in  the  col- 
leges, but  in  most  of  the  Hospital  Schools  a  large  jDortion  of  the 
clinical  teaching  is  done  by  those  having  no  part  in  the  didactic ; 
and  in  some  instances  special  professors  of  clinical  medicine  are  ap- 
pointed, who  give  lectures  on  elementary  clinical  subjects,  as  well 
as  upon  cases  which  occur  in  their  wards. 

There  are  two  terms  of  instruction  each  year  in  the  schools, — 
a  winter  term,  commencing  in  October  and  continuing  six  months ; 
and  a  summer  term,  commencing  near  the  close  of  the  winter 
term,  and  terminating  in  July,  continuing  about  three  months. 
During  the  winter  term,  in  most  schools,  are  taught,  didactically, 
Anatomy,  Physiology,  Chemistry,  Theory  and  Practice  of  Medicine, 


222  The  Peninsular  and  Independent. 

and  Surgery.  During  the  Bummer,  Materia  Medica,  Midwifery, 
etc..  Medical  Jurisprudence,  Comparative  Anatomy,  and  Botany ; 
while  Clinical  Medicine  and  Clinical  Surgery  (each  by  several 
teachers),  and  Clinical  Midwifery,  are  continued  throughout  both 
terms;  Practical  Anatomy,  in  its  different  branches,  being  chiefly- 
attended  to  during  the  winter  (though  Morbid  Anatomy,  as  cases 
occur,  is  continued  through  the  year),  while  Practical  Chemistry 
is  chiefly  attended  to  during  the  summer.  One  special  lecture  on 
Clinical  Medicine  and  one  on  Clinical  Surgery  is  usually  given  each 
week  throughout  both  sessions. 

Having  made  these  general  statements,  I  perhaps  can  not  do 
better  than  to  give  you  an  account  of  some  of  the  Schools  and 
Hospitals — the  men  and  the  things  connected  with  them — which  I 
have  observed.  I  shall  follow  the  order  in  which  I  happened  to 
see  them.  I  beg  to  have  it  fully  understood,  however,  that 
I  do  not  undertake  to  give  a  full  account  of  any  of  the  sixteen 
schools,  or  the  numerous  hospitals,  or  any  men  or  set  of  men  ;  I 
merely  attempt  to  state  some  of  the  things  I  have  observed,  and 
such  as  I  may  think  you  will  be  most  interested  to  know. 

I  first  visited  "  University  College  Ilospital "  and  Medical 
School.  The  chief  men  connected  with  with  this  school  and  col- 
lege are  Br.  Walshe,  Professor  of  tlie  Theory  and  Practice  of 
Medicine;  Dr.  Garrod,  of  Materia  Medica;  Dr.  Carpenter,  of 
Medical  Jurisprudence;  Dr.  Murphy,  of  Obstetrics,  &c. ;  Mr. 
Ericiison,  of  Surgery  ;  Prof.  Sharply,  of  Anatomy;  Mr.  Quain, 
of  Clinical  Surgery,  etc. ;  Wharton  Jones,  Opthalmic  Medicine, 
etc.;  Dr.  Parks,  Special  Professor  of  Clinical  Medicine;  Dr. 
Jenner,  Pathology  and  Pathological  Anatomy ;  and  Mr.  Harley, 
of  Histology,  etc. 

You  will  recognize  many  names  here  with  which  you  are  very 
familiar.  You  have  perhaps  all  read  Carpenter's  Physiology,  and 
all  ought  to  have  read  his  essay  on  Alcohol ;  many  have  studied 
Sharply  and  QuAiN's  elaborate  anatomical  works;  the  younger 
men,  Mr.  Erichson's  Surgery ;  while  others  have  read  Whar- 
ton Jones's  Opthalmic  Medicine;  and,  if  many  have  not,  I  hope 
they  will  hereafter,  study  Dr.  Walshe's  elaborate  work  on  the 
Chest. 

I  have  seen  all  these  men  at  their  work,  excepting  Professor 
Sharply,  who  is  not  now  on  duty ;  and  they  are  all  vigorous  and 
active  working  men. 


Editorial  Department.  223 

Dr.  Walshe  is  a  man  rather  under  fifty,  of  medium  size,  with 
a  very  finely  developed  brain,  of  good  quality.  I  have  been  par- 
ticularly interested  in  his  clinical  exercises  in  the  Hospital.  I 
have  never  witnessed  more  searching,  exact,  and  intelligent  ex- 
aminations of  patients,  particularly  in  all  cases  of  disease  of  the 
Chest.  Nothing  could  exceed  the  minute  care  exercised  in  physi- 
cal explorations,  and  so  far  as  I  could  judge  from  witnessing  his 
procedures,  and  hearing  his  remarks,  with  occasional  examinations 
of  particular  sounds,  he  is  unusually  discriminative  and  precise  in 
his  observations,  and  very  just  in  his  conclusions.  He  is  usually 
followed  by  from  six  to  ten  students,  among  whom,  including  his  as- 
sistants, several  are  sufficiently  advanced  to  follow  him  practically 
in  most  of  his  distinctions.  He  had  only  about  twenty  beds  in 
the  hospital  (which,  by  the  way,  is  not  a  large  one),  and  usually 
not  more  than  half  of  them  were  occupied  by  patients  requiring 
special  care,  and  not  unfrequently  an  hour  and  a  half  or  more 
were  employed  in  examining  two  or  three  cases.  A  single  case 
examined  in  that  minute  and  critical  manner,  is  more  valuable  to 
all  concerned,  than  the  largest  number  loosely  and  superficially  in- 
spected, and  prescribed  for  at  random.  Indeed,  such  methods  of 
procedure  in  the  presence  of  students  is  positively  pernicious,  en- 
couraging and  forming  in  them  the  worst  of  habits. 

Dr.  Walshe  visits  his  patients  at  the  hospital  three  times  a 
week  only,  leaving  them  the  rest  of  the  time  in  the  care  of  his  as- 
sistants. This  is  the  common  custom  with  all  the  visiting  phy- 
sicians and  surgeons  in  the  hospitals  of  London.  This  is  very  well 
in  chronic  diseases,  but  in  acute  cases  the  responsibility  must  be 
with  the  assistants.  Dr.  Walshe  dictates  the  most  minute  and 
circiim^stantial  report  of  each  of  his  cases,  carefully/  studied,  to  a 
student  acting  as  clinical  clerh,  who  writes  it  down  verbatum  as 
it  is  given  him.  Many  of  the  hospital  physicians  leave  their  clinical 
clerks  to  make  their  own  report  of  the  cases,  which  reports  are 
frequently  published  and  made  the  bases  of  clinical  lectures ;  few, 
I  should  say  now,  that  I  have  seen  here,  make  such  full,  careful 
and  reliable  clinical  reports  as  Dr.  W. 

I  have  seen  in  all  the  wards  here  a  considerable  proportion  of 
cases  of  rheumatism — more  I  think  than  are  seen  in  our  hospitals, 
or  usually  in  private  practice ;  and  a  larger  proportion  than  with 
us,  seem  to  have  heart  complications.  Pericarditis,  as  indicated 
by  the  friction  sounds,  and  in  many  cases  by  evidences  of  effusion, 


224  The  Peninsular  and  Independent. 

exists  where  no  pain  in  the  part  is  experienced  by  the  patient,  or 
scarcely  any  other  rational  symptoms  indicate  its  presence.  The 
old  fashioned  remedies  of  leeching  and  blistering  are  still  resorted 
to,  and  probably  long  will  be,  notwithstanding  the  new-fangled 
notions  taught  by  some.  General  blood-letting  is,  however,  very 
seldom  practiced  in  any  form  of  rheumatic  diseases.  Some  here 
say  they  have  less  severe  heart  complications  now,  than  when 
blood  was  drawn  more  freely.  The  alkaline  treatment  is  princi- 
pally used  in  rheumatism — the  carbonate  of  potash  being  the  arti- 
cles most  commonly  prescribed.  Nitrate  of  potash  is  often  com- 
bined with  the  carbonate ;  some  adding  oj^ium  to  these.  Some, 
however,  discard  the  alkalies  and  give  the  citric  acid,  and  others 
use  colchicum,  although  this  article  is  generally  thought  here  to 
have  much  more  effect  in  gout. 

Dr.  Walshe  has  delivered  only  one  set  clinical  lecture  this 
term,  which  one  I  had  the  pleasure  of  hearing.  It  was  uj^on  Me- 
diastinal Tumors,  and  based  upon  a  case  which  occurred  some 
time  before.  It  was  an  exceedingly  able  lecture,  philosophical  and 
discriminative — analysing  closely  all  the  symptoms,  comparing 
them  with  such  as  might  have  been  })roduced  by  other  pathologi- 
cal conditions,  and  with  which  they  might  have  been  confounded, 
<fec. ;  and  it  was  delivered  in  the  clinical  lecture  room  to  just  thir- 
teen students,  two  of  whom  were  asleep  during  most  of  the  hour. 
The  places  of  these  sleeping  ones  were  sujDplied  by  another  Ameri- 
can physician  and  myself,  so  tliat  there  was  still  an  audience  of  a 
baker's  dozen.  I  have  been  astonished,  everywhere,  to  find  the 
classes  listening  to  lectures  so  small.  There  is  only  a  dozen  at- 
tendhio*  Dr.  Jenner's  lectures  on  PatholoQ-ical  Anatomv ;  some 
fifteen  or  sixteen  Mr.  Erichson's  clinical  lecture  which  I  heard; 
and  in  the  large  school  and  hospital  of  St.  Bartholomew,  the  class- 
ical Dr.  West,  in  his  regular  course  on  Obstetrics,  is  lecturing  to 
between  thirty  and  forty ;  and  Dr.  Murphy,  in  the  same  regular 
course,  at  University  College,  is  addressing  about  half  that  num 
ber.  The  largest  class  I  have  seen  assembled  for  a  lecture  was 
at  Dr.  Garrod's,  at  University  College,  and  that  was  between 
fifty  and  sixty.  The  reason  of  this  is  to  be  found  in  the  large 
number  of  schools,  and  the  more  moderate  number  of  students 
studying  in  the  Metropolis.  The  practice  of  lecturing  to  so  few, 
gets  the  professors  in  the  habit  of  being  dull  in  their  manner.  As 
a  body,  they  are  very  much  more  prosy  than  those  I  have  been 
accustomed  to  hear  in  our  own  country. 


Editorial  Department,  225 

Dr.  Garrod  is  an  active  and  industrious  man,  and  is  on  duty  in 
the  hospital.  He  has  fewer  students  attending  in  his  ward  than  Dr. 
Walshe.  I  think,  I  have  not  seen  present  more  than  half  a 
dozen ;  and  the  average  of  those  attending  the  physicians  in  their 
wards  in  all  the  hospitals,  is  but  little  over  this  number.  The 
surgeons  are  generally  better  attended  —  their  numbers  being 
from  ten  to  twenty -five,  at  most,  except  when  there  are  opera- 
tions in  the  amphitheatres. 

Dr.  Garrod  is  engaged  in  a  work  on  Gout^  which  is  now  pass- 
ing through  the  press;  and  from  some  proof-sheets  which  I 
have  seen,  and  from  his  statements  as  to  its  contents,  I  have  no 
doubt  it  will  be  a  production  of  much  value,  becoming  a  standard 
on  the  subject.  He  has  long  been  engaged  in  investigating  the 
disease,  and  in  making  dissections  of  gouty  subjects,  dying  from 
whatever  cause,  and  in  nearly  all  such  cases,  he  has  found  deposits 
of  urate  of  soda  in  many  of  the  joints,  and  likewise  in  the  cones 
of  the  kidneys.  The  subject  of  the  book  will  be  illustrated  by 
plates,  showing  the  appearance  of  these  deposits  to  the  naked 
eye  and  under  the  microscope.  I  have  examined  many  of  the 
original  specimens  from  which  the  engravings  were  taken,  and 
know  them  to  be  true  to  nature.  Saw  one  post  -  inortem  of  a 
man  who  died  from  an  amputation,  necessitated  by  an  injury,  and 
who  had  had  several  attacks  of  gout,  and  there  were  found  such 
deposits  as  Dr.  G.  predicted,  both  in  the  cartilages  of  the  joints 
and  in  the  kidneys. 

Dr.  Gaerod  informed  me  that  his  full  course  of  lectures  on 
Materia  Medica  consisted  of  about  sixty  or  less ;  and  as  he  occu- 
pies much  of  the  time  in  chemical  and  pharmaceutical  details,  tests 
of  purity,  &c.,  he  can  do  very  little  in  the  way  of  teaching  the 
therapeutical  applications  of  medicines.  He  does  not  attempt 
much.  The  same  is  true  with  other  teachers  of  this  branch  in 
London ;  and  here,  as  in  many  other  places,  the  great  subject  of 
the  character  and  effects  of  medicinal  agents,  the  philosophy  of 
their  operations  and  applications  in  modifying  disease,  is  passed 
over  as  of  comparatively  small  consequence,  and  in  some  instances 
almost  entirely  neglected.  If  the  Science  of  Medicine  is  of  any 
use  to  mankind,  it  is  in  reference  to  the  treatment  of  their  dis- 
eases ;  and  if  therapeutical  agents  are  not  to  be  understood  and 
applied,  all  our  pathological  knowledge  may  indeed  be  interesting 
as  a  matter  of  science,  but  is  of  no  use  to  suffering  humanity.     If 

Vol.  II.  —  p. 


226  The  Peninsular  and  Independent. 

the  powers  of  many  agents  to  modify  disease  beneficially  are 
doubted,  tliis  is  an  additional  reason  for  examining  thoroughly 
those  powers,  and  scrutinizing  the  authority  on  wliich  their  claims 
rest. 

Dr.  Parks,  the  Special  Professor  of  Clinical  Medicine  in  this 
school,  is  one  of  the  most,  if  not  the  most,  animated  and  agreeable 
lecturers  I  have  heard  in  London.  I  have  heard  liim  in  two  or 
three  elementary  and  practical  prelections  on  physical  examina- 
tions in  heart  disease,  and  must  say  that,  in  matter  and  manner, 
they  were  excellent.  I  have  also  seen  him  engaged  M'ith  his  class 
in  the  wards,  pointing  out  to  them,  and  causing  them  to  listen  to, 
the  different  morbid  sounds  of  the  chest,  and  have  been  delighted 
with  his  method,  so  far  as  it  goes ;  and  with  his  zeal,  which  seems 
to  be  active  and  untiring.  Dr.  PaPvIvS  is  a  comparatively  young 
man,  and  his  health  is  not  firm,  but  should  it  continue  as  now,  he 
can  not  fail  of  being  very  useful  as  a  teacher,  and  of  attaining  to 
still  greater  eminence.  He  has  not  the  extent  and  minuteness  of 
knowledge,  and  the  grasp  of  mind  of  Dr.  Walsiie,  but  he  has 
more  than  his  animation  and  zeal,  and  exceeds  him  in  the  power 
of  communicatinoj  to  others  what  he  knows.  His  labors  are  bein<; 
bestowed  upon  a  class  of  some  fifteen,  or  a  few  more.  I  shall  re- 
member him  with  pleasure,  and  watch  his  future  course  with  in- 
terest, regarding  him,  as  I  do,  as  apparently  at  least,  the  most 
zealous  and  efficient  elementary  and  practical  teacher  it  has  been 
my  lot  to  fall  in  with  in  London. 

Dr.  Murphy,  as  many  of  you  know,  has  produced  an  ex- 
cellent book  on  Parturition,  but  his  lectures  can  not  be  char- 
acterized by  the  same  adjective.  They  are  to  be  sure  suf- 
ficiently correct  and  sound,  but  are  delivered  in  what  seemed 
to   me  a  hesitatinsr  and  dull   manner. 

Dr,  Jenner  is  a  highly  intelligent  and  industrious  man. 
His  labors  in  proving  the  essential  non- identity  of  Typhus 
and  Typhoid  Fevers,  are  an  honor,  not  only  to  himself,  but 
to  the  Profession.  His  careful  and  persevering  observations, 
his  rigid  analyses  and  accurate  deductions,  are  entitled  to  all 
praise.  He  is  lively  and  earnest  in  conversation,  but  all  these 
qualities  do  not  prevent  his  being  dull  in  the  lecture -room. 
He  has  a  subject  of  deep  interest  (he  was  dwelling  when  I  have 
heard  him  more  upon  what  might  be  called  Histological 
Pathology),  but  the   lectures   being  optional    with   students,   he 


Editorial  Department >  22*7 

attracts  a  class  of  only  a  dozen  (the  number  I  have  seen  present) ; 
and  in  this  case  I  do  not  so  much  wonder.  The  students  per- 
haps might  as  well  read  the  same  matter  from  the  books.  There 
is  nothing  in  his  manner  to  impress  the  subject  with  force  upon 
their  minds. 

Some  of  you  may  think  I  attach  too  much  importance  to 
raanner  in  lecturing  —  that  the  substance  of  the  lectures  is  the 
only  important  thing — every  thing  else  in  the  process  of  im- 
parting and  receiving  knowledge  depending  on  the  student. 
This  may  be  a  plausible,  but  is  not  a  correct  view.  The 
question  whether  medical  lectures  should  be  given  at  all,  I 
do  not  propose  here  to  enter  upon.  The  general  voice  of 
the  Profession  has  pronounced  on  this  subject,  and  if  lectures 
are  useful  at  all — if  they  have  advantages  over  reading  the 
same  matter  in  books,  it  is  because  of  the  enforcement  given 
to  the  matter  by  the  presence  and  manner  of  the  living  teacher 
—  greater  interest  being  given,  and  a  stronger  impression  is  made 
upon  the  attention  and  memory  of  the  student,  by  the  pres- 
ence and  the  associations  of  the  teacher  —  by  his  infusing,  as 
it  were,  his  own  individuality  and  energy  into  his  words. 
Manner  then  becomes  important  —  becomes  indeed  in  the  living 
teacher,  of  the  highest  importance ;  in  fact,  when  it  is  dull  and 
obscure — when  it  tails  of  possessing  emphasis  and  animation, 
the  lecture,  as  compared  with  the  book,  loses  not  only  its 
charm  but  its  value.  Manner  then,  in  a  lecturer  upon  medicine, 
as  in  a  lawyer,  a  preacher,  or  any  other  speaker  or  reader, 
is  not  only  a  matter  of  importance,  but  a  proper  subject  of 
intelligence  and  criticism.  My  observations  here  have  brought 
me  to  the  conclusion  that  the  manner  of  public  speaking  and 
reading  in  London,  not  only  in  the  medical  lecture  rooms, 
but  in  the  pulpit,  at  the  bar,  and  on  the  rostrum,  is  inferior 
to  that  in  the  United  States.  Here  it  is  comparatively  heavy, 
dull,  formal,  and  indistinct.  It  very  generally  wants  anima- 
tion and  emphasis;  and  in  the  same  cases  where  these  exist, 
there  is  apt  to  be  an  affectation  and  distortion,  which,  to  me, 
is  much  more  disageeable  than  the  dullness.  I  am  sorry  I 
can  not  write  more  favorably  in  this  particular;  but  so  it 
seems  to  me.  There  are  of  course  exceptions,  doubtless  many, 
but   they   do   not   alter   the   general  fact. 

I    have  followed    Mr.   Quain^  a  few  times    in    his   surgical 


228  T]ie  Peninsular  and  Independent. 

wards.  He  is  a  little  beyond  middle  age,  but  in  his  prime 
and  vigor,  about  medium  height,  with  large,  well  formed  head 
and  a  countenance  denoting  high  intelligence,  discrimination, 
and  energy.  He  is  rather  rapid  and  decisive,  yet  deliberate 
in   his   acts   with  his   patients. 

Mr.  Ericiison  is  younger,  with  a  brain  less  developed  in 
the  frontal  and  higher  regions.  He  is  rather  dashing  than 
deliberate  in  his  manner  with  his  patients.  He  had  heard 
nothing  of  the  plan  of  making  permanent  extension  in  frac- 
tures, hip -disease,  &c.,  by  means  of  adhesive  straps;  neither 
had  Mr.  Lawrexce.  Both  seemed  pleased  with  the  idea, 
and  said  they   would   try  it. 

I  have  heard  Mr.  Ericiison  deliver  one  set  lecture  on  Clinical 
Surgery.  It  was  upon  the  "  Causes  of  Death  after  Operations," 
an  inquiry  here  quite  "  fit  to  be  made."  The  subject  was  present- 
ed systematically  and  well.  He  is  a  much  more  energetic  and 
agreeable  lecturer  than  many  others.  He  had  evidently  prepared 
himself  with  care,  using  quite  extended,  though  by  no  means  full 
notes. 

Mr.  Wharton  Jones  is  a  small,  thin,  bent  man,  fifty  or  more, 
rather  slow  and  hesitating  in  his  manner  of  speaking,  and  in  no 
way  remarkably  impressive. 

You  will  all,  doubtless,  be  glad  to  hear  something  of  Dr.  Car- 
penter. In  person,  he  is  slightly  above  the  medium  height,  erect, 
and  rather  spare,  with  a  well- developed  head,  hair  thin  upon  the 
crown,  nose  rather  long,  and  by  no  means  thin  or  pale,  and  he  ap- 
pears to  be  some  years  less  than  fifty.  As  a  lecturer,  he  is  clear, 
direct,  nnd  distinct,  though  not  specially  felicitious  or  impressive. 
He  is,  however,  altogether  acceptable. 

Though  I  had  no  introduction  to  him,  simply  mentioning  to 
him  my  name,  locality,  and  objects,  he  has  been  exceedingly  polite, 
to  me,  and  I  am  under  many  obligations  to  him  for  several  impor- 
tant favors,  among  them  was  his  instrumentality  in  procuring  an 
invitation  to  attend  a  soiree  of  the  "  Royal  Society ^^^  at  their  spa- 
cious  and  interesting  rooms  at  Burlington- house,  where  I  had  an 
opportunity  of  seeing  a  large  body  of  the  most  learned  and  dis= 
tinguished  men  of  England,  in  literature  and  science  ;  and  a  more 
intellectual  and  dignified  set  of  men  I  have  certainly  never  seen, 
and  might  add,  scarcely  expect  to  see.  There  were  present  a  very 
large  company,  all  of  whom,  on  entering,  were  received  by  the. 


Editorial  Departinent.  229 

t^resident,  Sir  Benjamin  Beodie,  their  names  at  the  same  time 
being  announced.  Among  many  others  of  note,  there  were  pres- 
ent the  Bishops  of  Winchester,  Rypon,  Carhsle,  London,  and  Ox- 
ford ;  Sir  James  Ross,  Sir  James  Clark,  Professors  Sharply, 
Faraday,  and  Wheatstone  ;  Sir  J.Forbes,  Sir  C.  L acock,  Drs. 
Bruce,  Jones,  Watson,  and  Fuller  ;  Mr.  Fergusson,  &q.  &c. 
Various  objects  of  scientific  interest  were  exhibited  during  the 
evening,  among  them,  our  countryman  Professor  Hughes's  print- 
ing telegraph!  ;  and  an  entertainment  w^as  served  in  which  much 
coffee,  though  but  a  moderate  quantity  of  wine,  was  used.  The 
I'ooras  of  the  Royal  Society  are  quite  numerous  and  spacious,  and 
are  ornamented  with  original  portraits  and  busts  of  its  distinguish- 
ed members  of  past  times.  In  one  of  them  is  deposited  the  li- 
brary, the  herbarium  and  correspondence  of  Linn^us,  besides 
many  other  objects  of  interest. 

But  this  is  wandering  from  Dr.  Carpenter.  Though  he  has 
been  successful  as  a  teacher,  he  is  about  to  resign  his  position  as  a 
Professor  of  Medical  Jurisprudence  in  the  College,  having  been 
elected  Registrar  of  the  University  of  London — a  position  which 
will  occupy  a  considerable  portion  of  his  time,  yet  will  afford  him 
opportunities  for  pursuing  his  literary  labors,  which  he  much  de- 
sires to  do.  He  says  medical  teaching  is  so  much  divided  in  Lon- 
don, that  in  a  pecuniary  sense  it  is  not  worth  one's  time.  Others 
are  of  the  same  opinion ;  and  Mr.  Paget,  the  physiologist  and 
pathologist,  has  resigned  his  professorship  of  Physiology  in  the 
largest  medical  school  in  London  —  St.  Bartholomew — because  he 
has  too  much  practice  to  make  it  an  object  for  him  to  retain  it. 

The  University  of  London,  of  which  Dr.  Carpenter  is  the 
efficient  officer — and  the  only  one  who  devotes  any  considerable 
portion  of  his  time  to  it — is  comparatively  recent  in  its  origin,  and 
at  present  so  unique  in  its  character,  and,  withal,  so  important  in 
its  relations  to  general  and  professional  education,  that  a  brief  ac- 
count of  it  may  not  be  without  interest. 

It  was  founded  in  1836,  but  has  recently  received  a  new  char- 
ter, by  which  it  is  placed  upon  a  broader  and  more  liberal  basis 
than  formerly,  and  under  which  it  is  receiving  new  life.  Differing 
from  ordinary  Universities,  which  are  institutions  for  affording  the 
highest  grade  of  instruction  in  Arts  and  Sciences,  and  granting 
degrees  indicating  proficiency  therein,  this  corporation  is  destitute 
of   professors,    and  furnishes  no  instruction  at  all — its  functions 


230  The  Peninsular  and  Independent. 

being  simply  to  examine  for  and  grant  degrees,  allowing  its  matri- 
culants to  obtain  instruction  from  whatever  sources  they  please. 
Before  its  establishment,  there  was  no  power  in  the  Metropolis  to 
grant  degrees,  either  in  the  Arts,  in  Medicine,  Divinity,  or  in 
Law.  Those,  for  instance,  who  studied  medicine  in  London,  and 
sought  for  a  degree — aspired  to  anything  more  than  a  license  from 
the  Apothecaries'  Hall  or  the  College  of  Surgeons,  or  the  mem- 
bership of  some  Medical  Society — were  obliged  to  go  to  Oxford, 
Cambridge,  Edinburgh,  or  Dublin,  for  their  coveted  honors.  This 
corporation  was  established  to  prevent  that  necessity  ;  and,  without 
presenting  details  of  its  history,  specifying  the  changes  which  it 
has  undergone,  it  now  presents  itself  as  a  body  of  the  highest  re- 
spectability, under  the  management  of  a  Ciiancellor,  Vice -Chan- 
cellor, and  thirty -six  Fellows,  comprising  such  names  as  those  of 
Macaulay,  the  Duke  of  Devonshire,  Arxoit,  Brunell,  Fara- 
day, HoDGKiN,  Warburton,  &c.,  &c.,  witli  Lord  Granville  at 
their  head.  These  Fellows,  or  Senators  as  they  are  also  called, 
establish  rules,  appoint  examiners  in  the  various  departments  of 
Science  and  Art,  who  shall  test  the  qualifications  of  those  applying 
for  degrees, — the  University  conferring  such  as  the  applicant  may 
be  found  to  deserve.  From  the  first,  they  conferred  the  degrees  of 
Bachelor  of  Arts,  Master  of  Arts,  Bachelor  of  Laws  and  Doctor 
of  Laws,  Bachelor  of  Medicine  and  Doctor  of  Medicine,  and, 
within  the  last  few  months,  after  a  full  investigation  of  the  subject, 
taking  the  testimony  of  a  large  number  of  eminent  men,  and  in 
accordance  with  the  advancing  spirit  of  the  age,  after  overcoming 
the  servile  efforts  of  those  who  wished  to  maintain  Classical  Lite- 
rature in  its  old  and  almost  exclusive  pre  -  eminence,  they  have  es- 
tablished the  degrees  of  Bachelor  of  Science  and  Doctor  of  Sci- 
ence, requiring  of  such  only  a  very  small  amount  of  Latin  and 
Greek — intending  that  those  titles  shall  indicate  as  high  a  grade  of 
mental  cultivation — as  high  a  standard  of  accomplishment — as  the 
other  corresponding  degrees.  The  idea  for  years  acted  upon  in 
the  University  of  Michigan,  in  the  establishment,  and,  though  as 
yet,  imperfect  development  of  the  Scientific  Department,  is  now 
adopted  in  the  University  of  London,  through  the  strenuous  ef- 
forts of  men  of  the  very  highest  enlightenment,  and  who  had  suffi- 
cient independence  to  rise  above  the  influence  of  precedent,  and 


Editorial  Department,  231 

the  prejudices  of  their  education.  Upon  this  subject,  the  London 
Times^  of  May  13th,  in  a  leading  article,  somewhat  lightly,  but 
approvingly,  says — "The  chymist's  son,  who  has  never  stirred 
from  his  father's  shop  and  laboratory,  may  come  up  to  Burlington- 
house,  and  ask  for  a  degree  in  Science,  with  just  know^ledge 
enough  of  dog -Latin  and  Greek  to  be  able  to  read  and  speli 
chymical  names,  without  waiting  two  or  three  years  in  a  Gram- 
mar School,  in  the  attempt  to  construe  Virgil  and  HomerP  The 
idea  of  those  controlling  this  mattf^r  in  the  University  of  London, 
is  not  to  confer  degrees  upon  those  acquainted  with  a  single  sci- 
ence, as  Chemistry  for  instance,  being  ignorant  of  every  thing 
else,  but  they  regard  proficiency  in  scientific  knowledge,  together 
with  an  acquaintance  of  their  own  language  and  literature,  as  evi- 
dence of  as  much  cultivation,  of  as  high  a  degree  of  accomplish- 
ment, as  a  knowledge  of  the  Ancient  Classics,  and  equally — nay, 
more  than  equally — worthy  of  reception  of  University  honors. 

The  lenojth  of  this  letter  will  not  allow  me  to  2:0  into  details  of 
the  conditions  for  the  reception  of  these  degrees.  I  may  say, 
however,  that  the  standard  is  intended  to  be  high  and  the  exami- 
nations rigid.  The  great  idea  of  the  London  University  is  to  take 
the  student  as  he  is,  and  return  him  as  he  comes,  placing  its  hon- 
orable brand  upon  him,  indicating  his  quality.  If  the  young  man 
is  a  proficient  in  classical  learning,  has  a  respectable  knowledge  of 
general  literature,  mathematics,  philosophy,  &c.,  he  is  stamped 
B.  A.  If  he  is  a  proficient  in  scientific  knowledge,  and  has  a  re- 
spectable acquaintance  with  other  subjects  common  to  cultivated 
men,  he  is  stamped  B.  S.  Has  he  a  knowledge  of  the  law,  he  is 
stamped  B.  L.  or  LL.  D.  Has  he  like  knowledge  of  medicine, 
he  goes  into  the  world  with  the  mark  of  M.  B.  or  M.  D.  upon 
him.  These  titles  do  not  indicate  that  he  has  been  a  certain  num- 
ber of  terms  in  some  institution  of  learning,  but  simply  that  he 
has  a  certain  amount  of  knowledge  and  cultivation,  and  of  a  kind 
indicated  by  his  title.  The  idea  is  very  simple  and  easy  of  com- 
prehension, and  may  be  worth  contemplating. 

I  should  perhaps  add,  that  those  not  belonging  to  other  recog- 
nized institutions  are  required  to  pass  a  mild  matriculation  exami- 
nation, and  in  all  cases  for  the  first  degrees  two  examinations,  at 
different  periods,  are  required. 


232  The  Peninsular  and  Independent. 

Dr.  Carpenter,  in  his  capacity  of  Registrar  of  the  University, 
is  at  the  rooms  from  one  to  four  p.  m.,  each  day,  to  conduct  the 
general  business  of  the  corporation ;  the  rest  of  his  time  he  pro- 
poses to  devote  to  scientific  and  literary  j^ursuits.  He  does  not 
now  practice  the  profession  of  medicine. 

I  am  astonished  that  in  this  long  letter  I  have  mentioned  so 

few  of  the  very  many  interesting  medical  institutions  and  men 

of  London,  hut  every  thing   else  must  be  deferred  to  a   future 

occasion. 

Yours,  very  truly,  &c., 

A.  B.  P. 


SHttt^i  ^xixths,  libstratts,  it. 


ABSTRACTS  AND   SELECTIONS   for  the   PENINSULAR  AN»   INDEPENDENT. 

By  M.  A.  Patterson,  M.  D.,  Tecumseh. 


From  the   Virginia  Medical  Journal. 
ON  THE  COMPARATIVE  INFLUENCE  OF  THE  MALE  AND  FEMALE  PARENT 
UPON  THE  PROGENY.    By  J.  B.  Thomson,  L.  R.  C.  S..    Edin.,  Resident  Surgeon 
General  Priflon,  Perth. 

The  following  cases  appear  to  me  illustrative  of  a  very  curious 
and  not  unimportant  chapter  of  anthropology,  viz.,  "The  comparative 
influence  of  the  male  and  female  of  the  human  family  upon  their 
progeny"  —  a  subject  upon  which  very  crude  and  indefinite  notions 
are  held,  not  only  by  the  public,  but  by  members  of  our  Profession. 
It  is  a  settled  point  with  man}'-,  that  it  is  foolish  to  search  after 
any  laws  regulating  the  transmission  of  particular  textures,  features, 
and   constitutions  from  either   parent   to  the  offspring. 

While  it  is  admitted  that  we  can  found  little  upon  mere  sup- 
posed general  physical  or  psychical  resemblance,  I  think  the  method 
of  inquiry  followed  in  this  paper,  is  a  correct  one,  and  that  a  number 
of  individual  instances  of  the  transmission  of  abnormal  peculiarities 
from  parent  to  progeny  being  accumulated  and  balanced,  will  lead  to 
a  safe   and    scientific   induction. 

Mercatus,    in   his   work,     "De    Morbis    Hereditariis, ''    says    truly 
that   the  parents,  grandparents  and    great-grandparents   transmit  quality 
and  character,  form  and  structure,  proportion   and   disproportion,  or  any 
preternatural   condition   of  a  single  membrane  or  organ,  parts  or  parts. 

Of  this  statement  there  can  be  little  doubt.  We  may  go  further, 
and  affirm  that,  where  we  find  such  irregularities  and  defects  plainly 
appearing  in  one  parent,  and  re-appearing  in  any  of  the  offspring, 
such  irregularities  or  defects  are  attributable  to  the  influence  of  that 
parent.  The  order  of  causation  is  not  to  be  questioned.  And  further, 
when  striking  abnormal  conditions,  physical  or  mental,  are  transmitted 
in    families,    the    statistics    of  such   should   form   data   upon  which   to 


234  The  Peninsular  and  Independent. 

found  a  proof  whether,  and  in  what  proportion,  the  influence  of  the 
male  or  of  the  female  preponderates.  Beginning  with  physical  pecu- 
liarities of  the  external  structure,  transmitted  from  parents  to  progeny, 
let  us   examine   "the   transmission  of  the  skin   peculiarities." 

Case  I.  Ilereditary  transmission  of  wehhed  fingers. — A.  M.,  Alva. 
has  had  a  family  of  nine  children,  five  sons  and  four  daughters.  He 
himself  and  his  four  daughters  are  webbed  betwixt  the  middle  and 
ring  lingers,  or  close  -  fingered  as  their  mother  calls  it,  i.e.  the  skin 
stretches  across  and  unites  these  fingers  together.  None  of  the  sons 
have  this  peculiarity.  A.  M.'s  grandfather  had  the  same;  also  his 
mother  and  two  sons  and  one  daughter ;  his  uncle  two  daughters 
and  one  son,  this  son  having  all  the  fingers  of  both  hand  webbed 
together.  A.  M.'s  daughter  has  one  daughter  webbed  betwixt  the 
middle  and   ring   fingers  of  both   hands. 

Case  II.  Ilereditary  tramnnission  of  icehhed  fingcra  and  toen. 
—  (This  case,  from  a  recent  No.  of  the  Lancet.,  is  so  similar  to  the 
former,  that  I  make  no  apology  for  transferring  it  to  this  paper,  for 
the  sake  of  illustrating  my  argument.)  W.  S.  has  three  fingers  united 
throughout  by  skin,  viz.,  the  middle,  the  ring,  and  little  fingers  of 
both  hands.  His  mother  has  the  same,  but  Vs.  S.  is  only  one  of 
seven  children  so  malformed.  Her  uncle  (her  father's  brother)  had  the 
same,  and  her  paternal  grandfather  had  the  three  smaller  toes  on  each 
foot   similarly   united. 

Case  III.  Hereditary  transmissio-n  of  fingers  and  toe^a  partially 
webhed. — J.  B.,  Menstrie,  has  a  daughter  with  six  toes  on  each  foot, 
the  little  toe  and  its  neighbor  being  well  webbed;  also,  two  little 
fingers  on  each  hand  partially  adherent  by  skin.  J.  B.'s  great-grand- 
father had  the  same  number  of  toes,  and  two  little  fingers  on  the  left 
hand  also  partially  webbed.  No  other  member  of  this  fiimily  can  be 
traced   to   have  had   any   abnormal   physical   conformation. 

Case  IV.  Supernumerary  toes  and  fingers  welled. —  J.  R.,  Tilli- 
coultry, has  the  following  peculiarity  in  his  family,  viz.,  one  girl 
webbed  betwixt  the  little  toe  and  its  neighbor;  one  son  with  two 
little  fingers  on  each  hand  and  having  two  little  toes  on  each  foot. 
No  hereditary  trace  of  these  peculiarities  can  be  found  in  any  of  the 
ancestors  of  this  family,  unless  we  admit  the  account  of  the  mother 
as  the  true  cause.  She  says,  that  when  she  carried  this  boy  in  utero, 
she  met  with  an  accident  that  split  her  fingers  in  two,  so  that  it 
always   afterwards  looked  like  two   fingers. 

From  the  small  number  of  cases  now  set  forth  it  would  be  unsafe 
to  draw  any  strong  proofs,  lest  we  should  be  placed  in  the  category 
of  the  philosopher  in  Rasselas,  who  was  always  coming  to  conclu- 
sions without  anything  being  concluded.  But,  although  we  admit  that 
such  a  small  number  of  cases  is  not  proof  positive,  we  must  allow 
that  they  point  to  the  following  deductions: 


Selected  Articles^  Abstracts^  <bc.  235 

1.  That  the  male  parent  has  a  principal  share  in  the  transmission 
of  hereditary  skin  peculiarities  to  the  offspring. 

In  Case  T.,  we  have  a  grandfather,  a  father,  and  an  uncle  send- 
ing down  an  abnormal  condition  directly  through  the  male  line ; 
and  a  striking  resemblance  to  the  male  parent  belonged  to  all  those 
descendants  who  inherit  this  skin  peculiarity.  On  the  other  hand? 
we  have  a  gi'andmother  and  a  granddaughter  transmitting  the  same 
directly   to  their  children. 

In  Case  II.,  the  paternal  grandfather,  and  in  Case  III.  the  great- 
grandfather, was  the  original  progenitor,  to  whom  the  physical  mal- 
formations were  traced  back.  Leaving  out  No.  IV.  where  the  origin 
is  very  doubtful,  we  have  the  following  proportional  cases,  in  which 
the  immediate  influence  of  the  male  exceeds  that  of  the  female 
parents : 

Case  I. — Transmitted  immediately  by  male,  10,  female,  4 

II.  "  "  "       "        3,       "       1 

III  "  "  "       "         2,       '•        0 

15  5 

But   these   cases   point   to   another   interesting   deduction : 

2.  That  the  skin  peculiarity  in  all  these  cases  where  it  could 
be  traced  back,  had  its  origin  in  a  male  progenitor.  In  No.  I.,  it  came 
in  with  a  grandfather;  in  No.  II.  with  a  paternal  grandfather,  and  in 
No.  III.  with  a  greatgrandfather.  A  curious  question  here  arises:  Did 
the  influence  of  the  originator  of  this  malformation  extend  itself  through 
several  generations  who  bore  his  peculiar  characteristics  ?  Is  it  true> 
as  Dr.  Harvie  has  recently  asserted,  that  the  male  is  the  real  producer 
of  the  species?  Is  it  true  that  the  influence  of  the  male  (in  certain 
instances)   extends   beyond   the   first   impregnation  ? 

The  consideration  of  these  cases,  which  show  the  influence  of  the 
male  to  be  greater  than  that  of  the  female  parent  in  the  transmission 
of  skin  peculiarities,  led  me  to  look  at  the  history  of  certain  skin  dis- 
eases wich  are  hereditary,  and  the  following  instances  occurred  to  my 
recollection: 

Gcise  of  the  Porcupine  Family.  — The  original  porcupine  man,  Eb- 
Ward  Lambert,  had  six  children  and  two  grandsons,  with  the  same 
singular  skin  as  himself,  resembling,  it  is  said,  an  inumerable  com- 
pany of  warts,  of  dark  brown  color,  and  a  cylindrical  figure,  rising  to 
an  inch  in  height.  In  this  case,  the  disease  originating  in  a  male* 
continued  to  all  the  family  of  six,  and  descended  to  the  grand  children. 

Leprosy,  too,  seems  to  be  chiefly  derivable  from  the  male  parent. 
In  Dr.  Simpson's  curious  inquiries  into  the  history  of  leprosy,  we  find 
quoted  from  the  old  Burgh  Records  of  Glasgow  (1859),  "Robert 
Bogell,    son  to  Patrick  Bogel,"   both   lepers  in  that  city. 


236  The  Peninsular  and  Independent. 

The  modern  experience  of  this  malady  in  Norway,  where  it  has  go 
unaccountably  increased  of  late  jears,  has  led  to  serious  inquiry  how 
it  is  to  be  prevented.  Leprosy,  or  the  spedalkshed,  is  held  by  Drs. 
Broek  and  Danielson  to  be  purely  hereditary  ;  and  so  strong  is  the 
opinion  of  the  male  being  the  chief  propagator,  that  the  proposal 
has  not  only  been  laid  before  the  Strothing,  or  Norwegian  Parliament, 
to  prohibit  the  marriage  of  a  leper,  but  it  has  been  a  topic  of  public 
and  professional  discussion,  how  far  it  would  be  just  to  deprive  the 
male  infants  of  leprous  parents  of  the  power  of  propagation.  Ligature 
of  the  vasa  deferentia,  we  learn  has  been  seriously  contemplated  as  a 
national  measure. 

The  analogy  of  the  lower  animals  confirm  these  views  of  the  para- 
mount iniiuence  of  the  male  in  transmitting  generally  the  character  of 
the  skin  to  the  progeny.  The  spawn  of  the  salmon  being  impregnated 
with  the  male  trout,  the  skin  and  the  spots  upon  it  showed  the  charac- 
ter of  the  trout,  and  vice  versa,  the  salmon  being  the  male.  With 
birds,  generally,  the  outer  textures  follow  the  male.  With  quadrupeds, 
the  same  rule  holds.  An  intelligent  and  experienced  sheep  farmer  in' 
forms  me  that  it  is  the  practice  to  cross  the  blackfaced  sheep  on  the 
Ochils  with  the  Leicester  ram.  The  Ochil  ewes  are  blackfaced,  and 
have  horns.  The  Leicester  ram  is  not  blackfaced  and  has  no  horns. 
The  breed  follow  the  Leicester  ram,  whitefaced,  and  in  the  proportion 
of  about  86  per  cent,  have  no  horns.  A  few  years  ago,  on  the  estate 
of  Ava,  there  was  a  black  ram  with  five  horns,  two  on  either  side  and 
one  on  the  center.  The  breed  by  the  common  white  ewe  took  the  ab- 
normal character  of  the  ram,  white  a  few  exceptions.  We  know  also 
that  the  products  of  the  male  ass  by  the  mare,  and  of  the  stallion  by 
she  ass,  can  be  distinguished  by  the  skin,  having  the  distinctive  char- 
acteristics of  the  sire. 

Numerous  examples  of  this  law  must  be  well  know  to  cattle  dealers, 
and  this  subject  is  admirably  treated  by  Mr.  Okton,  of  Southerland,  in 
his  ingenious  papers  "On  the  Physiology  of  Breeding." 

We  may  safely,  I  think,  conclude  from  facts  before  us: 

L  That  in  the  lower  animals,  and  in  man  also,  the  influence  of  the 
male  is  greater  than  that  of  the  female  parent  in  the  transmission  of 
the  skin  texture  to  the  progeny. 

IL  That  the  exceptional  cases  (probably  more  in  man  than  the  lower 
animals)  lead  us  to  look  for  some  primary  or  secondary  law  presiding 
over  the  physiology  of  generation. 

I  intend  to  continue  this  inquiry  as  to  the  influence  of  the  male 
on  the  other  textures  and  organs  of  the  body,  in  a  series  of  cases  and 
notes. 


Selected  Articles^  Abstracts^  <jbc.  237 


ON  THE  OTORRHCEA  OF  YOUNG  CHILDREN. 

Otorrhcea,  or  a  discharge  or  running  from  the  ear,  consists  in 
very  many  cases  of  merely  a  chronic  inflammation  of  the  external 
passage  of  the  ear,  which  has  given  rise  to  an  increased  secretion. 
The  inflammation  is  usually  confined  to  the  external  portion  of  the 
meatus,  but  sometimes  extends  to  the  surface  of  the  membrane  of 
the  tympanum.  The  disease  is  most  frequently  observed  in  children, 
although  it  is  not  rare  in  adults.  In  the  former,  it  is  generally 
accompanied  by  a  tendency  to  glandular  engorgements,  with  symptoms 
of  general  debility ;  in  adults,  it  is  also  the  sign  of  a  depressed  con- 
dition of  health.  The  exciting  cause  may  be  a  blow  upon  the  ear,  the 
employment  of  irritating  local  applications  to  the  ear,  or  any  acute 
inflammation  of  the  lining  membrane  of  the  meatus;  but  the  most 
frequent  causes  are  scarlet  fever,  measles,  or  catarrhs.  Often  no  cause 
can  be  discovered ;  the  children  complain  of  a  slight  irritation  in  the 
ear,  which  they  seek  to  allay  by  introducing  the  finger,  or  a  little 
stick,  and  the  irritation  disappears  when  the  discharge  begins.  Some- 
times, however,  the  discharge  is  the  first  symptom  of  the  disease. 
In  the  early  stages,  the  hearing  is  only  slightly  diminished  by  the 
disease,  even  when  the  inflammation  and  swelling  extend  to  the  ex- 
ternal surface  of  the  membrane  of  the  tympanum;  but  when  the 
disease  has  existed  for  any  length  of  time,  the  membrane  itself 
participates  in  it,  and  dulness  of  hearing,  or  deafness,  ensues.  More- 
over, it  must  be  borne  in  mind  that  catarrh  of  the  meatus  and  ex- 
ternal surface  of  the  tympanum  is  often  but  a  symptom  of  irritation 
icithin  the  tymjmnum,  and  ceases  as  soon  as  this  irritation  is  re- 
moved. After  the  disease  has  existed  some  time,  there  is  often 
considerable  irritation  of  the  meatus,  amounting  at  times  to  acute 
pain,  with  occasionally  slight  haemorrhage.  E hemorrhage  is  more 
frequent,    however,    when  there   is   a   polypus   in  the   meatus. 

On  examination  of  the  meatus,  its  lining  membrane  is  found  to 
be  thicker  than  usual,  and  sometimes  so  much  so  as  to  close  the 
passage  entirely.  In  many  cases  the  membrane  is  red  and  destitute 
of  epithelium ;  on  the  other  hand,  it  is  frequently  white,  and  covered 
with  a  thick  epithelial  layer.  The  secretion  is  generally  very  foetid, 
of  various  colors,  sometimes  of  a  milk-white,  at  others  of  a  dark  slate 
color,  and  whatever  its  quantity,  color,  or  consistence,  it  never  con- 
tains flocculi,    but   when   mixed   with    w^ater,   renders   it   cloudy. 

It  need  hardly  be  said  that  polj^pus  sometimes  exists  along  with 
chronic  catarrh  of  meatus.  In  such  cases  there  is  bleeding  from  the 
ear,  and  flocculi  are  found  in  the  secretion.  The  latter  are  also 
found  when  there  is  ulceration  of  the  fibrous  tissue  of  the  mem- 
brana   tympani,    in    which    case   blood    is   very   often   mixed   with  the 


238  TJie  Peninsular  and  Tndejwndent. 

secretion.  If  the  catarrhal  inflammation  extends  to  the  mucous  mem- 
brane of  the  membrana,  the  latter  becomes,  like  the  meatus,  thickened, 
and  often  very  much  congested.  The  membrane  then  loses  its  natural 
color  and  form;  if  we  are  able  to  employ  a  speculum,  the  outer 
surface  is  seen  to  be  flatter  than  usual ;  and,  in  consequence  of  its 
thickening,  neither  the  long  nor  the  short  process  of  the  stapes  is 
visible. 

In  the  treatment  of  catarrhal  otorrhoea,  it  is  of  the  first  impor- 
tance to  remove  the  secretion,  and  keep  the  meatus  clean.  This  is 
best  done  by  frequent  syringing  with  lukewarm  water.  If  there  be 
so  much  pain  or  tenderness  that  the  syringe  can  not  be  used,  one 
or  two  leeches  must  be  applied  to  the  outer  edge  of  the  meatus, 
followed  by  warm  fomentations  or  poultices,  or  the  vapor  of  warm 
water  may  by  directed  upon  the  ear.  After  all  tenderness  is  remo- 
ved, and  the  meatus  cleansed  from  the  secretion,  weak  astringent 
solutions  should  be  injected,  and  moderate  counter-irritation  applied 
to  the  mastoid  process.  These  simple  means,  in  connection  with  re- 
medies for  improving  the  general  health,  especially  tonics,  suffice,  in 
very  many  cases,  for  curing  the  discharge.  In  ver}'  obstinate  cases 
the  counter-irritation  to  the  mastoid  process  must  be  maintained,  so 
as  to  keep  up  an  artificial  discharge,  which  is  best  done  by  means 
of  croton  oil;  and  a  strong  solution  of  nitrate  of  silver  (ten  to  forty 
grains  to  the  ounce)  should  be  thrown  into  the  meatus  every  third 
day,   by   means  of  a   glass   syringe. 

There  are  cases,  however,  which  resist  this  treatment,  the  dis- 
charge continuing  unchanged  for  two  or  three  months.  The  treat- 
ment should  then  be  steadily  persevered  in,  as  it  may  at  least  pre- 
vent ulceration  of  the  membrane  of  the  tympanum,  caries  of  the 
bones,    and   the  development  of  polypi. 

[Translated  for  the  Boston  Med.  and  Surg.  Joiirna',  from  the  Juur.  fur  Kinderkrankheiten. 


ADHESIVE    PLASTER     IN  MAINTAINING    EXTENSION    AND   COUNTER - 
EXTENSION  IN  OBLIQUE   FRACTURES   OF    LOWER   EXTREMITEIS. 

From  the  illustrations  of  practice  in  the  Maj^  23d  No.  of  the 
Med.  S  Surg.  Ecimrter.,  we  learn  that  Desault's  splint,  as  modified 
by  Physick  and  HuTcniNSON,  is  still  preferred  by  the  surgeons  of  the 
Pennsylvania  Hospital  in  cases  of  fracture  of  the  thigh  bone ;  also, 
that  in  place  of  the  old  fashioned  gaiter,  etc.,  extension  is  effected 
as  follows : 

One  extremity  of  a  long  strip  of  adhesive  plaster,  two  inches 
wide,  is  attached  to  one  side  of  the  wounded  limb,  just  below  the  frac- 
ture; the  sti-ip  is  then  brought  down  to  the  foot,  care  being  taken  that 
the  plaster  is  firmly,  smoothly,  and  evenly  applied  to  the  limb;  in  its 
progress    downwards   the  loop   below    the  foot   is  made  by  the  strip  of 


Selected  Articles^  Abstracts^  dc.  239 

plaster  as  it  is  conducted  from  one  side  of  the  limb  to  be  similarly  applied 
to  the  other.  To  take  off  pressure  from  the  malleoli,  a  block  of  wood  of 
sufficient  size  is  placed  in  the  loop,  and  to  this  extending  bands  at- 
tached;  the  descending  and  ascending  strip  of  plaster  is  more  securely 
fastened  to  the  limb  by  a  few  strips  of  plaster  circularly  applied  to 
the  leg. 

Counter-extension  is  made  by  a  land  which  is  put  around  the  groin 
and  the  ends  fastened  to  the  top  of  the  splint. 

Dr.  Neill,  the  clinical  surgeon. 

Observed  that  the  great  secret  of  success  in  treating  fractures 
was  attending  to  the  skin ;  and  that  not  merely  the  proper  applica- 
tion of  dressings  was  necessary,  but  their  maintenance  in  proper  po- 
sition.    They  should  be   constantly   watched  and   re-applied. 

This  direction  may  by  complied  with  in  the  hospitals,  where 
skillful  attendants  are  always  at  hand,  but  in  private,  and  especially 
in  country,  practice,  a  method  of  steadily  maintaining  counter-exten- 
sion, simple  in  application,  comfortable  to  the  patient,  and  not  liable 
to   constant   derangement  is   still   regarded   as  a  desideratum. 

It  is  several  3^ears  since  Dr.  Gilbert  proposed  what  he  regarded 
as  such  a  method ;  and  we  notice  that  continued  experience,  support- 
ed by  that  of  other  respectable  practitioners,  has  strengthened  his 
original  views  of  its  superiority  over  all  other  modes  of  effecting 
counter-extension.  AYe  are  therefore  disappointed  at  finding  no  refer- 
ence to  his  plan   in  the  reports   of  hospital   practice. 

His  method  is  simply  to  substitute  for  the  ordinary  unadherent 
*'  band  around  the  groin"  —  which  is  always  liable  to  produce  more 
or  less  friction  and  ultimate  excoriation  —  a  strip  of  ahhesive  plaster 
similarly  applied,  attached  to  the  splint,  and  supported  by  one  or 
more   circular   strips   above   the   pelvis. 

Believing  that  Dr.  Gilbert's  process  is  not  generally  known,  we 
will   refer,   more  minutely,    to  his  interestin  g  paper   hereafter. 


BALSAM  COPAIBA  IN  PSORIASIS. 

At  the  Hospital  of  St.  Louis,  M.  Hardy  has  experimented  with 
Balsam  Copaiba  in  the  treatment  of  psoriasis.  Cases  not  materially 
beneSted  by  arsenic  and  the  ordinary  local  treatment,  jaelded  to  the 
internal  administration  of  the  balsam,  in  doses  gradually  increased  from 
three-fourths  of  a  drachm  to  two  drachms,  repeated  before  meals 
daily.  At  the  same  time,  the  usual  local  adjuvants  M-ere  applied 
with  advantage  in   cases   of  unusual   obstinacy.  y^'' 

TREATMENT  OF  HOOPING-OOUG  H  BY  DILUTED  NITRIC  ACID. 

Diluted  nitric  acid,  originally  recommended  in  pertussis  by  Dr. 
Arnold,   of   Montreal,    is    extolled   by    Dr.    Atceerly,   in   the   British 


240  The  Peninsular  and  Independent. 

Medical  Times  and  Gazette^  as  an  efficient  remedy  to  abbreviate  the 
ordinary  term  of  hooping-cough.  lie  prescribes  the  dihited  acid  in 
doses  of  five  minums  for  a  child  six  months  old,  every  third  hour, 
and  increases  the  doses  in  proportion  to  the  severity  of  tlie  symptoms 
to  fifteen  minums  every  second  hour.  The  dilute  acid  is  mixed  with 
compound  tinct.  of  cardamums,  syrup,  and  water,  which  renders  it 
quite   palatable.     In   conclusion  he  remarks : 

"In  conjunction  with  the  above  treatment,  I  have  invariably  employd 
a  stimulating  embrocation  to  the  back  and  chest,  night  and  morning, 
consisting  of  one  ounce  of  camphor  liniment,  and  two  drachms  of  spirits 
of  turpentine.  I  have  also  seen  great  benefit  from  the  inhalation  of  the 
fumes  of  burning  nitre-paper  :  two  pieces,  of  about  four  inches  square,  are 
burnt  in  the  bedroom,  on  retiring  to  rest,  and  one  piece  burnt  occasionally 
in  the  room  occupied  by  the  child  in  the  day  time,  appears  to  shorten 
the  paroxysm,  and  to  deprive  it,  in  a  great  measure,  of  its  spasmodic  cha- 
racter, rendering  it  more  like  the  cough  of  common  catarrh. 


THE  ORACLE  FAIRLY  COMMITTED. 

Skoda  —  the  greatest  of  non-commital  medical  skeptics  in  Europe  — 
has  ventured  to  express  a  decided  opinion,  as  appears  by  the  following 
translation : 

PhthiHis  —  STioda.  —  In  iXxaWiener  Medical  Zeit.  this  world-renowned 
practitioner  particulaily  refers  to  the  importance  of  vinous  and  malt  liquors 
in  consumption.  They  afibrd  one  of  the  most  eflicacious  means  of  arrest- 
ing the  diarrhoea  which  so  often  debilitates  the  patient,  give  a  tone  to  the 
digestive  organs,  and  furnish  an  agreeable  way  of  generally  stimulating 
the  system. 

In  chronic   tuberculosis,    with  or    without  accompanying  diarrhoea, 
Skoda  regards  wine  or  beer  as  more  valuable  than  quinia  or  opium. 

[Mei.  <5*  Surg.  Reporter  —  trans,  by  J.  A.  Demmk,  M.  D. 


MORPHIA  AND  CARBONATE  OF  SODA  FOR  RETENTION  OF  URINE. 

After  several  unsuccessful  eftbrts  to  pass  a  catheter  in  the  case  of  a 
patient  laboring  under  retention  of  urine,  and  the  failure  of  ordinary 
doses  of  laudanum,  enemas,  warm-baths,  etc.,  Mr.  \yHEEDEN  Cooke, 
surgeon  in  charge  of  the  Royal  Free  Hospital,  of  which  the  patient 
was   an  inmate,    ordered   the  following  prescription: 

One  grain  of  muriate  of  morphia,  with  a  drachm  of  sesquicarbonate, 
of  soda  every  two  hours.  In  the  course  of  the  night  the  patient  passed 
about  four  ounces  of  urine,  and  the  following  afternoon  the  bladder  was 
fully  relieved.  He  had  taken  seven  grains  of  morphia,  and  seven  drachms 
of  soda,  before  sufiicient  relief  could  be  obtained.     He  is  now  doing  well. 

[Lancet,  April  30, 1859. 


Selected  Articles^  Abstracts^  dbc.  241 

PERCHLORIDE  OF  IRON  IN  IN-GROWING  NAIL. 

After  fomentation,  Dr.  Alcantara  interposes  beneath  the  nail  a 
small  piece  of  lint,  upon  which  some  ointment  of  perchloride  of  iron 
has  been  spread.  All  the  surface  of  the  excrescence,  deprived  of  its 
epidermis,  is  covered  over  with  this,  and  the  dressing  renewed  twice 
a  day.  At  the  end  of  four  days,  the  excrescence  becomes  dry,  and 
is  easily  detached.  The  wound  then  assumes  a  healing  aspect,  and 
the   cure   is   completed  at   the  end  of  a   week. 

[  Union  Medicate. 
BISMUTH  SNUFF  IN  CORYZA. 

Mr.  MoNNEKET,  we  are  told  in  the  Recue  de  Therapeutique^  has 
established  the  services  of  subnitrate  of  bismuth  in  coryza ;  and  Dr. 
SoBHiER  lias  lately  shown  that  by  the  addition  of  iodide  of  sulphur 
to  it,  a  cure  for  chronic  coryza  is  obtained.  The  following  is  his 
formula: — Subnitrate  of  bismuth,  4  parts;  liquorice  powder,  8  parts; 
iodide  of  sulphur,  80  parts.  Of  this  compound  the  patient  is  to  take 
ten   or  twelve   pinches   in   the   day,  according   to  their   effect. 

[Med.    Tirites  and  Gaz.  April,  1859. 
SUPPRESSION  OF  ILLEGAL  PRACTICE  IN  PARIS. 

The  twelve  different  districts  of  the  French  capital  have  almost 
each  a  medical  society.  That  of  the  second  district  has  lately  decided 
that  all  the  societies  shall  be  requested  to  act  in  concert,  with  a  view 
to  suppressing  illegal  practice,  in  imitation  of  the  societies  of  Blois 
and  Lyons,  where  prosecutions  of  this  kind  have  been  highly  successful. 


THE  PHYSIOLOGY  AND  PATHOLOGY  OF  THE  THYMUS  GLAND. 

A  valuable  contribution  to  our  knowledge  u|)on  the  above  subject  has 
been  made  by  Dr.  Alex.  Friedleben. 

After  years  of  patient  and  toilsome  labor,  he  has  presented  to  the 
profession  a  most  concise  and  complete  essay  upon  this  obscure  subject. 

We  condense  the  following: 

Development  of  the  2'hymus. — At  the  very  beginning,  the  thymus 
appears  as  a  very  narrow  strip  of  blastema,  a  remnant  of  the  blastodermic 
membrane,  lying  along  the  carotid  vessels;  this  is  about  the  fifth  or  sixth 
week.  Between  the  sixth  and  eighth  week,  small  vesicles  bud  out  on 
every  side.  The  attachment  becoming  more  and  more  contracted,  until  a 
little  cellular  tissue  is  all  that  connects  each  vesicle  with  the  primitive 
strip,  now  membrane  —  this  cellular  tissue  serving  merely  as  a  connecting 
hand;  there  is  no  tubular  arrangement.  The  vesicles  increase  by  branch- 
ing into  twos  and  fours.  Every  vesicle  or  cell  is  a  distinct.,  independent 
unit. 

Vol.  II.  —  Q. 


242  The  Peninsular  and  Independent. 

From  the  time  of  the  first  appearance  in  the  embryo,  the  thymus  in- 
creases in  length.  This  increase  is  more  marked  after  birth  than  during 
embryonic  and  foetal  life.  After  the  twenty-fifth  year,  the  length  decreases 
until  the  gland  is  entirely  absorbed. 

The  absolute  weight  of  the  thymus  increases  until  the  end  of  the 
second  year,  then  remains  stationary  until  puberty ;  and  between  fifteen 
and  twenty-five  years  of  age  it  gradually  decreases,  and  after  twenty-five  a 
very  rapid  diminution  takes  place. 

The  specific  weight  is  greater  during  the  embryonic  state  —  decreases 
until  the  time  of  birth,  then  steadily  increases  until  the  end  of  the  second 
year,  after  which  it  again  diminishes. 

This  is  the  reverse  of  what  takes  place  in  the  liver  and  spleen. 

Secretion — Most  active  at  the  end  of  the  first  year  of  life ;  still  con- 
siderable during  the  second  year,  and  continues  lessening  from  day  to  day, 
until  puberty,  when  it  is  almost  suspended.  The  secretion  of  the  thymus 
consists  of  a  liquid,  crowded  with  granules,  and  presenting  all  the  appear- 
ances of  a  nutritive  fluid:  it  gives  an  acid  reaction.  This  fluid  he  has  also 
found  in  the  vena  thymica,  but  not  in  the  lymphatics. 

The  quantitive  analysis  of  the  gland  give  the  interesting  result  that 
after  the  embryonic  state,  the  earthly  phosphates  predominate,  until  the 
time  of  the  thymus  involution,  when  the  alkaline  phosphates  are  in  excess. 
This  is  particularly  interesting,  inasmuch  as  the  reverse  obtains  in  most 
of  the  other  organs. 

[From  the  German^  by  T.  A.  Bcmmc,  M.  D.     Translated  in  Medical  and  Surg.  Reporter. 


On  the  Physiological  Position  of  Fibrin. 


By    Levix    S.   Joynes,  M.  D., 
Professor   of  Institutes   of  Medicine  in  the  Medical   College  of  Virginia. 


The  mutability  of  medical  doctrines  has  become  a  by -word,  and, 
with  those  who  judge  harshly,  a  reproach.  An  old  French  medical 
writer,  Bordeu,  compared  the  human  mind  in  the  pursuit  of  scientific 
truth,  to  a  drunken  man  on  horseback,  who  inclines  first  to  one  side, 
and,  in  endeavoring  to  recover  himself,  is  sure  to  swing  as  far  over 
to  the  other;  so  that  he  finds  it  impossible  to  sit  straight  up  in  his 
saddle. 

In  no  department  of  our  science  has  the  multiplicity  of  opinions 
and  the  ceaseless  tendency  to  revolution  been  so  conspicuous  as  in  phy- 
siology. This  is  due  in  a  chief  degree  to  the  inherent  diflBculties 
and  obscurities  of  the  subject  it  embraces.  Where  facts  are  imperfectly 
understood,  they  may  admit  of  several  different  explanations,  one  or 
other    of  which    will    prevail    according    to    the  preconceived   ideas   of 


Selected  Articles^  Abstracts^  €&c.  243 

inquirers;  or,  an  accepted  doctrine  may  be  overturned  by  the  dis- 
covery of  new  facts,  which  are  found  to  be  irreconcilable  with  it. 
Besides  which,  the  surpassing  interest  which  invests  the  operations  of 
the  living  organism,  too  often  tempts  the  physiologist  to  the  exercise 
of  the  inventive  faculty  in  the  solution  of  the  problems  which  present 
themselves ;  and  thus  he  assumes  facts,  which  afterwards  turn  out  to 
be  false:  nor  can  it  be  denied  that  a  natural  instability  of  mind,  and 
an  innate  passion  for  novelty,  on  the  part  of  the  "interpreter  of 
nature,"  has  now  and  then  given  birth  to  a  new  theory.  We  can 
only  lament,  but  can  not  remedy,  the  changeful  aspect  of  the  science, 
until  the  arrival  of  the  long  distant  period,  when  we  shall  see  all 
things  clearly   in  the  full   light  of  positive  knowledge. 

A'^ong  the  many  unsettled  questions  which  are  at  this  time 
attracting  attention  and  inviting  discussion,  is  that  which  I  have 
chosen  as  the  subject  of  this  essay.  A  few  years  ago,  it  is  true,  no 
chapter  of  doctrine  seemed  better  established  than  that  which  relates 
to  the  physiological  relations  of  the  animal  principle  which  we  term 
Jibrin — its  origin,  uses,  and  destination  in  the  economy.  But  for  some 
time  past  there  have  been  indications  in  various  quarters,  of  a  grow- 
ing revolution  of  opinion  on  this  subject,  which,  in  a  theoretical 
aspect  at  least,  is  of  fundamental  importance  both  in  physiology  and 
pathology,  and  it  may  not  be  uninteresting  to  inquire  into  the  sufficiency 
of  the  grounds  on  which  it  is  sought  to  justify  the  change  of  faith. 

A  peculiar  interest  has  always  attached  to  the  substance  in  question, 
by  reason  of  the  remarkable  phenomena  in  which  it  takes  a  leading 
share.  The  coagulation  of  the  blood  is  entirely  due  to  its  agency.  Though 
held  in  perfect  solution  so  long  as  the  blood  is  flowing  in  the  living 
vessels,  no  sooner  is  this  fluid  withdrawn  from  the  body,  than  the  fibrin 
(in  the  exercise  of  a  property  which  is  inherent  in  it,  and  distinguishes 
it  from  all  other  animal  principles)  passes  spontaneously  to  the  solid 
state.  Its  particles  concrete  in  the  form  of  innumerable  delicate  fila- 
ments or  "  fibrils "  —  and  these,  by  crossing  and  interlacing  with  each 
other  in  a  thousand  different  directions,  form  a  close  net  -  work,  in  which 
the  red  and  white  corpuscles  are  entangled  and  held  fast:  and  thus  it 
is  that  the  fibrin  is  the  active  agent  in  the  coagulation  of  the  blood ;  and 
though  its  proportion  in  the  fluid  amounts  to  no  more  than  two  or  three 
parts  in  1,000,  it  holds  in  its  grasp  the  red  corpuscles,  whose  norma 
proportion  is  from  125  to  140  parts.  Next,  the  fibrinous  net -work  slowly 
contracts  and  presses  out  the  yellow  serum,  which  soon  surrounds  the 
clot  and  bathes  its  surface.  In  the  l)uffy  coat  of  inflammatory  blood, 
we   have  an  example  of  nearly   pure  fibrin. 

The  same  principle  is  also  an  ingredient  of  the  chyle  and  the 
lymph  —  the  proportion,  however,  being  less  than  in  the  blood;  but  it 
is  not  normally  found  in  any  of  the  secreted  fluids^  whether  those  of  the 


244  The  Peninsular  and  Independent. 

excrementitious  class,    or  those  destined    to   some   special   office    in    the 
economy. 

In  disease,  it  not  unfrequently  escapes  from  the  circulating  fluid, 
especially  in  acute  inflammations — being  a  constant  ingredient  of  that 
"coagulable  lymph"  which  is  so  often  poured  out  either  into  the  paren- 
chyma of  organs,  or  upon  their  membraneous  surfaces.  The  tendency 
to  such  exudations  is  accompanied  by  an  increased  proportion  of  fibrin 
in  the  blood,  which  is  as  invariable  an  attendant  of  inflammation  as  the 
vascular  engorgement  which  belongs  to  it. 

A  plastic  fluid  of  analogous  constitution  is  the  material  employed 
by  nature  in  the  reparation  of  injuries,  whether  wounds  of  soft  partb, 
or  fractures  of  bone;  and  in  both  kinds  of  exudation,  the  fibrin  mani- 
fests the  same  tendency  to  spontaneous  coagulation,  and  after  the  same 
manner,  as  in  the  blood. 

It  does  not  appear  that  fibrin  enters  into  the  composition  of  any  of 
the  living  tissues.  Formerly,  indeed,  it  was  universally  regarded  as  the 
chief  constituent  of  the  muscular  fibre ;  but  according  to  the  view  of 
the  leading  physiological  chemists  of  the  present  day,  the  substance  of 
muscle  consists  of  a  peculiar  principle  (named  syntonine  by  Ledmann, 
muscuUne  by  Robin  and  Vekdeil),  which  diff'ers  from  fibrin  in  some  well- 
marked  particulars,  corresponding  rather  with  albumen,  with  which  it  ij. 
said  to  be  quite  identical  in  composition. 

It  would  be  foreign  to  my  present  purpose  to  describe  in  detail  the 
physical  properties  and  chemical  characters  of  fibrin.  As  to  the  former, 
if  any  one  will  take  the  trouble  to  examine  the  huffy  coat  of  inflamma- 
tory blood,  or  to  stir  any  specimen  of  fresh  drawn  blood  with  a  sticky 
and  wash  the  clot  which  adheres  to  it,  to  remove  the  red  coloring  matter, 
he  will  obtain  a  better  idea  than  can  be  conveyed  by  any  verbal  de- 
scription; and  if  he  will  take  a  thin  film  of  the  white,  fibrous -looking 
elastic  substance  thus  obtained,  and  examine  it  carefully  with  a  good 
microscope,  he  will  readily  distinguish  the  filamentous  aiTangement  which 
fibrin  assumes  in  its  coagulation. 

In  chemical  characters,  its  close  relations  to  those  other  "protein 
compounds,"  albumen  and  casein,  are  admitted  by  all  chemists,  notwith- 
standing the  remarkable  differences  in  the  conditions  and  mode  of  their 
coagulation  —  neither  of  these  kindred  principles  exhibiting  any  tendency 
to  spontaneous  coagulation,  though  this  change  is  readily  induced  by 
chemical  agents.  In  neither  case,  however,  does  the  coagulum  present 
a  definite  arrangement  of  its  particles,  like  that  of  fibrin. 

As  it  respects  their  composition,  it  is  suflBcient  to  examine  the 
analyses  made  by  various  chemists  of  late  years,  to  be  satisfied  how 
near  is  their  resemblance.  It  appears  singular  indeed  that  two  ingredi- 
ents of  the  blood,  so  different  in  the  particular  just  referred  to  as  are 
albumen  and  fibrin,  should  be  so  nearly  identical  in  composition.     Socr^ 


Selected  Articles ^  Abstracts^  <&c.  245 

analyses,  it  is  true,  give  a  somewhat  larger  proportion  of  oxygen  for 
Sibrin;  and  great  importance  has  been  attached  to  this  dirTerence:  but, 
if  it  exist  at  all,  it  is  very  trifling.  In  the  comparative  analyses  given 
by  LiEBiG  in  his  Letters  on  Chemistry,  which  Robin  and  Verdeil  con- 
sider the  most  trustworthy,  no  such  excess  of  oxygen  appears,  but  the 
reverse — the  numbers  being,  for  albumen,  22*54  per  cent. ;  for  fibrin 
21-7. 

There  is  little  doubt  that  the  two  bodies  may  be  converted  into 
each  other  by  the  processes  of  vital  chemistry  —  fibrin,  when  taken  into 
the  stomach,  being  transformed  into  albumen  by  digestion,  and  so  ab- 
sorbed; and  albumen,  in  its  turn,  being  continually  transformed  into 
fibrin  in  the  chyle  and  blood.  There  is  every  reason,  indeed,  for  the 
belief  that  such  is  the  source  of  all  the  fibrin  which  the  blood  contains. 
This,  however,  is  rather  prejudging  a  point  in  controversy. 

The  views  heretofore  generally  current  in  reference  to  the  offices  of 
fibrin  in  the  economy,  assigned  to  it  the  highest  place  among  all  the 
proximate  principles.  It  was  regarded  as  an  organizible  compound — as 
the  organizable  principle  |?a7'  excellence  —  the  immediate  nourisher  of  the 
living  tissues  —  the  form  through  which  the  albumen  of  the  blood  (which 
so  largely  exceeds  it  in  amount)  must  pass  before  accomplishing  its  work 
of  nutrition.  It  is  to  this  end  that  fibrin  is  being  continually  elaborated 
out  of  the  kindred  compound,  in  the  blood,  the  chyle  and  the  lymph,  as 
they  flow  in  their  vessels.  Fibrin,  it  was  said,  is  not  a  mere  chemical 
compound^  like  albumen  or  gelatin,  but  already  half-vitalized^  and  en- 
dowed with  an  inherent  tendency  to  organization  —  this  being  manifested 
by  its  passing  spontaneonsly  to  the  solid  form,  by  the  regular  arrange- 
ment or  structure  which  its  particles  then  assume  (reminding  one  some- 
what of  an  organized  fibrous  tissue)  —  and  by  its  invariable  presence 
and  agency  in  those  plastic  exudations  which  become  organized  into 
false  membranes,  and  form  the  medium  of  the  healing  process.  Its 
supposed  presence  in  the  muscular  fibre,  as  the  basis  of  its  composition, 
was  also  appealed  to  as  a  fact  of  much  significance. 

Of  late  years,  however,  various  considerations  have  been  adduced, 
tending  to  invalidate  this  attractive  theory,  and  to  establish  in  its  place 
one  which  is  more  or  less  completely  the  reverse  of  it.  Among  the  par- 
tisans of  this  new  view,  may  be  mentioned  the  names  of  Zimmerman, 
John  Simon,  Handfield  Jones,  Brown -Sequard,  Bernard,  and  Rokitan- 
SKY,  whose  authority  in  the  world  of  science  certainly  entitles  it  to  a 
candid  and  deliberate  examination. 

Fibrin,  it  is  maintained,  so  far  from  being  a  peculiarly  organizable 
or  plastic  material,  and  the  immediate  pabulum  of  the  most  highly- vital- 
ized tissues,  is,  in  reality,  an  excrementitious  compound^  not  at  all  avail- 
able for  nutrition,  and  to  be  reckoned  "among  those  elements  which  have 
■arisen  in  the  blood  from  its  own  decay,  or  have  reverted  to  it  from  the 


246  The  Peninsular  and  Independent. 

waste  of  the  tissues,"  and  are  in  process  of  elimination  from  the  system. 
{Simon^s  General  Pathology^  p.  44.)  Rokitansky  speaks  of  it  as  "  an 
excretory  formation  —  a  substance  brought  by  oxidation  nigh  to  the 
state  of  disintegration — an  albuminous  matter  consumed  by  oxidation,'^ 
&c.,  &c. 

All  idea  of  vitality  as  appertaining  to  fibrin,  is  of  course  repudiated, 
and  its  coagulation  is  regarded  as  a  mere  physical  consolidation,  or  a  pre- 
cipitation from  solution,  induced  by  external  conditions,  and  no  more 
vital  than  the  coagulation  which  we  cause  in  an  egg  by  boiling  it,  or  in 
milk  by  the  addition  of  an  acid. 

Fibrin  being  deposed  from  its  high  oflBce,  it  is  of  course  albumen 
that  takes  its  place  as  the  great  plastic  and  tissue -forming  element  of 
the  blood. 

Some,  however,  modify  this  view  so  far  as  to  admit  that  fibrin  is  ca- 
pable of  a  certain  degree  of  organization,  but  of  a  very  low  kind,  never 
rising  above  the  grade  of  the  white  fibrous  or  the  areolar  tissue.  It  is 
completely  foreign  to  the  nutrition  of  the  higher  tissues,  such  as  the 
muscular  and  the  nervous. 

[To  be  concluded  in  (he  August  No.] 


lErmat^tttital  Jeprtment. 


Fluid  Extract  of  Yarrow. 

A  new  therapeutical  use  for  Yarrow  (Achillea  millefolia)  having 
been  noted  in  our  last  No.,  we  here  insert  a  formula  for  a  fluid 
extract,  which  we  take  from  the  Journal  of  Maryland  College  of 
Pharmacy : 

Take  of  Yarrow  (the  recently  dried  herb)  in  coarse  powder  eight 
ounces  (officinal),  alcohol  diluted  (two  parts  95  per  cent,  alcohol  and  one 
part  water)  a  sufficient  quantity.  Pour  over  the  powdered  herb  four 
ounces  of  the  diluted  alcohol,  and  work  through  with  the  hands  until 
thoroughly  moistened ;  allow  it  to  stand  in  a  covered  jar  for  24  hours. 
Pack  closely  in  a  funnel  or  other  displacer,  and  proceed  to  displace,  until 
twenty-four  fluid  ounces  are  obtained,  which,  if  performed  with  proper 
care,  will  exhaust  the  herb,  as  tested  by  tasting  the  droppings.  The 
resulting  liquid  should  be  exposed  in  a  shallow  dish  (in  summer  to  a  draft 
of  air  under  an  open  window,  in  winter  on  a  shelf  near  the  top  of  the 
room),  and  allowed  to  evaporate  spontaneously  until  it  measures  sixteen 
fluid  ounces.  Thirty  or  forty  grains  bi-carb.  potassa  in  powder  may  then 
be  added,  which  retains  the  extractive  in  solution  and  clears  the  liquid, 
without  interfering  with  its  properties. 

The  evaporation  of  this  fluid  extract  may  be  continued,  if  desired, 
with  a  very  gentle  heat  (in  a  water-bath),  until  reduced  to  the  consistence 
of  an  ordinary  extract.  The  result  in  either  case,  fluid  or  solid,  possesses 
in  a  marked  degree  the  sensible  and  other  properties  of  the  herb,  each 
teaspoonful  representing  30  grains  of  the  herb. 

As  Yarrow  possesses  tonic,  astringent,  and  expectorant  powers,  in 
addition  to  those  noted  in  our  last,  it  is  probable  that  its  use  will  be- 
come more   extended  as   its   merits   are   known. 


Goulard's  Cerate  substituted  by  a  Glycerole  of  Lead. 

Draylit  (Why  not  Daylight?)  proposes  (Journal  of  Maryland 
College  of  Pharmacy)  the  following  glycerole  as  a  substitute  for 
Goulard's   Cerate.     He  says : 

This  cerate,  as  is  well  known,  becomes  speedily  rancid,  and  in  that 
state   is   more  irritating  than   soothing  to  inflamed  surfaces.     The  sub- 


248  The  Peninsular  and  Independent. 

stitute  does  not  change,  is  easily  washed  oflf  with  water,  and  can  be 
reduced  to  any  desired  extent,  for  the  purposes  of  a  wash,  with  rose  or 
distilled  water. 

Take  of  Pure  Glycerin 13ioz.  (fluid). 

Solution  of  Sub-acetate  of  Lead          .          .      2^oz.        " 
Camphor \  drachm. 

Triturate  the  camphor  into  powder  with  a  few  drops  of  alcohol ;  add 
the  glycerin;  heat  in  a  water  bath  until  the  camphor  is  dissolved;  when 
cool,  add  the  solution  of  lead,  and  shake  well  together. 

These  proportions  are  those  for  Goulard's  Cerate,  feubstituting  glycerin 
for  the  oil  and  wax. 


The  PreserTation  of  Infusious. 

Mr.  Robertson,  a  pharmaceutist  of  London,  recommends  that  in- 
fusions be  preserved  by  filling  bottles  of  any  convenient  size  (with  them 
when  freshly  prepared  and  filtered)  up  to  the  bottom  of  the  neck.  These 
are  placed  in  a  vessel  of  water,  put  on  the  fire,  and  allowed  to  remain 
until  the  water  has  boiled  around  them  for  ten  or  fifteen  minutes ;  by 
this  time  the  infusions  will  be  found  running  over  the  brims  of  the 
bottles.  They  are  then  removed  one  by  one,  and  immediately  closed  by 
simply  tying  a  piece  of  moistened  bladder  over  the  top. 

Infusions  can  be  prepared  for  a  three  or  six  months'  supply,  without 
danger  of  loss. 

Althea  Paper,  a  New  Test  for  Acids  and  Alkalies. 

Prof.  AiKiN  {Jour.  Maryland  College  Pharmacy)  proposes  the  color- 
ing matter  of  the  flowers  of  Althea  Rosea  (Hollyhock)  as  a  substitute  for 
litmus  and  turmeric,  as  a  test.  These  flowers  are  largely  imported  for  the 
purpose  of  coloring  artificial  wines,  &c.  He  states  that  the  paper  prepared 
with  the  coloring  matter  of  Hollyhock  is  more  permanent,  and  fully  equal 
in  sensitiveness  to  limus  paper. 

Samaderine. 

This  substance  has  recently  been  isolated  (as  a  new  organic  body) 
from  the  fruit  of  a  tree  found  in  Java,  of  the  order  Simaruboe,  {Samadera 
indica).  It  is  crystalline,  indifferent  to  most  reagents,  and  may  be  classed 
with  salicine,  phloridzine,  &c.,  and  possesses  a  most  intense  and  per- 
sistent bitter  taste.  As  the  bark  of  the  many  trees  of  the  order  Simarubm 
are  esteemed  as  tonics,  it  may  be  that  in  Samadarine  there  has  been  a 
valuable  addition   to  Materia  Medica. 


Pharmaceutical  Bepartment  249 

EMPLOYMENT  OF  IODIDE  OF  SODIUM.    Bt  Alexander  Ure,  Esq.,  F.  R.  C.  S- 

I  submit  to  the  profession  the  following  observations  respecting 
medicines,  which  will,  I  trust  be  found  useful  in  practice.  Iodide  of 
sodium  is  met  with  in  the  ashes  of  sea-weed  and  of  various  plants 
which  grow  on  the  sea-shore.  To  this  source  may  be  reasonably 
ascribed  the  belief  entertained  in  the  healing  virtues  of  sea-weed  by 
inhabitants  of  the  coast  in  different  parts  of  the  globe.  Professor 
Laycock,  in  an  ingenious  address  which  he  delivered  at  the  pharma- 
ceutical meeting  in  Edinburgh  last  November,  and  which  is  published 
in  the  PharmaceiLtical  Journal  of  the  month  following,  states  that 
*'in  the  pampas  of  South  America,  where  goitre  is  prevalent,  the 
remedy,  a  so-called  goitre-stick,  is  nothing  more  than  the  thick  stem 
of  a  sea-weed."  Mr.  Cooper,  in  his  "Surgical  Dictionary,"  recommends 
for  some   scrofulous   affections  the   use   of  poultices   of  sea-weed. 

Iodide  of  sodium,  as  a  therapeutic  agent,  is,  and  ought  to  be, 
more  active  than  iodide  of  potassium,  since  it  is  richer  in  iodine. 
According  to  Gmelin,  iodide  of  sodium  contains  84*45  parts  of  iodine 
in  the  hundred,  while  iodide  of  potassium  contains  but  74*27,  the 
proportion  of  sodium,  though  small,  being  still  sufficient  to  cover  the 
irritative   quality   of  its   associate. 

As  far  as  my  experience  goes,  iodide  of  sodium  is  a  blander 
salt,  more  assimilable,  and  better  borne  by  the  stomach,  than  iodide 
of  potassium.  It  is  moreover,  much  less  prone  to  produce  symptoms 
of  iodic  disturbance.  Patients  under  my  care  have  taken  it  steadily 
for  weeks  together,  without  suffering  the  slightest  inconvenience,  and 
with  uniform  advantage  as  regarded  the  morbid  condition.  On  no 
occasion,  save  one,  has  there  been  any  complaint  made  of  this  me- 
dicine producing  sense  of  w'eight  or  uneasiness  referred  to  the  stomach, 
nausea,  impaired  appetite  and  digestion,  headache,  running  from  the 
eyes  and  nostrils,  general  nervous  depression  —  symptoms  which  at 
times  supervene  during  the  administration  of  iodide  of  potassium, 
even  in  moderate  doses.  The  instance  in  question  was  that  of  a 
puny,   scrofulous  boy   with  disease   in  both   knee-joints. 

As  a  general  rule,  the  preparations  of  soda  are  milder  in  their 
operation  on  the  system  than  those  of  potash.  If,  moreover,  the 
important  view,  first  announced  by  M.  Dumas  in  the  92d  volume 
of  the  "Annales  de  Chimie,"  be  accepted,  that  there  are  certain 
salts  which  leave  the  blood  the  faculty  of  becoming  arterialized, 
while  others  deprive  it  of  this  property,  and  that  the  salts  having 
soda  for  their  base  are  more  proper  to  maintain  this  condition  of 
integrity  that  those  of  potash  or  ammonia,  it  may  be  fairly  assumed 
that  the  former  are  likely  to  exercise  a  more  favorable  remedial  in- 
fluence than  the  latter,  especially  if  exhibited  continuously  for  a 
length    of    time.      Soda,    variously    combined,    is    diffused    extensively 


250  The  Peninsular  and  Independent. 

throughout  the  organism ;  fully  five-sixths  of  the  saline  constituents 
of  healthy  blood  consists   of  salts   of  this  base. 

Iodide  of  sodium  may  be  prescribed  in  all  cases  in  which  the 
employment  of  iodide  of  potassium  is  indicated,  as  antidotal  to  various 
constitutional  symptoms  of  syphilis,  chiefly  of  the  so-called  tertiary 
group,  and  where  mercury  has  been  properly  used  beforehand ;  in 
certain  forms  of  rheumatism ;  in  chronic  affections  of  the  joints  and 
bones  of  a  scrofulous  character,  particularly  where  a  stealthy  inflam- 
matory process  has  determined  copious  fibro-plastic  deposition  or  hyper- 
trophy. If  judiciously  administered,  it  may  given  in  progessively- 
increasing  doses,  where  it  is  desirable  to  produce  a  decided  alterative 
efi'ect  on  the  system.  M.  Gamberini  has  famished  a  brief  notice  res- 
pecting its  use  in  the  volume  Schmidt's  "Jahrbiicher"  for  1858. 
Reference  is  made  to  116  cases  of  constitutional  syphilis  in  which  it 
had  been  exhibited,  and  where  it  was  found  to  have  acted  more 
rapidly  than  iodide  of  potassium,  and  often  proved  efficacious  where 
the  latter  drug  had  been  of  little  or  no  avail.  It  is  there  recom- 
mended to  be  given  as  follows :  —  One  scruple  is  to  be  dissolved  in 
three  ounces  of  distilled  water,  and  this  is  to  be  swallowed  in  di- 
vided doses  in  the  course  of  the  day.  After  the  lapse  of  two  or  three 
day,  the  above  amount  is  to  be  augmented  by  the  addition  of  six 
grains;  and  so  on  until  eventually  the  patient  comes  to  take  two 
drachms,  or  even  more,  of  the  salt  daily ;  the  time  for  taking  each 
dose  being  an   hour  before    meals. 

Hitherto  I  have  usually  prescribed  the  iodide  of  sodium  to  the 
extent  of  five  or  six  grains  twice  or  thrice  daily,  dissolved  in  four 
ounces  of  compound  decoction  of  sarsaparilla,  which  forms  a  convenient 
vehicle ;  occasionally,  in  pure  water,  with  the  addition  of  five  grains 
of  bicarbonate  of  soda  to  each  dose;  this  serves  to  counteract  aces- 
cency,  and  the  consequent  liberation  of  hydriodic  acid  in  the  stomach, 
which  is  sure  to  cause  headache.  In  scrofulous  complaints,  I  have 
given  it,  combined  with  cod-liver  oil,  and  with  manifest  benefit.  A 
remarkable  and  unexpected  effect  was  observed  in  one  instance  under 
this  treatment  for  diseased  bone,  where  a  marked  improvement  of 
sight  ensued  from  diminution  of  a  nebulous  condition  of  the  cornea. 
In  constitutional  syphilis,  I  have  found  it  advantageous  occasionally 
to  conjoin  the  use  of  the  iodide  with  that  of  bichloride  of  mercury, 
should  mercury  have  been  previously  withheld,  or  imperfectly  intro- 
duced into   the   patient's   system. 

As  a  general  rule,  the  iodide  ought  to  be  administered  in  plenty 
of  liquid,  and  not  on  an  empty  stomach,  as  suggCoCed  by  the  above  writer. 
It  is  readily  soluble  in  water,  has  a  cooling  saline  taste,  certainly  prefer- 
able to  that  of  potassium  compound,  and  by  no  means  equally  persistent 
in  the  throat. 


Pharmaceutical  Department.  251 

Subjoined  are  the  notes  of  one  of  the  several  cases  in  which  this 
medicine  has  been  employed  by  me.  Reports  of  others,  still  under 
treatment,  will  be  duly  communicated : 

G.  W ,    aged  twenty-eight,    a  footman,    was  admitted  into  St. 

Mary's  Hospital,  under  my  care,  on  the  15th  of  November,  1856.  He 
was  a  wan,  emaciated,  cachectic -looking  man.  He  complained  of  pain, 
referred  to  the  large  joints,  and  of  aching  in  the  back  and  loins.  He 
was  disfigured  by  patches  of  rupia,  scattered  over  different  parts  of  the 
surface ;  thus,  on  the  right  side  of  the  nose,  at  the  junction  of  the  nasal 
bone  with  the  cartilage,  was  a  dark  oval  scab,  overlying  a  sore  the  size  of 
a  shilling,  and  which  seemed,  as  it  were,  eating  its  way  into  the  nostril ;  on 
the  tragus  of  the  right  ear  was  a  similar  scab,  as  also  over  the  right  eye- 
brow ;  on  the  scalp  there  were  several  scabs  of  the  same  character ;  on  the 
right  arm  was  a  prominent  hardened  scab,  and  another  over  the  left 
wrist;  behind  the  inner  ancle  of  the  left  foot  was  a  round  excavated 
sore,  of  a  dusky -red  hue,  the  sequel  of  inflammation  of  the  corial  tissue. 
Each  scab  had  been  preceded  by  the  formation  of  a  small  vesicle  of  a 
punctuate  character.  This  eruption  was  of  a  month's  standing.  He 
suffered  besides  from  an  affection  of  the  throat  of  three  weeks'  duration, 
which  caused  great  distress  in  swallowing.  On  examination,  it  was  as- 
certained that  there  was  a  deep  oval  ulcer  in  the  the  left  tonsil,  covered 
with  a  grayish -yellow  film,  and  a  similar  sore  in  the  mucous  membrane 
of  the  back  of  the  pharynx.  He  had  enjoyed  good  health  until  fiive 
weeks  preceding  his  admission,  when  he  had  an  attack  of  rheumatism, 
and  for  which  he  was  successfully  treated  in  this  hospital.  He  denied 
ever  having  had  any  venereal  malady ;  had  then  been  married  fourteen 
months,  and  was  the  father  of  a  healthy  child. 

No'\).  V^ih. — After  the  scabs  had  been  softened  and  partially  detached 
by  the  application  of  wet  lint,  I  directed  the  different  spots  to  be  touched 
with  nitric  acid ;  the  sores  in  the  throat  to  be  swabbed  daily  with  dilute 
hydrochloric  acid ;  and  the  patient  to  take  five  grains  of  iodide  of  sodium 
in  four  ounces  of  compound  decoction  of  sarsaparilla,  thrice  every  day. 
Ordinary  diet. 

^hih. — Was  improved  in  all  respects,  more  particularly  as  regarded 
appetite. 

29  «^. — General  amendment ;  sores  in  the  throat  were  much  reduced 
in  size. 

Dec,  %d. — Nitric  acid  was  applied  to  the  crusts  on  the  scalp. 

^th. — The  ulcer  of  the  tonsil  was  healed,  and  that  at  the  back  of 
the  pharynx  nearly  so. 

^tli. — The  sore  on  the  nose  was  making  favorable  progress  under 
the  use  of  water  -  dressing ;  the  rupia  scabs  were  all  disappearing,  and 
there  was  manifest  improvement  of  the  general  health.  The  patient  was 
ordered  to  have  a  warm  bath  twice  a  week. 


252  The  Peninsular  and  Independent. 

15th. — The  throat  was  quite  well;  the  sore  on  the  nose  and  that  near 
the  ancle,  were  completely  cicatrized ;  the  rupia  was  extinct.  The  patient 
had  evidently  gained  in  flesh  and  strength;  his  cheeks  were  plump,  his 
complexion  was  florid,  and  he  was  perfectl}?-  free  from  pain  in  the  back, 
loins,  or  joints.  He  vras  discharged  cured  on  the  24th  of  December,  1858, 
a,fter  a  sojourn  of  thirty-nine  days  in  the  hospital. 

Nothing  could  be  more  satisfactory  than  the  result  of  treatment  in 
this  instance,  which  was  simpl}^  that  of  uninterrupted  progress  to  re- 
covery. The  case  was  one  of  the  eroding  variety  of  rupia,  termed  by 
some  writers  rupia  escharotica,  and  which  is  occasionally  witnessed  in 
the  persons  of  those  who  have  been  affected  with  the  constitutional 
symptoms  of  syphilis.  The  man,  at  the  time  of  his  admission,  was  in 
a  deplorable  state  of  health;  his  throat  was  the  seat  of  foul  ulcers,  one 
side  of  his  nose  was  on  the  verge  of  mutilation,  his  body  was  racked  with 
pain,  his  countenance  marred  by  an  unsightly  eruption.  After  the  lapse 
of  about  five  weeks,  he  had  regained  his  wonted  health,  and  returned 
home  without  any  appreciable  trace  of  the  disfiguring  malady  for  which 
he  had  sought  relief  within  the  walls  of  an  hospital. 

[London  Lancet. 

A  SUBSTITUTE  FOR  COD  LIVER  OIL. 

The  oil  of  the  dugong  has  been  lately  proposed  as  a  substitute  for 
cod -liver  oil  by  Australian  physicians.  Dr.  Hobbs,  Medical  Health  OflBcer 
of  Moreton  Bay,  Australia,  has  again  called  attention  to  its  curative  pro- 
perties ;  and  if  this  oil  should  prove  as  efficacious  in  the  hands  of  others 
as  he  believes  it  has  been  in  his  own,  there  will  be  great  reason  for 
congratulation.  The  dugong  is  very  abundant  in  the  Australian  waters 
and  in  the  Indian  seas,  and  might  be  obtained  in  large  quantities  at  a 
moderate  cost.  It  has  the  advantage  of  being  a  pure,  sweet,  and  palatable 
oil,  which  may  be  used  in  cooking,  and  is  peculiarly  digestible.  On  the 
other  hand  it  does  not  contain  iodine.  Those  who  look  upon  the  iodine 
of  cod -liver  oil  as  an  active  and  important  agent  in  the  production  of  its 
peculiar  effects,  will  probably  be  disinclined  to  accept  this  report  in  all 
its  details ;  it  strengthens  the  hands  of  those  physicians  who  believe  that 
cod -liver  oil  is  mainly  valuable  as  supplying,  in  a  digestible  form,  car- 
bonaceous material,  and  thus  sustaining  enfeebled  vitality.  Dr.  Hobbs 
prescribes  dugong  oil  in  those  cases  in  which  cod -liver  oil  is  usually  pre- 
scribed, and  his  success  has  been  very  encouraging.  He  believes  that  it 
is  particularly  well  suited  to  the  form  of  disease  known  as  "dyspeptic 
phthisis."  The  statements  of  Dr.  Hobbs  are  well  worthy  the  attention  of 
the  Profession  ;  and  if  it  be  found  that  the  dugong  oil  can  be  substituted 
advantageously  for  cod -liver  oil,  the  gain  will  be  great  to  the  patient, 
who  will  thus  be  enabled  to  procure  an  agreeable  and  palatable  oil  at  a 
much  less  cost  than  that  of  the  more  nauseous  and  unpleasant  medica- 
ment, now  in  such  high  esteem.  [London  Luncet. 


Pharmaceutical  Department.  253 

THE  ACID  NITRATE  OF  SILVER. 

M.  Crocq  lately  read  a  paper  before  the  Medical  Society  of  Brussels, 
wherein  he  sets  forth  the  advantages  of  a  caustic  solution  hitherto  not 
much  employed — namely,  the  acid  nitrate  of  silver.  The  author  states 
that  it  should  be  used  when  the  surface  acted  upon  is  to  be  more  or  less 
deeply  modified,  without  an  intention  of  destroying  much  thickness  of 
tissue  —  in  fact,  in  those  cases  where  the  solid  nitrate  of  silver  or  the 
acid  nitrate  of  mercury  are  generally  used.  The  acid  nitrate  of  silver 
is,  however,  superior  to  the  simple  nitrate,  as  it  penetrates  much  better 
into  interstices,  and  as  its  action  may  at  will  be  made  superficial  or  deep 
(the  difference  depending  on  the  longer  or  shorter  contact).  It  is  also 
preferable  to  the  acid  nitrate  of  mercury  because  it  produces  no  tonic 
effects,  and  never  gives  rise  to  alarming  symptoms,  however  extensive  the 
surface  may  be  with  which  it  is  brought  in  contact.  Nor  can  it  excite 
salivation.  Its  action  can,  moreover,  be  at  once  stopped  when  the  vagina, 
the  mouth,  or  the  eye  are  operated  upon,  as  an  injection  of  a  solution  of 
common  salt  will  immediately  render  it  inert.  Chancres,  simple  or  slough- 
ing ulcers,  hospital  gangrene,  lupus,  epithelial  cancer,  &c.,  can  be  treated 
with  this  caustic  solution.  It  may  be  prepared  either  from  the  simple 
nitrate  or  from  metallic  silver.  To  obtain  it  from  the  lunar  salt  it  will 
be  sufiicient  to  add  eight  times  by  weight  of  nitric  acid,  at  33  deg.,  to 
the  nitrate  of  silver,  and  expose  to  heat  in  a  stopped  bottle.  With  me- 
tallic silver,  ten  times  the  weight  of  nitric  acid,  at  35  deg.,  should  be 
poured  on  the  metal,  and  a  gentle  heat  be  used. 

\ France  Medicale  —  from  Lancet. 


kOUSSINE. 

M.  Pavesi,  and  subsequently  M.  Vee,  have  succeeded  in  extracting 
the  active  principles  of  kousso.  The  following  is  the  process:  — 300 
grammes  of  kousso  are  treated  with  100  grammes  of  alcohol,  and  25 
grammes  of  hydrate  of  lime,  at  a  temperature  of  from  140"  to  \bO° 
Fahr.;  the  residue  is  also  digested  in  600  grammes  of  barley-water.  The 
solutions  thus  obtained  are  mixed  together,  filtered,  and  precipitated  by 
acetic  acid. 

Koussine  is  yellow,  bitter,  insoluble  in  alcohol  and  in  alkalies,  and 
does  not  crystallize. 

^PURIFICATION  OF  SPIRIT  FROM  FUSEL  OIL. 

M.  Bketon  {Moniteur  Industriel)  has  proposed  a  method  of 
purifying  spirit  in  the  small  way ;  consisting  in  taking  advantage  of  the 
solubility  of  Fusel  Oil  in  Olive  Oil,  which,  however  can  not  dissolve 
the  spirit.    He  states  he 

First  made  use  of  a  filter  consisting  of  disks  of  woolen  stuff,  slightly 
soaked  in  oil,  and  held  between  two  perforated  plates  of  metal.  The 
spirit   was    deprived  of  fusel    oil,    but   only  until  the  woolen  cloth  was 


254  The  Peninsular  and  Independent. 

saturated  with  the  volatile  oil,  when  it  absorbed  no  more.  By  means 
of  a  current  of  steam  at  pressure  of  two  or  three  atmospheres,  the  wool 
could  be  readily  freed  from  the  volatile  oil ;  but  the  exposure  to  steam 
at  this  temperature  rendered  the  wool  useless  for  a  repetition  of  the 
process.  The  woolen  stuff  consequently  had  to  be  given  up,  and  after 
many  trials  it  was  replaced  by  a  layer  of  powdered  pumice-stone,  which 
acts  exactly  in  the  same  way  as  the  woolen  stuff,  but  without  losing 
its  power  of  absorption  when  exposed  to  a  temperature  necessary  for 
the  volatilization  of  the  fusel  oil. 


IODIZED  FOOD. 

Dr.  BioNET,  of  the  French  Academy  of  Medicine,  in  a  recent  paper 
asserts  that  scrofula  and  other  cachexiae,  may  be  removed  by  introdu- 
cing iodine  into  the  general  diet  of  the  patient.  He  proposes  to  do  this 
by  making  iodized  food,  compounded  of  such  plants  as  contain  iodine, 
as  sea  weeds  and  cruciferous  plants,  and  introduced  into  bread,  cakes, 
syrups,  etc. 

THE  "SPANISH  APPLE." 

Dr.  T.  MoKTON  Lyle,  of  Gonzales,  Texas  (lY.  0.  Med.  New8\  re- 
commends the  Spanish  apple  —  Mahamscus  Drummondii  —  as  a  valu- 
able addition  to  our  catalogue  of  demulcents  and  emollients.  Dr. 
Lyle  uses  the  root,  though  the  whole  plant  abounds  with  the  mu- 
cilaginous principle.  He  regards  the  mucilage  as  superior  to  that  of 
the  Cactus  Opuntia  or  the  Ulmus  Fulva.  He  employs  it  internally  in 
cases  in  which  demulcents  are  indicated,  and  externally  in  the  form 
of  cataplasms,  ointments,  etc.  Why  might  there  not  be  an  officinal 
ointment  prepared  from  it — Ung.  Malvavlsci  —  to  occupy  the  place  of 
the  Wng.  Althem  of  the  British  pharmacopoeias,  which  is  certainly  a 
useful  preparation.  [Med.  and  Surg.  Eep. 


CHLORIDE  OF  SODIUM  IN  CHRONIC  ULCERATION  OF  THE  CORNEA. 

M.  Tavignot  states  that  since  he  first  recommended  this  substance 
in  1843  he  has  met  with  numbers  of  cases,  all  exhibiting  its  remarkable 
efScacy.  His  formula  is  15  parts  of  the  chloride  to  125  of  filtered 
water.  [Moniteur  des  Hop.  1858,  No.  152.^ 

REVULSIVE  TREATMENT  OF  CHRONIC  AFFECTIONS  OF  THE  EYE. 

This,  when  properly  applied,  M.  Tavignot  regards  as  a  valuable 
adjuvant.  He  employs  two  kinds  simultaneously — 1.  A  cutaneous  ve- 
vulsive,  of  which  the  following  is  the  formula:  Resin,  yellow  wax,  of 
each  100;  turpentine,  50;  powdered  euphorbium,  25;  powdered  can- 
tharides,  15 ;   and  croton  oil,  5   parts.      This  is  less  painful  than  anti- 


Pharmaceutical  Department.  256 

monial  revulsives,  and  may  be  kept  applied  to  the  nape  if  both  eyes 
are  effected,  and  behind  the  ear  if  only  one,  for  two  or  three  weeks, 
without  inducing  excessive  irritation.  2.  The  mucous  revulsive  is  formed 
of —  powdered  iris,  25  ;  calomel,  4 ;  and  camphor,  2  parts.  This  is  used 
as  snuff  five  or  six  times  a  day,  after  blowing  the  nose.  It  excites 
the  pituitary  membrane  very  advantageously,  in  nervous  affections  of 
the  eyes.  [Moniteur  des  Hop.  1858,  No.  152. 


NEWS   ITEMS. 


The  New  British  Pharmacopoeia  is  being  prepared  by  the  Medical 
Council.  At  present  there  exists  three  works  of  the  kind,  under  direc- 
tions respectively  to  the  Colleges  of  Physicians  of  London,  Edinburgh, 
and  Dublin,  producing  a  confusing  diversity  in  pharmaceutical  practice. 
The  object  is  now  to  reconcile  these  inconvenient  discrepancies,  and 
produce  a  uniform  national  pharmacopoeia. 

Much   temporary   annoyance,    it   is   believed,    will   be   produced   by         "'Y"" 
the   change,  but  the  result  will  be  satisfactory,  and  will   create  a  uni-  ^ 

formity  which  has  been  much  needed. 

It  has  been  decided  to  adopt  the  Avoirdupois  weight  instead  of 
the  Troy  weight,  or  Apothecaries'  weight,  and  the  work  will  be  pub- 
lished  in   the  English  language  instead  of  the  Latin.  ^ 

Some  of  the  standard  medical  authorities  have  recently  been  trans-  "\^ 
lated  into  the  Chinese  language  by  Dr.  Hobson.  They  include  works  \ 
on  the  following  subjects  :  Philosophy  and  General  Anatomy,  Surgery, 
Diseases  of  Women  and  Children,  Medicine  and  Materia  Medica,  and 
on  General  Science.  Some  of  these  works  have  created  great  interest 
in  them,  and  have  been  re-published  by  Chinese  Mandarins,  and  widely 
circulated  over  China  and  Japan.  The  medical  works  of  the  Chinese 
show  them  to  be  totally  ignorant  of  medicine  as  a  science.  Anatomy 
has  never   been   studied,  and   they   do   not   comprehend   the   circulation  . 

nor    the  functions   of  the   viscerse.      It  is   believed  that  this   series   of       V**^ 
treatises  will  spread  much  useful   information  among  their  practitioners, 
and  induce  attention  to  medical  science. 

A  company  of  Virginians  are  now  erecting  warehouses  at  various  points  "^\ 

in  the  big  woods,  near  Minneapolis,  Minnesota,  fitted  up  with  the  necessary 
apparatus  for  curing  ginseng.     They  intend  to  go  into  the  business  on  an  ex- 
tensive plan.     From  60,000  to  60,000  pounds  will  be  gathered  this  year,  which 
will  net  the  diggers  some  sixteen  thousand  dollars.     We  export  ginseng  _^^ 
to  China. 

In  St.  Louis,  stereoscopic  pictures  have  recently  been  taken  of  different       '"""^ 
dissections  of  the  muscles,  by  Mr.  J.  P.  Soule.     He  has  already  prepared  a 
number  of  these,  and  proposes  to  continue  the  series  and  prepare  views 
of  the  arteries,  &c.     The  pictures  are  very  beautiful,  and  should  the  artist 
succeed  in  coloring  them  satisfactorily,  their  value  will  be  greatly  enhanced. 

The  Emperor  Napoleon  has  decreed  a  statue  of  Humboldt  to  be  placsd 
in  the  gallery  at  Versailles. 


,-^ 


256  The  Peninsular  and  Independent. 

In  Paris,  England,  and  Genoa,  the  number  of  deaths  by  suicide  appears 
to  be  about  four  per  cent,  of  the  whole  deaths.     And  as  in  the  whole  of 
Fr(wce  the  proportion  of  registered  suicidal  deaths  equals  only  one  per 
cent.,  it  is  evident  that  three-quarters  of  these  deaths  escape  official  notice 
altogether. 

Dr.  Austin  Flint,  Jr.,  Editor  of  the  Bvffalo  Medical  Journal^  has 
been  appointed  to  the  chair  of  Physiology  and  Microscopic  Anatomy  in 
the  Medical  Department  of  the  University  of  Buffalo,  and  Dr.  Sanford 
Eastman  has  been  appointed  Professor  of  Anatomy  in  the  same  Uni- 
versity. 

Honors  are  falling  thick  on  iSir  Benj.  Bkodie,  states  a  recent  No.  of 
London  Medical  Thaes.  Last  week  he  was  elected  President  of  the  Me- 
dical Council;  this  week  President  of  the  Royal  Society.  He  stands  in 
a  higher  position  than  any  surgeon  has  ever  attained  in  this  country. 

Lunovic  HiKSCiiFiELD,  the  author  of  the  beautifully  illustrated  work  on 
the  nervous  system,  and  formerly  cJief  de  clinirjue  at  Hotel  Dieu,  Paris, 
has  been  nominated  Professor  of  Anatomy  at  the  Medico-Chirurgical  Aca- 
demy of  Warsaw. 

The  mortality  from  small-pox  has,  by  the  general  adoption  of  vacci- 
nation, been  reduced  from  its  proportion  of  1  in  ]0  of  the  entire  mort- 
ality, to  1  in  2,378. 

The  amount  of  Otto  Rose,  imported  by  England  during  the  four 
years  1854  to  1857,  inclusive,  was  over  eighty -six  thousand  ounces,  or  two 
tons  and  a  half. 

There  are  forty-two  Medical  Colleges  in  the  United  States;  from  which 
there  graduated,  of  the  Session  1858-9  over  fifteen  hundred^  from  an  army 
of  nearly  five  thousand  students. 

ScANzoNi  received  twenty-five  thousand  dollars  for  obstetrical  services 
to  the  Empress  of  Russia. 

In  a  town  of  Wurtemburg,  a  Mr.  Helgard  has  established  a  printing 
house,  which  is  carried  on  solely  by  160  deaf  and  dumb  individuals. 

It  is  suggested  that  when  doctors  fight  duels,  the  weapons  used  should 
be  pills. 


THE 


PENINSULAR  and  INDEPENDENT 


MEDICAL  JOURNAL. 


Vol.  II.  DETROIT,  AUGUST,  1859.  No.  6. 


rigiital  C0mmititiatiinis. 


ART.  XVIII.— Selections  from  Surgical  JTotes. 


By  Moses  Gunn  M.  D.,  Prof.  Surg,  in  the  University  of  Mich. 

Case  I.  A  Novel  Case  of  Strangulated  Femoral  Hernia. — 
September  12tli,  1857,  Mrs.  W.,  of  Oakland  Co.,  then  up- 
wards of  sixty  years  of  age,  required  an  operation  for  the 
relief  of  strangulated  femoral  hernia.  The  contents  of  the 
hernial  sac  had  been  down  for  ten  days,  during  which  period 
she  had  not  had  a  passage  of  the  bowels.  The  hernia  had 
existed  for  some  years,  but  was  of  moderate  size,  though  it 
had,  in  the  present  descent,  advanced  to  the  third  stage : 
viz.,  the  protruding  viscus  had  curved  forwards  and  up- 
wards, and  was  lying  over  Poupart's  ligament.  The  pa- 
tient was  suffering  at  times  from  violent  pain,  and  for 
two  days  had  vomited  stercoraceous  matter.  She  was  evi- 
dently failing  in  vital  power,  though  there  were  no  signs 
that  mortification  had  taken  place. 

Repeated  efforts  at  reduction  by  taxis   had   failed,  and 

Vol.  II.  — K. 


258  The  Peninsular  and  Independent. 

excited  exquisite  tenderness  of  the  parts ;  I  was  not  inclined, 
therefore,  to  renew  the  proceeding.  Kesort  was,  conse- 
quently, had  to  the  operation  of  dividing  the  stricture; 
this  was  made  in  the  usual  way,  the  steps  of  which  it 
is  not  necessary  to  repeat.  A  large  knuckle  of  intestine 
composed  the  whole  contents  of  the  hernial  sac ;  and  this 
was  very  much  congested,  though  in  no  degree  gangrenous. 

Immediate  relief  succeeded  the  operation.  Vomiting 
ceased,  and  a  pleasant  night's  rest  ensued.  An  aperient 
dose  of  castor  oil  was  ordered  the  next  morning.  Twelve 
hours  subsequently  (twenty -four  after  the  operation)  vomit- 
ing recurred,  and  soon  became  stercoraceous.  Injections 
were  ordered,  and  repeated  sundry  times,  but  without  ef- 
fect. The  vomiting  continued,  the  pulse  became  feeble  and 
frequent,  and  dissolution  seemed  at  hand. 

On  the  second  morning  subsequent  to  the  operation, 
no  evacuation  had  been  had,  and  the  patient  was  deemed 
moribund.  Shortly  after,  a  very  coj)ious  discharge  from  the 
bowels  took  place,  to  the  great  relief  of  the  patient,  who 
now  rallied,  and  became  convalescent.  This  was  on  Mon- 
day morning,  at  eleven  o'clock  —  forty -one  hours  subsequent 
to  the  operation.  Daily  evacuations  occurred  until  Satur- 
day, w^hen  the  wound  in  the  groin  re -opened,  and  a  fecal 
discharge  from  it  took  place !  During  the  balance  of  the 
patient's  life,  which  continued  for  a  year  longer,  with  a 
comfortable  degree  of  health,  evacuations  occurred,  both 
through  the  artificial  anus  and  jj^er  viam  natiiralem.  Dis- 
inclination, on  the  part  of  the  patient,  alone,  prevented  a 
resort  to  an  operation  for  the  relief  of  this  disgusting  con- 
dition of  the  groin. 

What  produced  a  recurrence  of  the  stercoraceous  vomit- 
ing, and  other  signs  of  strangulation,  after  the  relief  of  more 
than  twelve  hours  which  succeeded  the  operation.? — what  de- 
layed the  operation  of  the  cathartic? — what  was  the  patho- 
logic condition   which  finally  permitted   free   daily  evacua- 


GuNN's  Selections  from  Surgical  Notes.  259 

tionSj  find,  after  five  days,  resulted  in  a  re -opening  of  tlie 
wound,  and,  tlirough  it,  a  fecal  discharge  ?  —  are  questions 
which  afford  ample  opportunity  for  conjecture  ;  but  I  con- 
fess that,  as  yet,  I  have  been  unable  to  satisfy  my  own 
mind  as  to  the  truthfulness  of  any  which  has  been  suggested 
to  me. 


C/ASE  II.  Descent  of  a  Hernia  through  a  Congenital  Pas-' 
sage  for  the  first  time  cfter  Thirty  Years  of  Age. —  In  the 
fall  of  1848,  I  reduced,  by  taxis,  a  hernia  which  had  been 
down  some  fifteen  hours.  The  case  occurred  in  the  person 
of  a  medical  gentleman  of  (I  believe)  thirty -five  years  of 
age.  The  first  descent  of  the  hernia  had  occurred  only  two 
X)i'  three  years  previously.  There  was  nothing  remarkable  to 
%e  'observed  in  the  case.  On  the  12th  of  December,  1852, 
\  was  summoned  to  attend  the  same  patient  for  the  same 
malady.  This  time,  I  found  the  hernia  strangulated,  and 
the  patient  in  a  very  critical  condition.  I  did  not,  conse- 
quently, long  persist  in  efforts  to  reduce  by  taxis,  but  soon 
had  recourse  to  the  knife.  On  laying  open  the  sac,  which 
was  done  very  freely,  and  reducing  the  prolapsed  intestinCj) 
1  was  surprised  to  see  the  testicle  lying  very  cosily  in  the 
sac,  as  I  pushed  up  the  scrotum,  in  the  act  of  returning 
the  hernia !  On  examination,  the  hernial  sac  was  found  to 
be  composed  of  the  tunica  vaginalis; — in  fact,  the  anatomi'- 
cal  relations  were  identical  with  those  of  congenital  ingui- 
nal hernia.  The  hernia  had  occurred  by  the  descent  of  the 
intestine  through  a  congenital  passage.  Anatomically  con- 
sidered, it  was  a  congenital  hernia,  though  occurring  for  the 
first  time  after  the  patient  had  passed  the  thirtieth  year  of 
iige. 

After  the  descent  of  the  testicle,  it  is  probable  that  the 
connecting  passage  between  the  general  peritoneal  cavity 
and  the  tunica  vaginalis  had  become  very  greatly  narrowed, 
but   not,   as   is   the   natural  course,  completely  obliterated. 


260  The  Peninsular  and  Independent. 

Through  this  narrowed  passage,  the  hernia  was,  at  last^ 
forced ;  thus  producing  the  novelty  which  may  be  called  a 
congenital  hernia  occurring  after  thirty  years  of  age !  A 
hernia  is  termed  congenital  when  it  occurs  through  a  con- 
genital opening,  whether  it  exist  at  birth,  or  shows  itself  a 
week  subsequently.  The  difference  in  time,  in  this  case> 
was  only  the  trivial  little  matter  of  thirty  years. 
87  Shelby  St.,  June  18th,  1859. 


ART.  XIX.— A  "Criticism"  Criticised. 

By  0.  C.  GiBBs,  M.  D. 

A  VERY  amiable  M.  D.,  J.  A.  Brown,  of  Kankakee,  111., 
perpetrates  a  double  criticism,  at  our  expense,  of  some  ^^q 
pages,  in  the  June  No.  of  the  Peninsular  and  Independent. 
In  the  November  No.  of  that  very  excellent  monthly,  we 
reported  a  case  of  obstruction  of  the  bowels,  finally  over- 
come by  a  copious  enema,  that,  by  its  mechanical  action, 
we  supposed  replaced  an  intussuscepted  portion  of  intestine. 
Dr.  J.  A.  Brown  has  incubated  upon  that  case  for  six 
months,  and  finally  brought  forth  a  criticism,  which,  in 
spirit,  we  should  consider  wholly  unworthy  of  notice,  did 
not  our  Kankakee  friend  misunderstand  or  misrepresent  us. 
The  talented  critic,  with  great  condescension,  thinks  our 
article  was  ^^  well- intended,"  but  he  thinks  we  "seem  to 
manifest  more  of  an  inclination  to  say  something  in  the 
Journal  than  to  communicate  any  new  fact.''  Now,  for  the 
information  of  our  amiable  friend,  we  would  say  that  we 
made  that  report  as  short  as  was  consistent  with  a  well 
understanding  of  the  case, — omitting  many  minor  details ; 
our  object  being  simply  to  add  another  case  of  intussuscep- 
tion rectified  by  mechanical  pressure  from  below,  with  the 
intent  of  urging  an  earlier  resort  to  such  means,  instead  of 


GiBBS. — A  "  Criticism^''   Criticised.  261 

trusting  to  worse  than  useless  cathartics,  wiiich  our    critics 
advise  to  the  contrary  notwithstanding. 

May  we  be  permitted  to  inquire  what  ^^new  fact"  Dr. 
Brown's  five  pages  are  calculated,  or  rather  intended,  to 
impart.^  After  searching  it  carefully,  we  can  see  none, 
save  that  he  has  self-conceit  enough  to  suppose  that  he,  in 
his  wisdom,  is  better  qualified  to  diagnosticate  and  prescribe 
for  a  case  hundreds  of  miles  away,  than  we,  with  the  patient 
before  us,  aided,  as  we  were,  by  the  best  counsel  in  West- 
ern New  York. 

As  the  Doctor  is  somewhat  exercised  over  what  seems 
to  him  our  vain  desire  to  appear  in  print  with  nothing  to 
say,  we  trust  we  may  be  permitted  to  refer  him  to  files  of 
Bankings  Abstract,  Braithwaite's  Retrospect,  The  British 
and  Foreign  Medico  -  Chirurgical  Beview  ;  the  editors  of 
which  journals  have  been  silly  enough  to  consider  some  of 
our  "well -intended"  articles  as  worthy  of  being  re -printed 
in  their  respective  journals.  If  Dr.  Brown  will  send  those 
weak-headed  editors  his  criticism,  they  will  doubtless  repeat 
that  foolish  thing  no  more.  • 

We  pass  over  the  criticism  upon  our  first  article,  re- 
marking, simply,  that  if  Dr.  DuBois  felt  himself  aggrieved 
by  our  article,  he  is  abundantly  able  to  defend  himself 
We  then  disavowed  all  intent  to  criticise — making  Dr.  Du- 
Bois's  article  a  text  for  a  few  remarks  of  our  own — never 
dreaming  that  every  medical  article  must  suggest  a  new 
remedy.  Did  it  never  occur  to  our  learned  critic,  that, 
though  Doctors  agree  in  regard  to  the  proper  remedies  in 
a  given  case,  they  Jaay  honestly  difier  in  regard  to  their 
proper  use  ? 

Our  critic  makes  merry,  and  puts  in  requisition  a  few 
unnecessary  exclamation  -  points,  because,  from  the  appear- 
ance of  the  patient  and  the  general  symptoms,  we,  at  first, 
and  before  a  full  examination  of  the  case,  suspected  stran^ 
gulated  hernia.     If  Dr.  Brown  has  never  seen  or  heard  of 


262  The  Peninsular  and  Independent. 

cases  of  strangulated  hernia,  where  the  patient  was  ignorant 
of  the  fact,  or  unwilling  to  confess  it,  he  had  better,  in  our 
judgment,  lay  by  his  pen- critical  and  resume  his  study  of 
elementary  works.  In  the  very  first  work  we  lay  our  hands 
upon,  we  find  the  following : 

"In  every  case  of  sudden  and  violent  vomiting  and  cholic,  the  bend 
of  the  thigh  should  be  well  examined,  and  inquiries  should  be  made  for 
any  tumor  about  the  abdomen — hecaufte  the  patient  may  hate  been  lobar- 
ing  under  hernia  for  ycarSy  and  yet  from  ignokance  or  mauvam 
honte,  may  not  mention  it." 

Had  Dr.  Druitt  been  as  wise  as  our  Kankakee  critic,  he, 
probably,  never  would  have  penned  so  foolish  an  item  of 
direction. 

With  a  flourish,  our  critic  wants  to  know — 

"What  tyro  in  medicine,  .  .  .  would  not  readily  hsiYe  predicted 
[diagnosticated  is  the  word]  the  real  difficulty,  viz.,  penitoncal  inflamma- 
tion"? 

For  the  benefit  of  our  learned  friend,  we  confess  we  were 
just  the  tyro  that,  at  Jirst,  could  do  no  such  thing.  The 
bowels  were  soft  and  painless^  excej^ting  a  spot  that  could  be 
covered  with  the  palm  of  the  hand,  in  the  region  of  the 
ilio-  cgecal  valve.  We  could  not  diagnosticate  intussusception 
even,  for  we  lacked  the  evidence ;  but  we  did  diagnosticate 
inflammation  of  that  limited  i^ortion  of  the  intestine  deno- 
minated the  caecum,  and  predicted  obstruction. 
With  another  flourish,  our  critic  asks  : 


■•? 


"What,   we  ask,    in   the  name  of  reason,        ild   it  have   been   but 


peritonitis  ?  " 


Guided  by   such   reason   as   is"  vouchsafed   to   us,  we  have 
re<>;istered  our  omnion  above. 

Our  critic  finds  fault  with  us  for  giving  opium  at  first^ 
instead  of  bleeding  and  giving  an  ^^-^fficient  and  reliable- 
cathartic."     Supposing  the  case  to  have  been  peritonitis,  as, 


# 


GiBB3.  —  A  '-'■  CriticisnV'^   Criticised.  263 

Dr,  Brown  supposes.  Dr.  Watson  condemns  cathartics  at 
first  in  such  cases,  and  quotes,  in  illustration,  a  case  nearly 
cured  by  opium,  in  the  hands  of  the  celebrated  Dr.  Stokes, 
and  finally  killed  by  a  cathartic,  and  remarks  : 

"This  example  puts  in  a  very  strong  light  the  good  effects  of  opium, 
and  the  dangerous  effects  of  2^urgatives.^^ 

But  Dr.  Watson   was   but   a   rush -light,    when   compared 
with  our  Kankakee  medical  luminary. 

Will  Dr.  Brown   remember  that   our  patient  was   ad- 
vanced in  years  ;  that  the   countenance  was  haggard  ;  that 
she  was  extremely  prostrated  ;  pulse  weak,  soft,  and  120  per 
minute.^     Bleeding  was  not  not  to  be  thought  of,  at  least 
general   bleeding.      The  Dr.  would  do  well  also  to  remem- 
ber that  vomiting  was  a  prominent  symptom  from  the  first 
— severe  and  persisting — soon  becoming  stercoraceous,  and 
continuing  until  the  obstruction  was  overcome.     In  such  a 
case,  active  cathartics  would  only  have  increased  the  patient's 
Bufierings,  aggravated    all    the    symptoms,    and    greatly   in- 
creased the  hazard.     In  such  cases.  Dr.  Watson  says,  ^'  To 
persist  in  the  use  of  drastic  purgatives,  is  to  inflict  wanton  and 
needless  torture  upon  the   patient."     In  our  humble  judg- 
ment, if  there    was    intussusception,    cathartics   were  worse 
than  useless ;  and,  if  not,  our  best  hopes  lay  in  first  quiet- 
ing  the  stomach,    so   that   it   would   not  reject   an   efficient 
cathartic.      If  our   critic  knows  of  anything  better  for  the 
accomplishment  of  this  end  than  opium  with  small  doses  of 
calomel,   will   he   please   oblige   us  with    the   result  of  his 
experience. 

Our  critic  seems  to  forget  that  cathartics,  consisting  of 
an  infusion  of  senna  and  salts,  were  repeatedly  given  per 
rectum.  Dr.  Brown  charges  us  with  neglecting  the  use  of 
efficient  cathartics.  When  every  means  failed  to  procure 
relief,  and  death  was  imminent,  though  we  were  firm  in  the 
faith  that  we  had  a  case  of  intussusception  to  deal  with,  and 


264  Hie  Peninsular  and  Independent. 

as  in  that  case  hope  was  almost  null,  we  were  bound  to  hope 
at  least  that  our  diagnosis  might  be  wrong,  as  a  dernier  resort ^ 
with  death  staring  us  in  the  face,  we  gave  the  cathartic 
powers  of  calomel  a  full,  and  even  rash,  trial.  If  we  rightly 
remember  (we  have  sent  the  Peninsular  and  Independent, 
for  1858  away  to  be  bounds  and  have  not  our  article 
before  us),  ten  grains  of  calomel  were  given  every  three  or 
four  hours,  for  two  days.  What  more  would  our  friend 
require  of  us  ?  In  our  judgment,  this  would  have  been 
imprudent  and  uncalled-for  at  first,  but  was  justifiable  at 
the  time  such  treatment  was  brought  in  requisition.  Our 
physicking  advocate  should  remember  that  even  this,  aided 
by  purgative  enemata,  failed  entirely  to  produce  alvine 
evacuations,  until  the  intussusception  was  removed  by  me- 
chanical means,  which  our  critic  vaguely  insinuates  was 
inhuman.  To  this  insinuation,  we  oppose  our  humble  con- 
viction that  the  purgatives  which  he  so  strongly  urges, 
were  worse  than  useless,  and  if  anything  deserved  such  a 
cognomen,  that  treatment  was  most  certainly  it. 

To  show  Dr.  Brown's  unfairness,  to  say  nothing  of 
dishonesty,  we  make  the  following  quotation,  in  which  he 
says  we 

'"'' ns^ii  solid  ojnum  for  three  or  four  days  together^  with  little  or  nothing 
else;  and  indeed,  nothing  else  in  anything  like  sufficient  quantities  to 
produce  catharsis." 

Now,  on  the  second  day  (not  the  fourth),  we  said,  '^  The 
treatment  was  continued,  the  opium  in  diminished,  and  the 
calomel  in  increased  doses."  From  aught  that  is  stated, 
and  for  aught  that  Dr.  Brown  knows,  calomel  might  (though 
we  aver  it  was  not)  have  been  used  in  teaspoonful  doses, 
so  early  as  the  second  day ;  yet  our  fair,  honorable,  and 
learned  critic  avers — upon  what  authority  we  know  not  — 
that  for  four  days  we  used  nothing  but  solid  opium  ! 

Dr.  Brown  flourishes,  with  manifest  satisfaction,    what 
he   supposes   is   an  inconsistency,   and  exclaims:    '^Now,  is 


GiBRS. — A  '•'•  Criticism'^^   Criticised.  265 

there  not  great  incongruity  just  here  V      We  answer  Yes, 
in  the  critic's  conception,  not  in  our  statement. 

The  difficulty  was  a  local  intestinal  inflammation,  caused 
by  the  intussusception  at  first,  and  it  is  not  improbable 
(which  is  all  that  was  stated)  that  the  local  inflammation 
extended  to  the  peritonaeum,  and,  in  time,  became  more  or 
less  general  peritonitis.  When  the  cause,  the  intussuscep- 
tion, was  removed,  the  consequences  had  progressed  beyond 
the  point  of  curability.  Our  obtuse  perceptions  fail  to  see 
the  incongruity. 

To  the  no  small  discomfiture  of  Dr.  Brown,  we  would 
say  that  the  patient  experienced  none  of  the  peculiar  effects 
of  opium  ;  it  is  probable  that  it  was  nearly,  if  not  entirely 
rejected  by  the  fre(][uent  and  persistent  vomiting.  "Large 
linseed  cataplasms,  saturated  freely  with  the  oleum  terabin- 
thence,"  were  early  and  persistently  used.  Our  critic  says, 
if  we  had  resorted  to  '^copious  blood-letting  and  a  brisk 
cathartic''  early,  "  the  result  might  have  been  different."  Of 
this  we  have  no  doubt — the  patient  might  have  died  sev- 
eral days  sooner  I  As  somewhat  explanatory  upon  this 
point,  we  would  say  that  for  the  last  three  years,  in  this 
locality,  all  diseases  have  assumed  a  typhoid  type.  Pneu- 
monia, for  instance,  has  only  been  successfully  treated 
without   blood-letting,    and   with  the   early   use    of  quinia. 

Asking  pardon  of  your  readers  for  occupying  so  much 
time  and  space,  we  now  take  leave  of  Dr.  Beown,  kindly 
reminding  him  that,  before  he  attempts  another  criticism, 
there  is  an  old  adage  that  it  would  be  well  to  remember— 
"  Be  sure  you  are  right,  and  then  go  ahead.'' 

Prewsburg,  N.  Y. 


266  The  Peninsular  and  Independent. 


ART.  XX.— Two  Cases  of  Strangulated  Hernia :  Operation  and 

Result. 


By  Z.  E.  Bliss,  M.  D. 


Case  I.  Strangulated  Inguinal  Hernia  of  Left  Side :  Ope- 
ration and  Recovery. — February  4tliy  1859,  I  received  a  note 
from  my  friend  Dr.  Cornell,  requesting  my  assistance  in 
a  case  of  strangulated  hernia.  My  friend  Dr.  Wilson 
consented  to  accompany  and  assist  me.  We  found  the 
patient,  Mr.  E ,  laborer,  aged  4.5,  suffering  from  a  stran- 
gulated inguinal  hernia  (oblique)  of  the  left  side,  of  thirty- 
six  hours'  standing. 

Previous  History. — Twenty  years  ago  received  a  fall, 
producing  hernia  on  either  side  ;  has  never  wore  any  sup- 
port but  a  bandage  and  compress,  and  at  intervals  nothing^ 
Three  years  ago,  the  intestine  came  down,  and  becoming 
strangulated,  his  physician,  Dr.  Cornell,  by  bleeding,  ice 
locally,  and  taxis,  succeeded  in  reducing  it. 

Condition  Thirty -six  Hours  after  Strangulation  com- 
menced.— Kestless,  pulse  one  hundred,  occasional  stercora- 
ceous  vomiting,  countenance  anxious  ;  scrotal  tumor  of  left 
side,  ten  inches  in  circumference,  somewhat  elastic,  dis' 
colored,  and  tender  to  the  touch. 

Taxis  had  been  thoroughly  tried  three  times,  with  patient 
under  the  influence  of  chloroform  ;  anodynes  internally,  and 
ice  to  the  tumor,  xifter  a  consultation,  the  patient  was 
placed  in  a  proper  position,  chloroform  given,  and  uninter- 
rupted taxis  continued  for  one  hour,  with  no  perceptible 
change  in  the  tumor.  After  a  second  consultation,  the 
patient  was  given  time  to  rally,  and  again  placed  under  the 
influence  of  chloroform,  at  which  time,  being  assisted  by  the 
above  named  gentlemen,  I  made  an  incision  three  and  one- 
half  inches  in  length,  corresponding  with  the  upper  border 
of  Poupart's  ligament,  and  dissecting  (by  an  artificial  light) 
down    to   the   sack,    opened   it,    and   a   quantity   of    serum 


Bliss'   Cases  of  Strangulated  Hernia.  267 

escaped.  The  intestine  presented  a  dark  purple  surface. 
The  stricture  being,  divided,  two  or  three  bands  of  adhe- 
sion were  found  between  the  neck  and  stricture,  at  the 
lower  and  inner  border,  which  being  broken  up,  the  tumor 
was  returned. 

A  few  stitches,  cold  water  dressings,  and  a  compress ^ 
completed  the  whole,  and  I  left  him  in  charge  of  his  phy- 
sician ;  who  has  since  informed  me  that  anodynes  were  given^ 
and,  on  the  fourth  day,  the  dressings  were  for  the  first  time 
removed,  when  union  by  first  intention  had  taken  place 
through  nearly  the  whole  wound,  and  on  the  same  day 
there  was  a  spontaneous  movement  of  the  bowels.  No 
unpleasant  symptoms  occurring,  in  three  weeks  he  was  able 
to  resume  business.  He  was  directed  to  wear  a  compress 
for  several  months. 


Case  II.  Strangulated  Femoral  Hernia  of  Right  Side : 
Operation,  and  Death. — June  11th,  1859,  I  received  a 
summons  to  meet  Drs.  Dodge,  of  Palo,  and  Leonard,   of 

Greenville,  in  consultation,  at  the  residence  of  Mr.  B- -, 

in  Montcalm  county. 

Mr.  B ,  aged  42,  a  laborer,  says  a  tumor  has  made 

its  appearance  in  the  right  groin,  at  intervals  for  the  last 
seventeen  years.  June  9th,  he  had  been  lifting,  heavily,'' 
the  tumor  came  down,  appeared  larger,  and  became  painful. 
His  physicians  were,  sent  for,  and  the  usual  means  of 
reduction,  such  as  taxis  with  its  auxiliaries,  cold  to  the 
tumor,  anodynes  internally,  and  tobacco  enema;  but  all 
availed  nothino^. 

I  first  saw  the  patient  fifty  hours  after  the  commence- 
ment of  strangulation,  countenance  sunken  and  expressive  of 
great  anxiety  and  sufi"ering,  pulse  125,  and  occasional  ster- 
coraceous  vomiting.  The  tumor,  fi^e  inches  in  circumfer^ 
ence,  lay  over  Poupart's  ligament. 

As   the  strangulation   was   of  long  duration,  and   taxis 


268  The  Peninsular  a7id  Independent. 

had  been  thorougbly  tried,  an  operation  was  deemed  the 
only  alternative.  Accordingly  ether  and  a  little  chloroform 
was  given,  to  full  anaesthesia,  and,  assisted  by  the  above 
mentioned  gentlemen,  I  proceeded  making  an  incision,  about 
three  and  one -half  inches  in  length,  corresponding  with  the 
inferior  border  of  Poupart's  ligament,  and,  dissecting  up 
the  different  layers,  exposed  the  sack,  and  opening  it  found 
firm  and  extensive  adhesions  between  it  and  its  contents^ 
which  was  not  further  disturbed.  The  stricture  was  divided? 
also  the  sac  at  the  seat  of  stricture  ;  and  there  being  no 
contra -indications,  the  whole  was  reduced.  At  this  stage, 
the  extremeties  became  cold,  and  their  arteries  pulseless  ;  a 
cadaveric  countenance,  abdominal  respiration,  and  slow  pul- 
sation of  the  carotids,  all  told  too  plainly  of  what  was  likely 
very  soon  to  follow.  A  current  of  air,  ammonia  to  the  nostrils, 
dashing  of  cold  water  upon  the  face  and  chest,  alternated  with 
friction  and  flagellation,  and  friction  to  the  extremities, 
were  instantly  resorted  to,  but  the  patient  ceased  to  breathe. 
Makshal  Hall's  ready  method  was  now  tried,  and  contin- 
ued with  the  above  mentioned  auxiliaries,  for  eight  or  ten 
minutes,  when  I  had  the  good  fortune  to  see  the  patient  rally, 
who,  without  this  timely  means,  must  have  died  under  the 
operation.  A  few  stitches  were  made,  and  a  compress  and 
cold  water  dressings  applied  to  the  wound.  In  one  hour, 
the  patient  had  sufficiently  rallied  to  express  himself  com- 
fortable ;  pulse,  ^^. 

I  left  him  in  charge  of  his  physician.  Stimulating  doses 
of  morphine  were  to  be  given  every  two  or  four  hours  ;  and 
if  he  sank,  brandy  and  opium. 

The  following  is  from  Dr.  Dodge  :  Three  hours  after  the 
operation,  pulse  70,  and  fuller.  One -eighth  grain  of  morphia 
acetat.  Patient  fell  asleep,  and  in  three  hours  awoke  with 
great  prsecordial  distress  ;  pulse  rapid  and  feeble.  Brandy 
and  opium.  Patient  sank  rapidly,  and  in  three  hours  (it 
being  nine  after  the  operation,  and  fifty  -  nine  from  the  com- 
mencement of  strangulation)  expired. 


Bliss'    Cases  of  Strangulated  Hernia.  269 

It  is  quite  likely  that  this  man  died  from  peritonitis,  or 
from  the  shock  to  the  system  occasioned  by  the  operation  ; 
but  probably  from  both.  I  think  that  a  single  incision  is 
quite  sufficient  for  all  practicable  purposes,  and  gives  ample 
room  for  all  necessary  manipulations  around  the  neck  of  the 
sac  (provided  the  tumor  is  not  large  —  and  which  we  know 
is  seldom  the  case  in  Femoral  Hernia),  thereby  doing  less 
injury  to  the  parts,  and  leaving  less  surface  to  unite. 
Ionia,  June  29th,  1859. 


ART.  XXI.— Treatment  of  Chronic  Conjunctivitis— A  lew  Agent. 


By  F.  Rice  Waggoner,  M.  D. 

Chronic  Conjunctivitis,  when  a  sequel  of  an  acute  inflam- 
mation, is  of  indefinite  duration.  In  our  Prairie  State  and 
southwestern  district,  we  frequeDtly  meet  with  cases  of  three, 
four,  and  five  years'  duration,  and  not  unfrequently  it  runs 
into  tens  of  years.  In  all  cases,  the  conjunctiva  is  gran- 
ulated^  and  more  or  less  thickened.  In  one  case  that  came 
under  my  observation,  the  conjunctiva  and  lids  were  thick- 
ened to  twice  their  normal  condition :  the  case  being  one  of 
thirty -five  years'  standing.  As  every  practitioner,  who 
has  tried  his  skill  upon  it,  too  well  knows,  this  form  of 
Ophthalmia  is  one  very  difficult  to  treat  successfully,  and 
often  he  is  pained  to  see  his  patients  fall  into  the  hands  of 
unmerciful  quacks,  to  have  their  eyes  injured  tenfold,  and 
their  pockets  drained  of  often  hard  earnings. 

During  my  papilage,  I  was  taught  a  mode  of  treatment 
not  common  to  the  "  books,"  nor  do  I  think  to  the  Profes- 
sion at  large,  which  I  desire  briefly  to  submit. 

Treatment. — After  correcting  their  general  health,  if  de- 
ranged, I  require  my  patients  to  attend  my  office  twice  per 
day,  morning  and  evening.     First  application  is  a  small  (one 


270  The  Peninsular  and  Independent. 

sixteenth  of  a  grain)  quantity  of  sulph.  morphine,  dissolved 
in  pure  water,  and  applied  with  a  earners  hair  brush  ;  this 
treatment  to  be  continued  for  one  or  two  days,  until  al^ 
irritability  is  allayed.  In  turn  follows  acetat.  plumbi,  sulph, 
zinci,  acetat.  zinci,  sulph.  cupri,  and  nit.  argent.  This  con- 
stitutes my  Materia  Medica. 

Experience  has  taught  me  that  the  mucous  membrane 
of  the  eye  will  not  tolerate  any  one  application  more  than 
twice  or  thrice  without  positive  damage  to  the  organ  dis- 
eased ;  hence  the  secret  of  successful  treatment. 

In  the  application  of  our  remedies,  the  milder  astrin- 
gents should  be  used  until  the  active  phlogosis  is  all  sub- 
dued ;  then  follow  with  the  more  active  agent,  which  should 
be  applied  with  care,  ancl  never  be  so  strong  as  seriously  to 
irritate  the  organ  ;  but  use  them  generally  in  succession^ 
governed  by  the  stage  of  the  inflammation,  when,  sooner  or 
later,  our  patient's  malady  progresses  to  a  termination — gene- 
rally within  six  or  eight  weeks. 

The  case  referred  to  in  this  article  who  had  been  a  sub- 
ject of  the '^  sore  eyes"  for  the  majority  of  her  days,  was 
treated  by  me  on  this  alternating  plan,  and  a  cure  effected 
in  ten  weeks. 

Latterly  I  have  incorporated  in  my  Materia  Medica  the 
iodide  of  zinc,  the  effects  of  which  have  proved  salutary 
beyond  all  anticipation.  This  drug  is  passed  over  in  all  of 
our  standard  works  on  Therapeutics,  in  almost  profound 
silence.  In  no  case,  in  which  I  have  observed  its  effects  in 
the  treatment  of  Ophthalmia,  has  it  deserved,  in  my  humble 
opinion,  a  place  second  to  any  other  remedy.  In  one  scro- 
fulous case,  it  acted  like  a  charm. 

Will  not  the  Profession  give  attention  to  this  very 
deserving  agent,  and  more  fully  prove  its  worth  ? 

Oconee,  111. 


HoRTOisr's  Meteorological  Register  for  June, 


211 


ART.  XXII.  —  Meteorological  Register  for  Montli  of  June,  1859. 
By  L.  S.  Horton,  House  Physician  to  U.  S.  Marine  Hospital. 

AUitude  of  Barometer  above  the  level  of  the  sea,  597  feet.     Latitude,  420  24'N,;  and 
Longitude,  82*58'W.  of  Greenwich. 


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MEDICAL  HEROISM.  Address  before  the  Philadelphia  County  Medi- 
cal Society.  Delivered  February  24th,  1859,  by  John  Bell,  M.  D., 
at  the  close  of  his  official  term  as  President.  Published  by  order 
of  the  Society.     Philadelphia.     1859.     38  i^p. 

Medical  Heroism  !  Is  there  really  such  a  thing  ?  The 
world  knows  nothino^  of  it.  Who  ever  talks  of  such  a  thino^  ? 
Who  ever  disconnects  the  idea  of  heroism  from  feats  of 
"  broil  and  battle"  ?  Who  ever  thinks  of  seeking  for  true 
courage  in  the  much  despised,  often  ridiculed,  and  very  gene- 
rally unrequited  vocation  of  the  Medical  Practitioner  ?  Does 
History,  in  the  discharge  of  her  duties,  rake  up  for  record 
instances  of  heroism  from  such  a  despised  source  ?  Does 
the  Novelist,  as  he  ransacks  history,  or  scrutinizes  society 
from  palace  to  hovel,  for  material,  ever  dream  that  "Doctor" 
of  his  story  can  figure  in  any  other  than  a  ridiculous  atti- 
tude ?  Is  there  truly  anything  in  the  actions  of  medical 
men  that  is  heroic?  Is  the  "Doctor"  ever  the  hero  of 
anything  save  a  nauseous  draught  or  a  petty  professional 
quarrel  ?  Alas !  that  the  world  generally  can  ask  these 
questions  in  the  utmost  sincerity.  Alas  !  that  the  Profes- 
sion must  sound  its  own  praise,  or  never  hear  it.  Alas  ! 
that  it  was  necessary  for  our  author,  in  addressing  his 
brethren  upon  the  subject  of  Medical  Heroism,  to  hold  the 
language  that  he  does. 

Medical  Heroism  is  not  a  myth.     Every  practicing  phy- 
sician has   often   braved   danger,   without    hope    of  reward, 


Bibliographical  Record.  273 

cither  in  money  or  fame.  But  it  is  not  strange  that  the 
world  does  not  fully  appreciate  this  fact.  It  is  too  common 
to  be  noticeable.  But  when  pestilence  walketh  abroad,  and 
startled  comuunities  fly  from  the  scene  of  danger  and  death 
— when  ties  of  friendship  or  bbod  are  not  strong  enough 
to  retain  the  fleeing  one,  to  smooth  the  dying  couch  and 
administer  the  cup  of  water  to  the  loathsome  relic  of  friend 
or  brother — who  stand  firm,  and  faithfully  discharge  duties 
which  are  now  heroic  in  their  nature  ?  Not  only  so  ;  but 
when  the  ranks  of  these  brave  men  are  thinned  by  the 
enemy  which  they  so  determinedly  battle,  who  step  in  ta 
take  their  places  ?  Who  leave  home  and  friends,  to  fly  to 
the  rescue  ?  Medical  Men.  Is  it  not  strange  that  such 
deeds  do  not  live  in  history  ?  Perry  lives  m  the  hearts  of 
his  countrymen,  and  monumental  fame  will  be  his ;  but 
will  admiration  or  gratitude  ever  call  up  and  perpetuate  the 
names  of  those  brave  men  who  volunteered  and  fought  the 
cholera  in  Sandusky,  with  a  courage  unsurpassed,  and  a 
determination  in  which  ^' Do  n't  give  up  the  ship"  was 
written  in  acts  of  love  and  mercy  ?  The  two  are  neighbor- 
ing scenes :  one  is  already  sacred ;  will  the  other  ever  become 
so  .^  Will  the  Medical  Heroes  of  Norfolk  live  in  history  ? 
Yet  deeds  of  bravery  were  there  enacted  such  as  were  never 
witnessed  on  battle-field.  No  short-lived  excitement  moved 
those  men,  but  for  weeks  they  coolly  faced  the  enemy, 
mitil  they  finally  fell  in  action,  or  were  permitted  to  share 
in  victory. 

But  let  us  hear  from  Dr.  Bell  himself 

The  medical  hero  in  Christian  lands  is  not  to  be  sought  for  in 
courts  or  in  camps,  nor  in  the  busy  and  crowded  haunts  of  the 
wealth- seeking ;  he  is  not  on  the  Rialto  or  the  Exchange,  nor  promi- 
nent at  the  polls  ;  he  is  neither  a  demagogue,  inflaming  the  passions 
of  the  multitude,  nor  a  parasite,  flattering  the  prejudices  of  the  rich, 
or  ministering  to  the  caprices  of  those  in  power.  He  seldom  finds  a 
place  in  pageant  or  in  festival ;  seldom  is  called  upon  to  add  his  voice 
to  the  peans  of  victory.  He  passes  through  the  crowd  often  unknown 
Vol.  II.  -  S. 


274  The  Peninsular  and  Independent. 

uncarcd  for,  unless  indeed  it  may  be  when  he  meets  the  face  of  one 
radiant  'uith  Fmilcs,  whom  he  had  visited  but  a  short  time  before, 
pi'ostratc  on  the  bed  of  sickness,  or  hears  his  name  uttered  by  another 
in   a  tone  equivalent  to  saying,    "God  bless  him!" 

But  in  what  terms,  by  wliat  epithets  shall  wc  designate  him  who, 
without  any  such  genial  incentives,  without  any  expectation  of  possi- 
ble reci[)rocity,  or  hope  of  applause,  and  certainly  without  any  of  ihc 
returns  for  self-  exposure  which  men  might  expect  fiom  men,  goes 
about  from  day  to  day,  and  often  too  in  the  silent  watches  of 
the  rn'ght,  in  a  spirit  of  self-sacrifice  of  case,  comfort,  health,  and  life 
itself,  ministering  lelicf  to  his  pestilence -stiicken  and  fever  -  tossed  fel- 
low-creature, the  inmate,  it  may  be,  of  a  garret  or  a  cellar  of  sorao 
wretched  tenement,  in  an  affected  court  or  alley,  the  approich  to  which 
is  by  a  narrow  passage,  obstructed  by  accumulations  of  all  kinds  of 
refuse  and  impurities?  Is  this  man  a  soldier,  inured  to  scenes  of  car- 
nage and  death,  whose  vocation  makes  him  regardless  of  danger,  and 
who,  although  he  may  be  detailed  on  the  f>il()rn  hope,  knows  that  if 
he  fall,  his  name  will  bo  recorded  in  ihj  Gazette,  and  his  wife  and 
children  receive  perhaps  a  pension  ?  Or  is  he  a  salaried  official,  who, 
for  a  certain  pecuniary  return  and  perquisites,  is  discharging  a  pre- 
scribed and  covenanted  duty  ?  Oh,  no!  This  simple- minded  man,  who 
goes  about  his  duty  for  duty's  and  humanity's  sake,  is  only  a  doctor^ 
one  of  a  class  at  whom  every  wittling  is  privileged  to  fling  a  sarcasm, 
and  whom  every  venal  quack  may  accuse  of  selfishness,  and  greediness 
of  gold. 

"  During  the  famine  fever  of  18-47  in  Ireland,  one  hundred 
and  seventy  -  eight  Ii  ish  medical  practitioners,  exclusive  of  medical 
pupils  and  army  surgeons,  died,  being  a  proportion  of  nearly  seven  per 
cent.,  or  one  in  ever}-  ] -5  medical  practiiioners,  in  a  single  year.''  Some 
persons  may  say  that  physicians  who  thus  expose  themselves,  and  who 
pay  tl.c  penally  of  death  for  their  exposuie,  rre  encouraged  by  the  ex- 
pectation of  pecuniary  advantage  in  the  v'-hapc  of  fees.  We  must  all 
wish  that  they  had  such  inducements ;  the}'  could  readily  afford  to 
forego  a  part  of  their  reputation  f(^r  benevolence  and  disinterestedness, 
in  cjnsidcration  of  their  receiving  that  by  which  they  could  support 
their  wives  and  children,  or  an  aged  parent,  or  a  lone  sister.  But  it 
ro  happens,  that  in  all  c[)idemic  and  pestilential  diseases,  the  chief  pri- 
vations and  dangers  incurred  by  medical  men  are  in  their  attendance 
on  the  poor,  the  nced\^  and  the  destitute,  and  not  seldom  the  dissolute, 
who  have  no  claim  on  them  by  prioi-  acquaintance  or  the  most  tiivial 
scivice,  and  from  whom  they  receive  no  fees,  and  often  no  thanks,  or 
the  slightest  token  of  gratitude. 

The  greater  part  of  the  mortality  among  the  Irish  physicians  was 
caused    by    their    attendance   on  hospitals,    and    on    the    poor  and  half- 


Blhllographical  Record,  275 

starved  occupants  of  cabins  and  haralets,  the  air  of  which  was  often 
in  such  a  state  of  concentrated  virulence  as  to  strike  on  the  Dcrvous 
S3"stcm  with  almost  the  force  and  suddenness  of  the  electric  aura.  And 
shall  no  page  in  histor}'',  no  lines  in  poetr}'',  celebrate  the  heroic  deeds 
of  these  devoted  men,  who  must  have  battled  with  a  stouter  heart 
against  an  unseen  enemy  than  Lt:0NiDAS  and  his  Spartan  band  against 
the  Persian  host,  or  the  Light  Brigade  in  its  daring  and  rash  charge 
on  the  scried  Russian  lines  at  Inkermann  ?  These  heroes  of  humanity 
ought  to  be  honored  with  a  monumental  inscription,  even  though  it 
were  couched  in  as  brief  phrase  as  that  over  the  remains  of  the  Athe- 
nians under  Miltiades  — 

"They  fought  at  Mi'ralbon." 

Dr.  Bell  alludes  also  to  the  New  York  physicians  who 
fell,  a  few  years  since,  in  attending  upon  newly -arrived  emi- 
grants, lie  refers  at  length  to  the  plague  of  Marseilles  in 
1720,  and  the  yellow  fever  of  Philadelphia  in  1793.  Of 
Dr.  BenjaiuIN  Eush,  who  was  active  in  the  latter,  he 
says  : 

In  the  history  of  the  war  of  tho  Revolution,  Dr.  Benjamin  Rush, 
RS  one  of  the  signers  of  the  Declaration  of  Independence,  and  Phj^sician' 
General  to  the  army,  will  ahvaj^s  iigurc  with  the  other  worthies  of  that 
momentous  period.  But  in  the  history  of  philanthropy  he  will  occupy 
a  still  higher  place,  as  one  of  the  medical  heroes  who  won  his  honors 
and  enduring  fame  in  the  trying  year  of  1793,  and  in  the  other  epi- 
demic invasions  of  the  yellow  fever  during  the  next  twelve  years.  The 
fever  of  1798  revived  the  terrors  and  the  mortality  of  1793,  and,  at 
the  same  time,  gave  opportunities  for  a  display  of  heroic  devotcdness 
on  the  part  of  the  physicians  similar  to  that  manifested  in  the  latter 
year. 

The  following  selections  contain  a  good  illustration  of 
the  difference  in  the  courage  which  is  shown  on  the  battle- 
field and  that  which  faces  pestilence  ;  and  also  a  fine  in- 
stance of  courage,  devotion,  and  zeal : 

Slill  more  animated  must  have  b:ea  the  feeling  of  the  whole  French 
army  in  Egypt  under  Napoleon,  or,  as  he  was  then  more  common'y 
calletJ,  Bl'onap\ute,  towards  the  chiefs  of  the  medical  and  surgical 
staff.  The  troops,  after  witnessing  the  ravages  of  the  plague,  became 
alarmci  and  dishcarttncd ;  and  m.en  v.ho  had  never  feared  an  enemy  in 
Xhc  field  of  battle,   now  shrank  with  horror  from  the  touch  and  breath 


276  The  Peninsular  and  Independent. 

of  a  sick  companion  in  the  quiet  tent.  To  the  General,  such  a  state  ot 
things  was  worse  than  the  loss  of  a  battle.  In  vain  were  the  soldiers 
told  that  their  fears  were  without  foundation  ;  in  vain  were  they  ad- 
dressed in  the  language  of  encouragement  and  hope.  Something  must 
be  done,  cither  to  change  their  belief  or  to  appeal  strongly  to  their 
imagination.  Accordingly,  Napoleon  himself  conversed  freely  with  tho 
patients  who  were  stricken  with  the  plague,  and  touched  their  bodies, 
and  even  sometimes  performed  the  part  of  a  nurse  by  raising  them  up. 
and  supporting  them  in  their  beds,  in  order  to  prove  that  there  was. 
no  danger,  and  that  the  disease  was  not  contagious.  These  traits  of 
cool  courage  are  recorded  by  every  historian  of  the  wars  of  the  French 
Revolution  ;  but  few  have  thought  it  worth  while  to  notice  the  more 
daring  exploit  of  Dksoenettes,  one  of  the  physicians  of  the  army  of 
Egypt.  He  not  only  touched  and  handled  the  bodies  of  those  who  had 
sickened  with  the  plague,  but  he  inoculated  himself  with  their  blood 
and  other  iluids.  On  another  occasion,  after  Beuthollet  had  expressed 
his  belief  that  the  poison  of  the  plague  was  conveyed  into  the  body 
by  means  of  the  saliva,  a  patient,  dying  of  this  disease,  begged  that 
Desoenettes  would  take  a  part  of  what  was  left  of  the  draught  that 
had  been  prescribed  for  him.  AVithout  hesitation,  or  betraying  tho 
slightest  emotion,  Desgenettes  took  the  cup  from  the  sick  man,  filled 
it  up,  and  drank  its  contents  entire. 

If  we  believe  that  the  design  of  the  two  —  the  military  leader  and 
the  physician  —  was  the  same  at  this  time,  viz.,  to  infuse  confidence 
into  the  minds  of  the  soldiers,  it  is  not  difBcult  to  decide  to  which  of 
them  should  be  awarded  the  palm  for  this  daring  exposure  of  his  life. 
Napoleon  felt  that  all  his  prospects  of  conquest  and  fame  would  be 
clouded  unless  he  could  restore  the  sinking  courage  of  his  army  ;  and 
hence  he  readily  incurred  some  danger  to  secure  so  important  an  end. 
Desgenettes  was  buoyed  up  by  no  such  aspirations.  His  incentives 
were  humanity  and  a  search  after  truth.  AVhy  not  make  this  fine  trait 
of  the  physician  more  prominent  than  that  of  the  soldier  in  a  school 
history  ?  A  small  volume,  consisting  of  incidents  of  this  nature,  might 
be  prepared  and  introduced  into  the  public  schools.  I  would  offer  some 
additional  facts  and  reflections,  in  the  way  of  contributing  a  chapter  to, 
a  work  of  this  kind. 

While  French  medicine  was  thus  represented  in  Egypt  by  the  calrct 
and  self-  possessed  Desgenettes,  who  was  at  the  head  of  the  medical 
staff,  French  surgery  shone  with,  perhaps,  still  greater  lustre  in  the 
person  of  the  eminent  Lakkey,  who,  by  his  invention  of  the  light  am- 
bulance for  carrying  off  the  wounded  from  the  field  of  battle,  won  the 
affection  of  the  soldier,  and  by  this  act  alone  becomes  entitled  to  honor- 
able mention  in  the  annals  of  philanthropy.  From  the  burning  sands 
of  Egypt,  to  the  ice-bound  rivers  and  snow -covered  plains  of  Russia,, 
in  Poland,  in  Prussia,  in   Saxony,  in  Austria,   in  Italy,  in  Spain,  and  ir^ 


Bibliographical  Record.  277 

franco  itself,    Larkey  not  only  encountered  all  the  vicissitudes  of  climate 
and  season,   and  the  hardships  incident  to  camp -life,    but   he   was    con- 
stantly engaged  in  the  discharge  of  his  arduous  duties  as  field  and  hos- 
pital surgeon,  fearless  of  personal  risk,  and  intent  only  on  affording  the 
promptest  relief  to  those  placed  under  his  care.      He  did  not  wait  at  a 
'safe  distance  from  the  field  of  battle  for  the  wounded  to  be  brought  to 
him  ;  he  was  found  in  the  midst  of  the  wounded,  the    dying,    and   the 
d«ad,    ready   and   resolute,    and   always    self-possessed;    operating   with 
•equal  promptitude  and  skill  on   those  whom  he  could  first  reach  or  who 
'were  most   in  need  of  his  services,  and  not  caring  for  the  rank  of  the 
'prostrate  man  before  him.       Instances  are  recorded  in  which  Lakrey  and 
liis  assistants,  carried  away  by  their  professional,  and  shall  it  be  said,  in 
part,  also,  their  national  enthusiasm,  were  seen  giving  their  attentions  to 
the  wounded  near  the  imminent  and  deadly  breach  itself,  amidst  a  shower 
of  destructive  missiles  which  were   carrying  wounds  and  death  to  those 
uround  them.     Lauijey  was  exposed  to  the  same  fire  under  which  CaffeK' 
9ELLI,  Lannes,  Akkigiii,  Beauhaknais,  and  many  others,  fell,  either  wounded 
■or  never  to  rise  again.       After  the  long  -  contested  and  bloody  battle  of 
Eylau,  in  Polish  Prussia,  between  the  French  and  Russians,  the  Emperor 
Napoleon  found  Lakrey  standing  in  the  snow,  under  a  slight  canopy  of 
branches  of  trees,  engaged  in  dressing  the  wounded ;   and  on  his  passing 
by  the  same  place,  at  the  same  hour,  on  the  following  day,  he  saw  the  in- 
defatigable surgeon  still  occupied  as  before.     In  this  way  did  Larrey  spend 
twenty -four  hours  uninterruptedly,  except  in  the  few  minutes  snatched 
for  a  hurried  repast.       We  have  all  heard  or  read  of  displays  of  zeal — 
religious,  fanatical,  patriotic,  and   amorous  —  but  seldom  has  there  been 
recorded  a  finer  example  of  benevolent  zeal  spent  on  so  good  and  useful 
ft   purpose. 

The  Crimean  War,  too,  is  drawn  upon  for  illustrations 
t)f  Medical,  as  well  as  Military  Heroism,  and  the  diiference 
in  the  estimate  which  is  placed  upon  the  two  : 

We  change  the  scene,  and  this  time  it  opens  in  the  Crimea,  after  the 
battle  of  the  Alma,  in  which  the  Russians  were  defeated  by  the  allied 
troops  of  France  and  England,  in  1854.  You  have  read  of  the  feats  of 
valor  displayed  on  both  sides  on  that  bloody  field — the  sweeping  fire  of 
the  artillery,  the  daring  charge  of  cavalry,  the  deadly  encounter  of  the 
columns  of  infantry,  when  men  met  men  with  bayonets  crossed,  in  the 
mixed  excitement  of  animal  passion,  national  rivalry,  and  the  thirst  for 
honor  and  distinction.  The  names  of  St.  Arnaud  and  Raglan,  the  victo- 
rious Generals,  were  suddenly  sounded  and  sung  in  both  hemispheres,  and 
they  took  at  once  their  places  in  history.  But  the  real  hero,  the  saviour, 
not  the  destroyer,  appeared  on  the  day  after  the  battle,  unheralded  by 
drum  or  trumpet,  a  devoted,  and  to  all  appearances  a  doomed  volunteer  in 


2V8  The  Peninsular  and  Independent. 

the  cause  of  humanity.  The  allied  forces  were  under  the  military  ohliga- 
tion  of  advancing  rapidly  on  Sebastopol  in  pursuit  of  the  Tcticating  Rus- 
eians,  and  in  doing  so  to  leave  750  wounded  of  ihe  enemy  behind  them  on 
the  field  of  battle.  "  Who,"  to  use  tlie  words  of  an  English  medical  jour- 
nal, "is  that  single  individual  who,  of  all  the  host  that  is  murching  away 
from  the  scene  of  its  late  triumph,  is  still  to  be  found  on  that  blood-stained 
field?  And  what  is  the  errand  on  which  he  is  engaged,  thus  alone  among 
his  enemies,  watching  the  retreating  forms  of  his  friend<,  his  countrymen, 
and  gathering  up  his  courage  as  best  he  may,  to  undertake  the  duties 
which,  in  obedience  to  the  dictates  of  humanity,  it  had  become  his  duty 
to  perform  ?  This  most  painful  and  desolate  duty  was  imposed  on  himself 
by  Dr.  Thomson,  of  the  44th  regiment,  a  native  of  Cromart}^  in  the  noith- 
crn  part  of  Scotland,  the  birthplace  also  of  Hugh  Mii.leji,  of  the  Red  Sand- 
stone fame.  Provided  with  some  rum,  biscuit,  and  salt  meat,  he  was  left 
with  his  charge;  his  only  companion  a  private  soldier,  acting  as  his  ser- 
vant. This  was  indeed  a  forlorn  prospect.  Could  he  escape  from  tho 
savage  assaults  of  the  marauding  Cossacks,  a  party  of  whom  had  ruthlessly 
destro^'cd  a  villa  not  many  miles  off,  on  the  road  to  Balaklava,  tho 
residence,  too,  of  a  Russian  country  surgeon  or  physican,  who  had  been 
obliged  to  make  a  hasty  retreat?  Even  the  patient  themselves,  whether 
under  the  influence  of  fever,  caused  by  their  wounds,  or  by  mere 
brutal  ferocity,  had  fired  at  or  stabbed  the  humane  individuals  who 
were  then  dressing  their  wounds.  Five  days,  however,  did  Surgeon 
Thomson  pass  in  the  midst  of  such  a  people,  whose  language  was 
unknown  to  him,  without  any  companion  but  his  soldier -servant. 
Often  were  these  two  Englishmen  obliged  to  extricate  the  wounded 
from  beneath  the  dead  before  their  gashes  could  be  healed,  and  alsa 
to  bury  the  dead  because  of  the  pestilential  smell  arising  from  the 
mutilated  carcasses.  Their  scanty  supply  of  food  was  about  to  fail 
them.  On  the  dreaded  approach  of  a  swarm  of  Cossacks,  840  wounded 
men,  who  five  days  previously  lay  in  helpless  agony  on  the  ground^ 
walked  away  with  Surgeon  Thomson  to  the  shore,  and,  after  over- 
whelming their  deliverer  from  death  with  expressions  of  gratitude, 
sailed  for  Odessa.  The  surgeon  himself  escaped  from  the  Cossacks, 
and  reached  the  English  head-quarters  on  the  4th  of  October,  but  died 
of  cholera  the  next  day,  worn  out  by  the  hardships  he  had  under- 
gone. Surely,"  adds  the  English  journalist,  ''James  Thomson,  of  the 
4:4th  Regiment,  has  earned  a  monument,  for  in  his  own  noble  char- 
acter were  united  the  physician's  skill,  the  soldier's  courage,  and  the 
Christian's   humanity." 

The   heroism   and  philanthrophy  of  Pinel   is  thus   de-. 
scribed : 

Another   passage   for   the  records  of  lledical   Heroism,   and   I  have 
done: — 


JBihUograpliical  Record.  27D 

The  name  of  IIowakd  is  everywhere  celebrated,  and  praised  in 
terms  of  warm  gratitude,  as  the  reformer  of  prison  abuses  and  prison 
cruelties.  It  has  obtained  a  place  in  the  history  of  the  world's  pro- 
gress. The  name  of  Pinel  is  not,  I  am  afraid,  familiar  even  to  the 
medical  world;  and  it  is  still  less  to  the  world  at  large,  as  that  of 
a  ph3^sician,  who,  both  by  personal  services  and  earnest  teaching, 
brought  about  a  reform  in  the  management  and  discipline  of  Asylums 
for  the  Insane,  which  may  now  be  properly  regarded  one  of  the  strongest 
proofs  of  advanced  civilization.  If  a  proper  sympathy  and  sentiment 
for  humanity  and  justice  have  been  enlisted  by  the  benevolent  Eng- 
lishman, in  what  light  ought  we  to  regard  the  services  of  the  equally 
benevolent  Frenchman,  who  reminded  men  of  their  duties  to  the  Pro- 
vidence-stricken but  irresponsible  insane?  Excuse  might  be  found  for 
vindictive  harshness  to  the  criminal  who  has  made  war  on  society; 
but  where  is  the  extenuation  for  more  deliberate  cruelty,  practiced  so 
long  and  so  generally  on  those  unfortunate  beings,  barefc  of  their 
reason,  many  of  whom,  but  a  short  time  before,  had  been  the  delight 
of   the    social    circle,    and    cherished   members  of  the  family  ? 

When  we  think  of  the  old  Bedlams  and  Hospitals  for  the  Insane, 
in  which  not  only  the  raving  maniac,  but  the  melancholy  monomaniac 
was  confined,  and  in  which  the  only  sounds  were  those  of  the  clanging 
chain,  the  echoing  lash,  and  mingled  cries  and  vociferations  of  the 
brutal  keepers  and  the  mfariated  inmates;  and  then  look  abroad  over 
the  better  portions  of  the  civilized  world,  including  our  own  favored 
land,  and  see  the  many  noble  edifices  erected  for  the  reception  and 
treatment  of  this  class  of  unfortunate  fellow-beings,  we  feel  that  we 
live  in  an  age  not  only  of  progress,  but  of  real  improvement ;  one 
in  which  humanizing  influences  are  more  active  and  diffused  than  they 
ever  were  btifore.  The  cDntrast  between  the  present  and  the  past  in 
this  particular,  while  it  should  pr"o:iipt  all  to  tha  liveliest,  manifest- 
ations of  gratitude,  ought,  undoubtedly,  to  find  a  place  in  general 
history,  in  which  proper  credit  would  be  awarded  to  our  Profession, 
so  many  members  of  which  have  imitated,  in  their  official  position  as 
superintendents  of  Insane  Asylums,  the  noble  example  set  by  Pinel 
at  the   Bicetre   and   the   Salpetriere. 

That  was  indeed  a  critical  moment  in  the  life  of  Pinel,  and  in 
the  history  of  benevolent  trials  for  the  mitigition  of  human  suffering, 
when  he  resolved  to  test  the  correctness  of  his  principles  of  non-re- 
straint, by  holding  direct  personal  intercourse  with  a  violent  maniac, 
whose  chains  and  fetters  he  had  previously  directed  to  be  removed. 
The  trial  was  entirely  successful.  After  an  eager  gaze  and  a  move- 
ment, as  if  preparatory  to  a  tiger-like  spring  on  his  visitor,  who  had 
just  entered  his  cell,  the  unfortunate  being  saw  eyes  beaming  with 
kindness  and  placid  features,  expressing  benignity  and  good-will.  Soon 
his   own  countenance   underwent  a   change;  the  mere  brute  was   once 


280  The  Peninsular  and  Independent. 

again  a  human  being;  and  when  the  tones  of  affectionate  inquiry 
reached  his  car,  and  the  hand  of  greeting  was  extended  towards  him, 
he  could  only  answer  and  reciprocate  by  shedding  tears,  the  foun- 
tains of  which  had  long  been  dried  up  by  the  fiery  furnace  of  mad- 
dened feelings,  wrought  to  fury  by  angry  menace  and  brutal  punish- 
ment. From  this  moment  the  cure  of  the  poor  maniac,  which  had 
been  before  regarded  as  hopeless,  was  begun,  and  terminated  in  entire 
restoration   to   health   and   reason. 

After  the  inrpiiring  visitor  has  been  taken  through  a  modern 
lunatic  asylum,  and  traversed  its  spacious  corridors,  and  has  looked 
into  its  neat  and  cheerful  dormitories,  and  is  then  taken  to  the  saloon 
and  the  lecture  room,  and  the  rooms  for  social  meetings  and  amuse- 
ments, and  is  farther  shown,  out  of  doors,  the  extensive  grounds  for 
exercise  and  recreation,  all  under  the  direction  of  the  medical  super- 
intendent, the  presiding  genius  of  the  place,  he  gives  utterance  to  his 
conviction  by  exclaiming:  "After  all,  madness  is  not  so  dreadful  an 
infliction,  when  it  is  met,  controlled,  and  so  often  conquered  by  the 
harmonious  union  of  medical  science,  philanthropic  vigilance,  and  in- 
genuity, and,  at  fitting  times,  the  soothing  balm  of  religious  counsel 
and   exhortation. " 

In  the  vestibule  of  every  modern  lunatic  asylum,  the  visitor 
might  naturally  expect  to  see  a  statue  of  Pin  el,  unless  he  should 
think  at  the  moment  of  the  inscription  on  St.  Paul's  Cathedral,  Lon- 
don, in  allusion  to  its  celebrated  architect.  Sir  Christopder  When, 
"If  you  ask   for  a  monument,    look   around   you." 

Such  is  Medical  Heroism.  Such  are  some  of  the  bright 
examples  ^vhich  our  much  disparaged  Profession  furnishes. 
It  is  true  the  ^vorld  ignores  them,  and  that  Medical  Heroes 
are  not  appreciated  when  living,  and  are  forgotten  when 
dead.  But  he  who  patterns  after  them,  and  strives  to 
equal  them,  evinces  true  and  laudable  ambition  ;  for  it  is 
a  yearning  after  virtue  for  virtue's  sake. 

We  have  no  apology  to  offer  for  devoting  so  much  space 
to  the  notice  of  a  mere  pamphlet.  To  its  author,  Dr.  Bell, 
we  say:  Well  done;  a  worthy  subject  worthily  handled. 

G. 


Biblio graphical  Record.  281 

A  TREATISE  OxX  HUMAN  PHYSIOLOGY;  Designed  for  the  Use  of 
Students  and  Practitioners  of  Medicine.  By  John  C.  Dalton,  Jr., 
M.  D.,  Professor  of  Physiology  and  Microscopic  Anatomy  in  the 
College  of  Physicians  and  Surgeons,  New  York,  etc.  etc.  With  Two 
Hundred  and  Fifty -Four  Illustrations.  Philadelphia:  Blanchard  k 
Lea.     1859. 

There  are  two  classes  of  new  medical  works  which  we  greet 
w  ith  a  hearty  welcome :  they  are  Monographs,  and  Text- 
Books  for  the  use  of  students  which  have  not  been  subjected 
to  diluting  process.  The  book  whose  title  is  given  above 
belongs  to  the  latter  class.  It  is  not  as  extensive  a  work  as 
we  had  anticipated  ;  still  it  is  full  and  comprehensive  within 
its  scop-e.  In  the  latter,  it  has  been  the  object  of  the 
author  to  communicate,  "in  a  condensed  form,  such  new  facts 
and  ideas  in  physiology,  as  have  marked  the  progress  of  the 
science  within  a  recent  period." 

The  teacher  is  apparent  throughout.  Clear  and  concise  in 
his  statements,  the  reader  at  once  comprehends  his  meanings 
The  author  writes  jusfc  what  he  means,  and  means  just  what 
he  writes.  Words  are  not  used,  except  for  this  legitimate 
purpose,  viz..  To  express  an  idea.  Too  often,  with  authors, 
it  is  otherwise,  and  sentences  must  be  re-read,  scanned, 
compared  with  the  context,  and,  even  then,  if  the  author 
himself  ever  had  a  clear  idea  of  the  matter,  he  has,  by  the 
use  of  language,  so  successfully  hidden  it,  that  the  reader 
fails  to  obtain  it.  Dr.  Dalton  is  entirely  free  from  all  this  ; 
he  has  evidently  been  in  the  habit  of  talking^  to  convey  his 
true  meaning,  and  now  he  writes  in  the  same  style. 

The  typography  of  the  book  is  excellent.  The  illustra- 
tions are  beautifully  executed ;  and  of  the  two  hundred  and 
fifty -four,  all  but  eleven  are  original.  This  fact,  alone,  is 
enough  to  commend  the  book.  It  shows  that  the  enterprize 
is  not  one  originating  with  professed  book-makers.  It  is 
the  result  of  labor,  and  does  greai  credit  to  the  author. 

Let  us   have   more   real  authors,  and   let  the   horde   of 


282  The  Peninsular  and  Independent. 

qnaclving  editorial  parasites  betake  themselves  to  honest 
l.ibor;  so  shall  oiir  literature  and  our  national  credit  Lo 
alike  improved.  G. 

CLEVELAND  MEDICAL  GAZETTE.  A  Monthly  Journal  for  the  Ad- 
vancement and  Review  of  the  Medical  Sciences.  Edited  by  Gustav 
C.  E.  Webek,  M.  D.,  iVofcssor  of  Surgery  in  the  Cleveland  Medical 
College. 

No.  1,  Vol.  I.  of  this  new  journal  is  on  our  table.  Wo 
cordially  extend  the  hand  of  fellowship,  and  wish  the  editor 
all  the  success  he  desires.  It  has  been  placed  on  our  ex- 
oh  an  ire   list. 

o 

NORTH  AMERICAN  MEDICAL  REPORTER.      No.  2,  \'ol.  J  I. 

This  journal  has  changed  somewhat  in  appearance  since 
the  1st  No.  was  issued,  and  has  an  accession  to  its  Edito- 
rial corps  in  the  person  of  Louis  Elsburgh,  M.  D. 

ATe  are  under  obligations  to  the  courtesy  of  the  Editor 
for  giving  so  favorable  a  mention  of  the  Penxnsidar  and 
Independent. 


(Biiittixhl  §t^utmt\\t. 


»•  • 


Pharmaceutical  Education  of  Medical  Students. 

Pharmacy  is  making  rapid  strides  from  the  subordinate 
position  it  formerly  held  among  the  arts,  and  is  assuming  a 
high  position  in  its  double  relation  to  art  and  to  science, 
demanding  in  its  votary  mechanical  skill,  artistic  taste,  and, 
above  all,  chemical  knowledge.  While  its  progress  is  so 
rapid,  why  is  it  not  taught  in  all  of  our  medical  schools 
as  a  distinct  branch,  rather  than  as  an  adjunct  to  the 
Chair  of  Chemistry  ?  In  its  practical  relation  to  the  needs 
of  the  physician,  is  not  an  intimate  knowledge  of  the 
manipulatory  details  of  Pharmacy  of  infinitely  more  value 
to  him  than  a  sujoerficial  knowledge  of  chemical  laws,  theo- 
retically taught,  and  practically  almost  useless  ? 

An  intimate  investigation  of  the  physical  qualities,  as 
well  as  differences  and  kinds,  of  remedial  agents,  belongs 
to  a  pharmaceutical  education ;  and.  it  certainly  would  aid 
a  physician  in  determining  by  external  characteristics  alone 
the  quality  of  his  remedies. 

A  laboriously  acquired  skill  in  clothing  preparations 
with  attributes  of  permanence,  elegance,  concentration,  and 
efficiency,  is  a  part  of  the  Pharmaceutist's  requirements  — 
would  not  such  skill  aid  the  Physician,  especially  that  one 
who,  settled  in  the  more  thinly  scattered  portions  of  the 
country,  is  debarred  from  relying  upon  the  professional 
Pharmaceutist  ?     Apropos,  are  the  remarks  of  Dr.  Robert 


284  The  Peninsular  and  Independent. 

Battey,  of  Kome,  Georgia,  upon  this  subject,  tlie  pith  of 
which  are  given  below,  from  the  Southern  Medical  and 
Surgical  Journal: 

Pharmacy,  which  for  ages  occupied  the  position  of  a  mere  art, 
and  a  very  simple  one  at  that,  has,  daring  the  past  half  century, 
gradually  aroused  itself  from  this  long  sleep,  and  is  now  making 
giant  strides  towards  a  degree  of  perfection  little  dreamed  of  in  the 
phiiosnph}''  of  its  ancient  votaries.  Tlie  elixirs  and  amulets  of  our 
fathers  are  remembered  onl}'  with  a  complacent  smile  in  our  conscious 
superiority;  ignorance  and  superstition  have  given  place  to  the  light 
of  reason  and  inductive  philosoph}'.  A  co  mmendable  industry  and  zeal 
is  manifest  among  pharmaceutists  all  over  the  world,  vicing  with  each 
other  in  ransacking  the  nooks  and  corners  of  the  great  storehouse 
of  nature,  in  quest  of  hidden  treasures  to  be  added  to  the  rapidly 
augmenting  fund  of  the  Materia  Medica ;  while,  foremost  among  the 
evidences  of  progress  in  manipulative  pharmacy,  we  have  the  isolation 
of  the  distinct  active  proximate  principles  of  plants  from  the  inert 
and  valueless  ligneous  fibre,  and  the  substitution  of  small  doses  of 
these  refined  materials,  for  the  former  large  draughts  of  nauseous  in- 
fusions  and   decoctions. 

Not  only  has  Pharnlacy  thus  distinguished  herself  in  her  chemi- 
cal capacity,  but  she  been  equally  busy  in  the  improvement  of  her 
extemporaneous  and  more  mechanical  departments.  The  subtile  aeri- 
form spirit,  so  full  of  death  to  any  who  breathes  it,  has  been  chained 
down  in  its  watery  bed  by  strongest  bonds  of  iron,  whence  from 
time  to  time  it  issues  forth  under  the  guiding  hand  of  the  master, 
in  the  sparkling  and  healthful  mineral  water.  The  disgusting  epsom 
or  glauber  salt  no  longer  distorts  the  visage  of  the  invalid  —  but  he 
drinks  his  glass  of  effervescing  citrate  with  as  much  gusto  as  ho 
would  take  his  champagne  or  julep,  when  in  health;  his  castor  oil 
or  copaiba  glides  smoothly  along  his  alimentary  canal,  securely  stowed 
in  the  hold  of  a  tiny  gelatine  boat;  his  pill  no  longer  offends  the 
palate,  nor  sticks  fast  in  his  reluctant  throat,  but  with  its  firm  casing 
of  purest  sugar,  slips  swiftly  down;  and,  if  he  be  a  miser  at  heart, 
he  may  have  it  at  his  bidding,  clothed  in  all  the  charms  of  glitter- 
ing silver   or  still  more  precious  gold. 

The  spirit  of  the  age  is  progress  —  upward  and  onward  is  the 
watchword  we  catch  on  every  hand ;  in  perhaps  no  department  of 
natural  science  is  this  progressive  disposition  more  manifest  than  in 
the  one  under  consideration.     Scientific   Pharmacy  is  no  longer  a  mere 


Editorial  Department.  285 

abstraction  —  it  is  full  of  practical  results ;  nor  is  its  advancement  pre- 
mature —  the  people  have  kept  up  fully  with  the  times,  and  eagerly 
seize  and  appropriate  to  their  comfort  and  advantage  the  new  reme- 
dies as  fast  as  they  arc  brought  forward.  Its  products  are  not  to  be 
confined  to  the  more  refined  and  opulent  denizens  of  our  larger  cities, 
for  the  humble  settler  in  his  backwoodi  cabin  is  bsginning  to  hear 
the  sound  of  glad  tidings,  and  already  demands  that  the  more  palp- 
able impositions  upon  his  gustatory  nerve  shall  cease,  and  calls  for 
less  bulky  nauseous  remedies.  The  voice  of  the  masses  is  loud  in 
favor  of  the  reform,  and  the  old  fogy,  or  his  younger  pupil,  who 
refuses  to  inform  himself,  that  he  may  keep  up  with  the  improvQ' 
ments,  while  he  continues  to  laugh  at  the  disgust  and  wry  faces  of 
his  patrons,  will  find  his  moi'e  enterprising  and  worthy  competitors 
sweeping  by  him  in  their  onward  march  to  a  deserved  fame  and 
popularity. 

So  generally  is  the  want  of  pharmaceutical  knowledge  among 
physicians  felt  and  appreciated,  that  many  are  induced  to  seek  the 
schooling  of  the  apothecary's  shop  prior  to  entering  upon  the  study 
of  medicine;  while  others,  already  practitioners  of  Pharmacy,  are  led 
to  graduate  and  enter  the  medical  fraternity,  as  a  means  of  greater 
professional  elevation  and  emolument.  It  is  evident  that  very  few, 
comparatively,  of  our  medical  men  can  obtain  this  schooling  in  the 
shops,  requh'ing  as  it^  does,  a  series  of  3'^ears  before  an  apprentice  is 
judged  competent  to  execute*  the  more  responsible  manipulations. 
However  well  this  apprenticeship  system  may  work  in  England,  and 
however  desirable  so  thorough  pharmaceutical  attainments  may  be  to 
the  medical  man,  there  is  too  much  valuable  time  consumed  in  the 
pupilage   to   suit   the  fast  ideas   of  our  aspiring  young  men. 

The  office  of  the  preceptor  might  be,  and  ought  to  be,  a  valu- 
able preparatory  school  of  Pharmacy,  as  well  as  of  other  branches 
of  medical  science.  What  are  the  facts  ?  The  observation  is  common, 
that  the  medical  instructions  of  the  majority  of  preceptors  amount  to 
little  more  than  the  use  of  a  few  text-books  from  their  too  meagre 
libraries,  with  an  occasional  explanation,  and  a  rather  semi-occasional 
examination  upon  the  leading  topics  of  study.  Pharmacy  as  a  science, 
or  even  as  an  art,  is  very  rarely  mentioned,  and  seldom,  perhaps 
ne\>er^  taught;  and  if  we  ask  the  reason  of  this  we  shall  not  be^at 
a  loss  for  an  answer.  The  preceptor  himself  knows  little  or  nothing 
of  the  subject,  and  of  course  can  not  be  expected  to  teach  it  —  what 
little  he  has  acquired  has  been  the  result  of  hard  earned  experience; 
let   his   student   dig  it   out  as   lie  did. 

We  next  look  for  the  attainment  of  this  instruction  to  the  medical 
colleges   of  the   country,    and   with  what  better  success  ?    With,    I  be- 


2 so  The  Poiuisular  and  Independent. 

licvc,    but    one    honorable  exception    (the    University  of  Midiigin),    no 
distinct   Chair   of  Pharmacy  is    to  be   found.* 

In  most  instances  it  is  attached  cither  to  the  Chair  of  Chemistry 
or  Materia  Mcdica,  and  in  some  of  these  a  meagre  outline  of  tho 
subject  is  given,  while  the  majority,  perhaps,  retain  only  the  name, 
and  find  no  time  for  the  practical  instruction;  some  few,  it  is  be- 
lieved, do  it  not  the  honor  of  even  mentioning  its  name,  in  their 
annual  announcements.  In  some  of  the  larger  cities  this  deficiency  is 
in  a  measure  supplied  by  public  or  private  pharmaceutical  schools; 
but,  from  inabihty  or  indifference,  the  great  mnjorit}'  of  students  do 
not  avail  themselves  of  these  extra  privileges,  while  much  the  larger 
number  of  colleges  are  located  in  cities  where  these  private  schools 
are  not  accessible  and  can  not  be  maintained.  Besides,  it  is  unquestion- 
ably tlic  rUjlit  of  the  studoiit  to  look  to  the  regular  course  for  this 
indispensable  knowledge ;  as  well  might  the  school  refer  him  to  tho 
hospital  for  his  instruction  in  Surgery;  to  the  private  anatomical  room 
for  his  Anatomy;   or   to   the  private    laboratory   for   his   Chcmistr3^ 

In  our  college  courses  upon  Chemistry  much  valuable  time  is 
spent  ui)on  the  laws  of  heat,  light,  and  olectiicity  —  important  and 
interesting  topics  —  not  perhaps  too  fully  taught,  but  yet  it  may  well 
be  questioned,  whether  the  more  practical  details  of  Pharmac}'',  bearing, 
as  they  do,  upon  the  every  day  experience  and  wants  of  the  prac- 
titioner, arc  of  greatly  more  re(d  value.  It  is  ircU  to  have  the  ability 
to  discourse  learnedly  upon  the  laws  which  govern  the  imponderables, 
but  it  certainly  more  practical  to  be  able  to  dispense  an  eligible  and 
scientific  compound  for  the  relief  and  cure  of  one's  patient.  By  do- 
voting  one  half  or  more  of  time  usually  allotted  to  these  to  Pharmacy, 
much  valuable  instruction  could  be  given,  and  profession  thereby 
greatly  benefited.  The  Chemical  Chair,  however,  is  already  over- 
burdened ;  time  can  not  ordinarily  be  found  in  our  short  terms  to  so 
far  elucidate  the  various  topics  as  to  give  the  class  any  adequate 
knowledge  of  the  subject.  It  is  notorious  that  few  know  anything 
practically  of  the  science,  nor  do  they  pretend  to  any  degree  of 
proficienc3^  The  mass  of  the  candidates  single  out  this  branch  as  their 
lame    one,    and    more    than    all  else    usually    dread   the    ordeal   before 

"old "  (the  chemist)  in  the  green   room.    'The   subdivisions  of 

Organic  and  Physiological  Chemistry  are  daily  becoming  more  extended 
in  range  of  topics,  and  more  useful  and  important  in  results  —  it  is 
highly  desirable  that  the  standard  of  education  should  be  more  ele- 
vated  in   this   direction.     Look    now  to   the  Chair   of    Materia  Medica, 


*  We  mn«t  correct  the  above.  There  is  no  distinct  Chnir  of  rharmncy  in  the  Uai- 
vcvsity  of  Micliipaii,  it  1  oil  g  oltiiclicd  1o  tlie  riofcBsortliip  of  Chemistry,  etc.,  as 
is  usual  in  mcdlcul  scbools  iu  this  coautry. 


Editorial  Department.  2S7 

and  wc  find  medical  botany,  together  with  the  varieties,  physical  pro- 
perties, qualities  and  adulterations  of  drugs  so  inadequately  taught,  as 
to  leave  but  little  lasting  impression  upon  the  mind  of  the  hearer. 
The  whole  subject  is  exceedingly  dry  and  uninteresting  —  and  why? 
Not  always  from  want  of  ability  on  the  part  of  the  professor,  but 
rather  from  the  hurried  manner  in  which  the  subjects  must  be  dis- 
cussed, from  which  cause  the  student  gathers  an  insufficient  amount 
of  information  to  appreciate  and  enjoy  the  lecture;  so  he  must  often 
go  forth  into  the  world  dependent  npon  the  interested  drug  man  for 
the  selection  of  his  medicines,  and  perchance  to  mourn  over  the  dead 
bodies  of  his  victims  through  his  want  of  attention  to  the  stud}^  of 
these  subjects. 

The  only  efficient  mode  of  teaching  these  several  branches,  and 
giving  them  the  position,  which  their  practical  utility,  as  compared 
with  the  other  departments  of  medicine,  demands,  would  seem  to  bo 
the  addition  of  a  Chair  of  Pharmacy,  to  lighten  the  labors  of  the 
other  two,  as  well  as  to  tench  extemporaneous  and  manipulalivo 
Pharmacy  proper.  Such  an  innovation  upon  old  usage,  would  not  only 
lie  productive  of  much  good  to  the  Profession  in  elevating  the  edu- 
cational standard,  but  would  likewise  equip  our  medical  colleges  with 
all  the  facilities  and  advantages  of  a  well  regulated  college  of  Pharmacy, 
and  enable  them,  in  the  three  Chairs  alluded  to,  to  extend  facilities 
for  education  to  such  pharmaceutists,  and  their  clerks  and  apprentices, 
as  have  not  enjoyed  these  advantages,  in  places  "^here  no  regular 
organization  exists  for  their  benefit.  The  question  of  policy  might 
also  be  entertained  —  whether  or  not  diplomas,  or  certificates  of  pro- 
ficiency in  their  branch,  such  as  are  granted  by  the  Philadelphia 
College  of  Pharmacy,  should  be  bestowed  upon  these  pharmaceutical 
students  after  examination  at  the  close  of  a  second  course.  Next  to 
a  well  educated  medical  profession,  wc  need  intelligent  and  profession- 
ally accomplished  apothecaries ;  and  it  is,  perhaps,  worthy  of  thought, 
whether  the  general  adoption  of  this  system,  of  educating  apothecaries 
in  conjunction  with  students  of  medicine,  would  not  have  a  tendency 
to  infuse  a  more  high  minded  and  professional  spirit  into  the  former, 
and,  perhaps,  in  a  measure,  wean  them  off  from  their  quacking  pro* 
clivities,    by   attaching  them  more   strongly   to  our  Profession. 

That  the  study  of  Pharmacy,  in  its  practical  bearing?, 
will  be  added  to  the  curriculum  of  the  student  in  any 
of  our  numerous  medical  schools,  we  do  not  soon  expect ; 
but  that  it  is  desirable,  and  would  be  of  very  great  advantage 
to  them,  we  think  the  remarks  of  Dr.  Battey  suffieienlly 
prove.  r.  S. 


288  TJie  Peninsular  and  Independent. 

French  Pharmaceutical  rreparatlons. 

The  numerous  manifestations  of  skill  which  the  French, 
as  a  nation,  exhibit,  is  nowhere  more  clearly  exemplified  than 
in  the  products  emanating  from  the  laboratories  of  their 
Chemists  and  Pharmaceutists. 

The  rou(JEiiA  BiiOTHEUS,  of  New  York,  have  recently 
laid  on  our  table  samples  of  many  preparations,  with  which 
all  arc  fiimiliar  as  products  of  our  own  country,  but  which,  in 
the  forms  before  us,  bear  the  imprint  of  the  original  dis- 
coverers. 

Thus,  we  have  the  Iron  rtduccd  hij  llydrocjeUj  iji  QuE- 
VENNE  and  MiQUiLAiiD  (who  first  introduced  this  form  of 
Iron  into  therapeutical  use),  in  the  elegant  form  of  sugar- 
coated  drag6es. 

The  Pearls  of  Ether,  of  Cleutan,  in  which,  by  means 
of  a  gluten  capsule,  thin  and  transparent,  an  adequate  dose 
of  sulphuric  ether  is  enclosed,  and  in  such  a  manner  reaches 
the  stomach  before  its  peculiar  effects  are  obtained,  and 
without  beino:  lost  as  in  most  forms  in  which  it  is  exhibited. 

Lactate  of  Iron,  in  elegant  pas  tiles,  pleasantly  flavored, 
as  made  by  Gelis  and  Conte,  who  first  introduced  this 
advantao'eous  form  of  Iron. 

o 

The  Ergotine  of  Bon  jean — in  substance  and  dragees. 
This  extract  from  Ergot,  introduced  by  M.  Bonjean,  is 
made  by  exhausting  Ergot  with  water,  precipitating  with 
alcohol,  and  evaj^orating  to  the  consistency  of  a  soft  extract. 
It  is  held  in  high  estimation  in  France. 

Boudault's  Pepsin,  in  substance  and  in  powders,  all 
ready  divided.  This  "  aid  to  digestion"  is  coming  largely 
into  use  as  a  therapeutical  agent. 

Laurent's  Dragees  of  Acetic  Extract  of  Colchicums, 
form  an  excellent  bon-bon,  in  which  to  exhibit  this  remedy. 

Blancliard's  Preparation  of  Iodide  of  Iron,  in  pills  and 
syrup,  are  too  well  known  in  this  country  to  require  com- 
ment. 


Editorial  Department.  289 

We  must  particularly  mention  tlie  Copaliine  Mege  of 
JozEAU,  and  the  Savonules  of  Lebel^  in  both  of  which 
copaiba  is  very  nicely  disguised — not  only  disguised,  but, 
in  the  first,  by  boiling  the  copaiba  with  a  small  proportion 
of  nitric  acid,  oxidizing  it ;  and  in  the  second,  by  saponifi- 
cation, the  balsam  is  rendered  much  more  active,  digests 
readily,  and,  to  a  great  extent,  produces  its  specific  local 
action. 

A  hundred  other  remedies,  in  elegant  forms,  are  before 
us  ;  many  of  which,  however,  have  only  a  local  reputation, 
but  all  bear  the  impress  of  skill  and  taste. 

A  French  pharmaceutist,  in  making  any  discovery,  sub- 
mits it  to  the  Academy  of  Medicine  of  Paris.  If  it  obtains 
the  approval  of  that  body,  the  method  of  making  it  is 
published,  but  the  right  of  manufacture  is  reserved  by 
governmental  protection  to  the  discoverer.  Thus,  it  will  be 
seen,  that  the  French  scientific  pharmaceutist  has  the  hope 
of  pecuniary  reward  as  well  as  scientific  reputation,  as  an 
incentive  to  research.  F.  S. 


voL.n.~T. 


tUtlti  ^rlitUs,  ^hstxutis,  &t. 


On  the  Physiological  Position  of  Fibrin 

By   Lbvih  S.   Jotnes,   M.  D., 
ProfoMor  of  Initiiutes  of  Medicine  in  the  Medical  College  of  Virginia. 


(Concluded  from  the  July  No.) 

Let  us  now  sec  what  arc  the  principal  facts  and  arguments  by  which 
this  view  is  supported,  and  endeavor  to  appreciate  their  value: 

1.  It  is  urged  that  the  proportion  of  fibrin  in  the  blood  is  too  small 
to  warrant  the  idea  that  it  is  the  sole,  or  even  the  chief  pabulum  of  the 
tissues.  It  amounts  to  but  two  or  three  parts  in  1,000  of  the  fluid,  while 
the  albumen  is  estimated  at  about  70,  and  the  red  corpuscles  at  125  to 
140  parts. 

2.  There  is  no  fibrin  in  the  egg  from  which  all  the  tissues  of  the 
young  bird  are  developed — "little  or  none"  in  the  blood  of  the  foetus 
—  and  less  in  the  new-born  child  than  the  adult;  although  at  these 
periods  of  existence  nutrition  and  development  arc  proceeding  with  greater 
activity  than  in  after  life. 

3.  "I  find,"  says  Mr.  Simon  (?<>(•.  cit.),  "that  fibrin  is  undiminished 
by  bleeding,  however  frequently  repeated ;  nay,  that  it  often,  or  even 
usuall}''  increases  under  this  debilitating  treatment:  its  highest  figure 
given  in  Andral's  book  (10-2),  was  at  a  fourth  bleeding:  and  Scherer 
found  it  as  high  as  12-7  at  the  third  venesection  in  a  case  of  pneumonia. 
I  find  that  under  man}^  other  circumstances  of  exhaustion  and  weakness 
and  inanition,  during  the  progress  of  starvation,  during  diseases  essentially 
anasmic,  during  violent  fatigue,  and  the  like,  its  proportion  has  been  found 
at  least  as  high,  perhaps  higher  than  in  the  inflammatory  process."  In 
these  respects  its  proceeding  is  in  direct  contrast  to  that  of  the  red  cor- 
puscles. Andkal  and  Gavarret  have  also  found  an  improvement  of  the 
breed  of  an  animal  is  attended  with  a  diminution  of  the  fibrin  of  its 
blood,  but  with  an  increase  of  its  red  corpuscles. 

4.  Fibrin,  it  is  said,  does  not  arise  from  the  ingestion  of  food,  for 
its  proportion  in  the  blood  is  not  increased  by  the  most  abundant  nutri- 


Selected  Articles^  Abstracts^  (Jbc.  291 

Incnt,  and  there  is  less  in  the  blood  of  the  carniverous  animals  than  in  that 
of  the  herbivora. 

5.  Its  composition  shows  that  it  is  an  oxidized  product — that  it 
results  from  the  oxidation  of  albumen  (or  of  some  kindred  principle  of 
the  tissues) ;  and  in  the  animal  economy,  oxidation  pertains  rather  to 
disintegration  and  waste  than  to  the  repair  of  tissue.  It  marks  the 
descending  scale  of  metamorphosis  rather  than  the  ascending  —  a  ten- 
dency to  destruction  rather  than  a  tendency  to  organization.  Thus 
urea,  uric  acid,  and  other  ingredients  of  the  excretions  are  oxidized  pro- 
ducts. Experiment  proves  conclusively  that  the  respiration  of  pure 
oxygen  causes  an  increase  of  the  fibrin  of  the  blood. 

6.  Although  the  majority  of  chemists  have  agreed  in  stating  that 
there  is  a  somewhat  higher  average  proportion  of  fibrin  in  arterial 
than  in  venous  blood,  it  is  now  said  that  Lehmann  had  recently  found, 
that  while  this  is  true  so  far  as  regards  a  comparison  of  the  blood  of  the 
large  veins  with  that  of  the  arteries,  -the  blood  of  the  smaller  veins 
-contains  moi'e  fibrin  than  arterial  blood,  as  if  it  had  just  derived  a  fresh 
"charge  from  the  disentegration  of  the  tissues.  {Broion-Sequard^s  Jour, 
de  Physique,  April,  1858). 

7.  The  proportion  of  fibrin  in  the  blood  is  always  increased  in  in- 
flammatory affections,  where  the  acceleration  of  the  capillary  circulation 
and  the  attendant  emaciation  indicate  an  increased  waste  of  tissue.  As 
the  excitement  of  the  circulation  subsides,  and  nutrition  resumes  its 
healthy  course,  so  does  the  fibrin  return  to  its  normal  standard. 

8.  Experiments  on  the  transfusion  of  blood  prove  that  fibrin  is  not 
^essential  to  nutrition.  If  an  animal  be  bled  to  complete  syncope,  and 
its  own  blood  or  that  of  another  animal  of  the  same  species  be  injected 
into  its  veins  (being  first  wholly  deprived  of  its  fibrin  by  stirring  it  with 
-a  bundle  of  twigs  while  still  fluid),  the  animal  nevertheless  seems  to 
^'  acquire  fresh  life  at  every  stroke  of  the  piston,"  and  is  after  a 
"time  completely  restored.  The  red  corp)uscles  are  evidently  the  efficient 
agents  in  the  resuscitation;  for  if  the  serum  of  the  blood  only  be  in- 
jected, the  animal  is  not  revived. 

In  like  manner,  Brown -Sequard  has  found,  that  if  the  amputated 
limb  of  a  man  or  animal  be  allowed  to  lie  for  several  hours,  until  its  vital 
properties  (muscular  irritability  and  impressibility  of  the  nerves  to 
timuli)  have  disappeared,  they  may  be  promptly  restored  and  maintained 
for  hours  by  the  injection  of  defihrinated  blood  into  the  vessels.  And, 
what  is  very  singular,  it  is  stated  by  the  experimenter,  that  although 
the  blood  be  injected  without  its  fibrin,  and  arterial  in  hue  (from  expo- 
sure to  the  air),  it  returns  by  the  veins,  presenting  the  appearance  of 
venous  Mood  and  containing  fibrin  —  whence  he  infers  that  fibrin  is 
formed  in  the  tissues,  especially  in  the  muscles,  as  a  product  of  their 
■their  waste  or  vital  decay.     This  conclusion  is  also  adopted  by  Bernard 


292  The  Peninsular  and  Independent. 

in  his  late  work,   ^■'■LeQons  sur  les  Proprietes  Physiologiques.  et  Us  Alte- 
rations Fathologiqves  des  Liquides  de  V  Organism e.'^''     Paris,  1859. 

Experiments  similar  to  the  above  were  performed  upon  decapitated 
criminals,  and  with  corresponding  results. 

9.  The  blood  of  the  hepatic  veins  contains  no  filrin.  (Lehmann, 
Brown- Sequard,  Bernard.)  The  same  is  also  true  of  the  renal  xein, 
(Franz  Simon,  Bernard,  Brown -Sequard.)  Fibrin,  therefore,  disappears 
from  the  blood  which  traverses  these  glands ;  it  undergoes  destruction 
there.  Brown -Sequard  has  endeavored  to  prove  by  a  mathematical  cal- 
culation, in  his  journal  above  cited,  that  this  destruction  amounts  to  some 
four  or  five  killogrammes  (10  or  12  pounds)  daily,  while  its  normal  pro- 
portion in  the  blood  is  kept  up  by  the  waste  of  the  tissues. 

10.  Effusions  of  fibrin,  it  is  argued,  either  exhibit  no  tendency  at 
all  to  undergo  organization,  or  their  organization  is  of  the  lowest  charac- 
ter, "never  in  any  known  instance,"  says  Dr.  Handfield  Jones,  "amount- 
ing to  more  than  the  formation  of  a  fibrous  tissue,  more  or  less  closely 
resembling  the  natural."  "That  fibrin  takes  an  important  part  in  the 
reparative  process,  can  not  be  doubted.  We  constantly  find  it  forming  the 
uniting  medium  between  divided  parts;  but  have  we  any  evidence  that 
it  becomes  further  developed,  and  passes  into  the  form  of  any  tissue 
more  highly  organized  than  that  of  the  cicatrix?  Surely  there  is  not  the 
least;  or  rather,  all  that  we  know  of  the  process  of  reparation  tends  to 
contradict  such  an  idea."  (Jones  and  Siecel:ing''s  Pathological  Anatomy^ 
p.  59).  Mr.  Simon  (op.  cit.  j).  82)  is  still  more  decided:  "So  far  as  my 
knowledge  extends  of  adhesive  inflammation,  and  of  the  several  repa- 
rative processes,  I  see  no  evidence  that  fibrin  takes  a  more  important 
part  in  them,  than  that  of  holding  the  true  albuminous  blastema  within 
its  meshes,  and  thus  occasionally  serving  as  a  provisional  matrix  and 
scaffolding  for  the  development  of  cells,  fibres,  and  blood  vessels."  He 
also  refers  to  the  absence  of  organization  in  the  fibrinous  clots  lining  an 
aneurismal  sac,  in  the  coagula  which  forms  in  arteries  after  ligature,  and 
in  the  fibrinous  concretions  often  seen  in  the  substance  of  the  liver, 
spleen,  and  kidneys,  as  proof  that  fibrin  is  destitute  of  that  high 
plasticity^  or  tendency  to  organization,  which  has  been  ascribed  to  it^ 

Such  is  the  formidable  array  of  arguments  that  we  have  to  consider. 
That  they  make  out,  at  first  sight,  a  very  strong  case,  can  not  be  denied. 
Some  of  the  facts  adduced  seem  to  be  in  complete  opposition  to  the 
ideas  heretofore  entertained.  A  deliberate  and  candid  survey  of  the 
whole  ground,  however,  will  suffice  to  convince  an  unprejudiced  mind,  I 
think,  that  these  arguments  are  wholly  insufficient  to  prove,  either  that 
fibrin  is  an  excretory  compound,  resulting  fi-om  the  destructive  changes 
going  on  in  the  tissues  or  in  the  blood,  or  that  its  function  in  the  nutri- 
tion and  repair  of  tissue  is  of  the  very  lowest  order.  "We  are  still  fully 
justified  in  adhering  to  the  belief  that  fibrin  is  a  highly  important  "  ele- 


Selected  Articles^  Abstracts^  <&g.  293 

tnent  of  nutrition,"  specially  and  eminently  organizable,  though  we 
have  no  sufiBcient  reason  for  asserting  that  it  is  the  only  histogenetic 
principle  of  the  blood,  and  that  albumen  was  must  pass  through  the 
condition  of  fibrin  in  order  to  be  applied  to  the  wasting  tissues. 

1  will  examine  the  above  arguments  in  the  order  in  which  they  have 
been  presented. 

If  the  quantity  of  fibrin  in  the  blood  be  small,  compared  with  that 
of  the  albumen  or  red  corpuscles,  how  large  is  it,  on  the  other  hand, 
when  compared  with  that  of  the  organic  matters  admitted  by  all  to  be 
effete  and  useless  —  for  example,  urea,  uric  acid,  creatine,  &c.  In  order 
to  detect  these  in  the  blood,  we  are  obliged  to  analyze  several  pounds  of 
the  fluid  —  nature  guarding  the  system  with  the  utmost  jealousy  against 
the  accumulation  of  compounds  which  are,  at  best,  but  useless  refuse, 
and  would  soon  become  noxious,  if  allowed  to  taint  the  blood  in  notable 
quantity.  The  amount  of  fibrin,  on  the  contrary,  is  such  as  to  impart 
to  the  blood  some  of  its  most  remarkable  properties,  and  sufficient,  too, 
one  would  think,  to  make  good  its  claim  to  a  function  of  importance. 

Besides,  although  the  amount  of  fibrin  in  the  circulating  fluid  at  any 
one  moment  be  small  —  not  more  than  five  drachms,  it  is  estimated  —  it 
Ttnust  be  recollected  that  it  is  leing  continually  produced  in  the  organism, 
as  it  is  being  continually  disposed  of  in  the  operations  of  life;  and  thus, 
beyond  question,  a  large  amount  is  daily  generated  and  expended.  Fi- 
brin is  being  constantly  introduced  into  the  blood  as  an  ingredient  of 
the  chyle  and  Ij^mph,  and  as  incessantly  formed  in  the  blood  itself — in 
all  probability,  by  the  transformation  of  albumen. 

There  is  no  fibrin,  it  is  said,  in  the  egg^  which  contains  all  the 
organic  matters  which  are  requisite  for  a  perfect  animal  development. 
True  —  but  the  material  from  which  fibrin  may  be  elaborated  (albumen), 
is  there  in  abundance;  and  this  elaboration  does  take  place  at  an  early 
period  of  development;  for  when  the  blood  makes  its  appearance,  fibrin 
too  appears  as  one  of  its  constituents. 

I  am  not  acquainted  with  any  well-authenticated  analysis  which 
justifies  Mr.  Simon's  assertion  that  there  is  "little  or  no"  fibrin  in  the 
blood  of  the/b^ws.  There  is  somewhat  less,  it  is  true,  than  in  the  blood 
of  the  adult.  The  analysis  of  Denis,  which  is  quoted  in  all  the  works 
on  physiology,  gives  for  the  mother's  blood,  2-4  of  fibrin,  and  for  that  of 
the  foetus,  2-2  in  1,000  parts  of  the  fluid.  The  difference  is  certainly 
not  great  enough  to  serve  as  the  basis  of  an  argument  on  the  question 
at  issue,  and  is  no  greater  than  often  exists  in  the  blood  of  different 
healthy  adults.  The  same  remark  may  be  made  with  reference  to  the 
comparative  deficiency  of  fibrin  in  infancy.  And  it  may  be  asked  whe- 
ther the  smaller  proportion  of  this  principle  at  these  early  stages  of 
'existence,  may  not  be  owing  to  its  more  rapid  consumption  for  the  pur- 
poses of  development  and  nutritition? 


294  The  Peninsular  and  Independent. 

The  great  and  striking  peculiarity  of  foetal  blood,  is  its  high  proper-. 
tion  of  red  globules  and  iron. 

That  the  abstraction  of  blood  in  inflammatory  diseases  does  not  di- 
rectly reduce  the  proportion  of  fibrin,  can  not  appear  surprising,  when 
we  recollect  that  a  cause  is  in  operation,  tending  directly  to  its  increase  ;■ 
and  it  can  not  be  expected  to  diminish  until  the  inflammation  begins  to. 
subside.  Even  in  health,  however,  bleeding  has  no  tendency  to  reduce  the- 
proportion  of  fibrin,  but  (if  often  repeated)  rather  the  reverse,  as  certain, 
remarkable  experiments  of  Magendi  have  shown.  It  appears,  therefore,^ 
that  the  system  enjoys  the  power  of  rapidly  repairing  the  loss  of  its 
fibrin,  by  the  conversion  of  the  albumen  of  the  blood ;  and  when  excited' 
by  unusual  demands,  this  physiological  action  may  become  excessive. 

As  to  the  increase  of  fibrin  in  starving  animals^  which  at  first  view 
seems  so  paradoxical,  we  find  a  very  satisfactory  explanation  in  the  ob- 
servations of  Andral  and  Gavarket,  who  found  this  condition  of  the 
blood  in  animals  deprived  of  food,  to  coincide  with  lesions  of  the  sto- 
mach "  of  the  most  clearly  inflammatory  nature,  such  as  bright  redness,^ 
softening,  and  numerous  ulcerations  of  the  mucous  membrane," 

So  in  phthisis  —  the  excess  of  fibrin  which  is  common  in  the  bloo^ 
after  the  first  stage,  is  not  to  be  referred  to  the  anaemic  or  cachectic 
condition  of  the  system,  but  to  the  inflammatory  irritation  of  the 
lungs  and  pleura,  which  attend  the  softening  and  evacuation  of  the  tuber-, 
cles.  The  mere  tubercular  deieloj^ment  is  not  attended  with  any  such 
alteration  of  the  blood.  Andral's  researches,  in  like  manner,  establish^ 
that  in  the  blood  of  persons  affected  with  cancer,  there  is  no  increase  of^ 
fibrin,  sometimes  on  the  contrary  a  diminution,  unless  there  be  accom-. 
panying  inflammation  of  some  kind. 

It  ought  not  to   seem   so   unaccountable  that  the  fibrin  is  undimi- 
nished in  anaemia  —  for  no  good  reason  can  be  given  why  the  loss  of  red' 
corpuscles  should  be  attended  with  a  corresponding  loss  of  fibrin.     The 
several  ingredients  of  the  blood  may  vary  in  proportion  quite  indepen- 
dently of  each  other. 

The  alleged  diminution  of  the  fibrin  in  the  blood  of  animals,  simul-. 
taneously  with  an  "improvement  of  breed,"  is  a  circumstance  of  rather 
too  vague  and  indefinite  a  character  to  merit  much  consideration.  It  i&. 
not  pretended,  I  believe,  that  the  difference  thus  occasioned  is  any- 
greater  than  may  normally  exist  between  two  individuals  of  any  one 
breed  —  nor  is  it  proved  that  the  nutritive  process  is  nK)re  perfectly  ac- 
complished  in  proportion  to  the  loss  of  fibrin.  Differences  of  breed  ir^ 
animals  relate  to  other  and  more  prominent  characters  than  this. 

There  is  no  sufficient  reason  for  saying  that  the  fibrin  of  the  blood 
does  not  derive  its  source  fi-om  the  food,  or  that  its  amount  is  not  affected 
by  the  nature  of  the  food.  True,  the  blood  of  the  carnivora  contains.- 
less  than  that  of  the  herbivora;   but  this  is  connected  with  differences. 


Selected  Articles^  Abstracts^  <&c.  295 

of  organization  and  vital  action  in  the  two  orders,  which  forbid  us  to 
refer  to  them  as  true  standards  of  comparison  for  each  other.  In  any- 
one animal,  or  in  different  individuals  of  one  species,  the  proportion  of 
fibrin  is  higher  under  an  animal  than  under  a  vegetable  diet.  This  is 
proved  by  Lehmann's  experiments  upon  himself,  and  by  those  of  Nasse 
upon  dogs.     Fibrin  itself,   when  employed  as  food,  is  certainly  nutritious 

—  capable  of  furnishing  plastic  material  to  the  blood.  In  making  this 
statement,  I  am  not  alluding  to  muscular  flesh,  which,  according  to  the 
chemists  is  not  fibrin:  I  speak  of  the  fibrin  of  the  blood.  The  "gelatin 
committee  "  of  Paris  found  that  dogs  fed  on  this  fibrin  alone,  lived  from 
75  to  80  days,  while  on  a  diet  of  pure  gelatin,  they  died  in  about  20 
days.  It  is  true  that  the  fibrin  did  not  sustain  life  continuously,  but  it 
proved  no  worse  in  this  respect  than  albumen  or  muscular  fibre  (if  de- 
prived of  the  matters  associated  vvith  it  by  long  boiling.  Dogs  lived  no 
longer  on  these  than  on  the  fibrin  of  blood.  The  simple  fact  is,  that  no 
one  proximate  principle,  whether  animal  or  vegetable,  is  capable  of 
nourishing  the  animal  body  perfectly  and  for  a  length  of  time :  but  we 
have  the  same  experimental  proof  that  fibrin  can  do  its  part  in  alimen- 
tation, that  we  have  in  the  case  of  albumen  or  the  muscular  substance. 
(See  BerarWs  Cours  de  Fhys.  vol.  1,  p.  591).  But  fibrin,  when  in- 
jested,  does  not  all  find  its  way  as  Jibrin  to  the  blood:  for  in  the 
process  of  .gastric  digestion,  it  is  transformed  into  that  modification 
of  albumen  called  albuminose  or  peptone,  in  order  that  it  may  be  the 
more  readily  absorbed.  Once  within  the  absorbent  vessels,  part  of  it 
reverts  to  the  condition  of  fibrin,  in  order  to  meet  the  demand  of  the 
organism  for  this  principle.  So  when  the  albumen  of  the  egg  or  the 
casein  of  milk  is  employed  as  food,  a  part  after  absorption,  is  converted 
into  fibrin,  as  shown  by  the  coagulability  of  the  chyle. 

The  excess  of  oxygen  which  the  ultimate  analysis  of  fibrin  exhibits 
as  compared  with  that  of  albumen  and  other  protein  compounds,  and 
which  is  relied  upon  to  prove  that  the  former  is  an  "oxidized  product" 

—  a  protein  compound  in  the  first  stage  of  "destructive  metamorphosis" 
or  decay,  and  therefore  to  be  placed  in  the  same  category  as  urea,  &c., 

—  is  very  inconsiderable,  if  indeed  it  exists  at  all.  Can  it  be  admitted 
(in  view  of  what  has  already  been  stated)  that  the  differences  between 
these  compounds  are  such  as  to  require  us  to  assign  to  them  different 
physiological  relations  ?  Can  it  be  for  a  moment  supposed  that  two 
principles  so  slightly  differing  from  each  other  in  composition  and  other 
chemical  characters  as  albumen  and  fibrin,  should  ho^NQ  precisely  oppo- 
site destinations',  the  former  to  nourish  and  repair  the  most  highly  vi- 
talized textures  —  the  other  to  encumber  the  circulation  as  so  much  offai 
until  it  finds  an  outlet  in  a  still  more  degraded  form  by  the  channels  of 
excretion?  Certainly  such  a  supposition  does  great  violence  to  proba- 
bility. 


296  The  Peninsular  and  Independent. 

Ledmann,  with  reference  to  the  relation  of  these  hodic.",  remarks 
{Manual  of  C hem.  Fhys.  p.  110):  It  must  be  conceded,  from  the  whole 
occurence  of  fibrin,  that  it  is  a  product  of  the  transformation  of  albu- 
men." "7/*  ice  could  rely  wpon  the  elementary  analysis  of  these  sub- 
stances, the  small  excess  of  oxygen  which  is  found  in  fihrin  might  char- 
acterize it  as  a  product  of  oxidation.''^  But  he  none  the  less  admits 
"the  physiological  importance  of  fibrin,  as  a  transitionary  state  towards 
the  more  highly  oxidized  tissue  materials"  :  for  in  another  place  he  points 
out  the  fact  that  the  tissues  "  are  on  the  average  much  richer  in  oxygen 
than  thejn^otein  hodies^  Whence  it  follows,  that  the  action  of  oxygen 
upon  the  latter  is  far  from  being  necessarily  a  destructive  or  retrograde 
action,  as  has  been  rather  too  hastily  supposed,  under  the  influence  of 
preconceived  ideas. 

The  statement  made  by  Brown -Sequard,  on  the  authority  of  recent 
researches  of  Leiimann,  that  the  blood  of  the  small  veins  contains  more 
fibrin  than  that  of  the  arteries,  is  certainly  worthy  of  attention:  and  if 
the  fact  could  be  accepted  as  undeniable,  it  would  certainly  afford  a  very 
plausible  ground  for  presuming  that  the  excess  of  fibrin  in  the  small 
veins  had  been  derived  from  the  tissues,  as  a  product  of  their  waste.  We 
may  take  leave,  however,  to  hold  the  fact  sith  judice,  until  it  shall  bo 
confirmed  b}''  the  analysis  of  other  observers  and  shown  to  be  generally 
(and  not  merely  exceptionally)  true.  It  must  be  confessed  that  the  fact 
is  completely  at  variance  with  the  general  result  of  previous  researches, 
which  had  revealed  an  average  preponderance  of  fibrin  in  arterial 
blood. 

The  invariable  augmentation  of  fibrin  in  the  blood  of  inflammation, 
is  a  fact  full  of  interest  in  a  physiological  aspect,  but  very  difficult  of 
consistent  explanation,  whatever  be  our  view  of  the  character  and  des- 
tination of  this  substance.  If  we  regard  it  as  a  product  of  the  disinte- 
gration of  the  bodily  structures,  we  maj"  reasonably  ask,  how  it  is  that 
in  grave  typhoid  fever^  where  the  wasting  and  exhaustion  are  certainly 
much  greater  than  in  sthenic  inflammations,  there  is  a  loss  of  fibrin 
instead  of  an  increase  ?  Whereas,  on  the  hypothesis  in  question,  the  pro- 
portion ought  to  be  higher  than  in  the  phlegmasias.  If  we  regard  fibrin 
as  a  product  of  oxidation,  why  should  it  be  constantly  increased,  and 
often  to  a  very  high  figure,  in  inflammations  of  the  respiratory  organs, 
however  severe  or  extensive  —  though  these  must  necessarily  interfere 
with  the  supply  of  oxygen  to  the  blood  ?  If,  on  the  other  hand,  we  re- 
gard fibrin  as  a  nutritive  or  histogenetic  principle,  shall  we  say  that 
the  blood  in  inflammation  contains  more  of  it  because  the  demand  for 
it  on  the  part  of  the  tissues  is  less  active,  and  therefore  more  remains 
unused?  We  should  then  have  to  encounter  the  difficulty,  that  the 
fibrin  undergoes  increase  in  starvation,  where  there  is  certainly  no  lack 
of  demand  for  whatever  nutriment  the  tissues  may  obtain. 


Selected  Articles^  Abstracts^  dbc,  '     297 

In  a  word,  the  true  cause  of  the  fibrinous  character  of  inflammatory 
blood  is  a  problem  yet  to  be  solved — and  at  present  the  fact  can  afford 
no  valid  support  to  any  physiological  hypothesis. 

The  results  of  the  transfusion  of  defibrinated  blood  in  living  animals, 
and  the  highly  interesting  experiments  of  Brown -Sequard  upon  its 
injection  into  decapitated  bodies,  and  amputated  limbs,  do  not,  I  appre- 
hend, justify  the  inference  that  has  been  drawn  from  them.  They  do 
not_  prove  that  fibrin  has  no  office  in  the  blood  as  a  source  of  nutri- 
ment to  the  tissues.  As  well  might  we  argue  from  them  that  albumen 
is  equally  to  be  excluded  from  the  category  of  nutritive  principles ;  for 
when  an  animal  is  bled  to  the  point  of  death,  the  injection  of  the  serum 
of  blood  (which  contains  all  the  albumen)  will  not  effect  resuscitation. 
The  red  corpuscles  are  the  potential  agents  in  the  restoration  of  the 
vital  properties  of  the  nerves  and  muscles,  not  because  they  alone  take 
part  in  the  nutrition  of  these  tissues,  but  because  they  are  carriers  of 
oxygen^  and  the  presence  of  oxygen  is  necessarry  to  the  manifestation 
of  the  properties  in  question.  There  are  satisfactory  reasons  for  believing 
that  every  development  of  nerve  force,  and  every  muscular  contraction,  is 
attended  with  (and  necessitates)  a  clw.nge  in  the  active  tissue  —  a  disinte- 
gration of  part  of  its  substance  —  in  which  the  oxygen  of  the  blood  takes 
an  essential  part.  It  is  for  tins  reason  that  the  presence  of  the  red  corpus- 
cles is  necessary  for  the  restoration  of  nervous  and  muscular  irritability; 
but  there  is  a  wide  difference  between  this  action  and  the  supply  of  solid 
material  to  the  tissues  for  the  repair  of  waste.  The  experiments  are 
entirely  consistent  with  the  supposition  that  the  fibrin  and  the  albumen 
both  take  part  in  this  office. 

The  fact  stated  by  Bkown- Sequard,  that  the  blood,  though  bright 
red  when  injected,  had  the  appearance  of  venous  blood  when  it  returned 
by  the   veins,  is  perfectly  in  accordance  with  the  explanation  just  given. 

The  presence  of  fibrin  in  the  blood,  after  traversing  the  limb,  though 
it  contained  none  when  injected,  by  no  means  compels  the  admission 
that  this  fibrin  was  derived  from  the  tissues,  as  the  experimenter  sup- 
poses. It  was  simply  an  example  of  the  transformation  of  albumen  into 
fibrin,  such  as  is  continually  going  on  in  the  circulation  during  life. 
Robin  and  Vekdeil  expressly  take  this  view  of  it.  A  similar  formation 
of  a  small  quantity  of  fibrin  in  blood  which  has  been  deprived  of  it,  is 
occasionally  seen  when  the  blood  is  allowed  to  stand  in  an  open  vessel. 
However,  the  amount  of  fibrin  which  appeared  in  the  blood  in  the  ex- 
periments above  cited,  is  admitted  by  the  author  himself,  to  have  been 
^^exti'Smement  minlme.'''' 

The  alleged  absence  of  fibrin  in  the  venous  blood  returning  from 
the  liver  and  the  kidneys,  has  been  regarded  a  vcrj  significant  and  con- 
clusive fact.  If,  indeed,  fibrin  undergoes  destruction  in  those  glands, 
and   the  products  of  its  composition  are  eliminated  by  them,  we  must 


298  The  Peninsular  and  Independent. 

abandon  all  opposition  to  the  hypothesis  which  regards  fibrin  as  merely 
a  part  of  the  refuse  of  the  system,  circulating  for  a  time  in  the  blood 
only  that  it  may  find  an  outlet  through  the  organs  of  excretion.  But 
I  attach  little  value  to  all  that  has  been  said  on  this  subject,  for  more 
than  one  reason.  In  the  first  place  I  do  not  think  it  is  proved  that 
fibrin  is  normally  and  constantly  absent  from  the  blood  of  either  of  the 
above  mentioned  veins.  As  to  the  hepatic  veins,  the  statement,  though 
very  confidently  made  by  the  authors  already  cited,  is  directly  negatived 
by  the  results  obtained  by  Fkanz  Simon,  and  recorded  in  his  "  Chemis- 
try of  Man,"  p.  174.  In  two  instances  (the  only  ones  in  which  he  ex- 
amined this  blood)  he  found  it  to  contain  2  0  and  2*5  parts  of  fibrin  — 
the  proportion  of  the  same  element  in  the  blood  of  the  portal  vein  of 
the  same  animals,  being,  in  the  first  case  3  2;   in  the  second,  3-5. 

Buown-Sequahd  also  admits 'that  he  has  three  times  observed  co- 
agula  (though  of  no  great  size)  to  form  in  blood  drawn  from  the  hepatic 
veins  —  and  further,  that  after  death  the  blood  contained  in  these  vessels 
is  ordinarily  found  "coagulated  or  coagulable"  —  to  explain  which,  he 
thinks  it  necessary  to  suppose  a  reflux  of  blood  (of  course  containing 
fibrin)  from  the  vena  cava.  Admitting  it  to  be  true  that  the  venous 
blood  from  the  liver  contains  less  fibrin  than  that  of  other  parts  of  the 
vascular  system,  and  sometimes  none  that  we  can  detect,  it  must  be 
borne  in  mind  that  the  reduction  has  already  commenced  in  the  jjortal 
circulation^  .and  should  not  be  set  down  wholly  to  the  action  of  the  liver ; 
for  all  observers  agree  that  the  portal  blood  is  poor  in  fibrin. 

As  it  respects  the  blood  of  the  renal  vein,  too.  Brown -Seqcaud 
admits  that  after  death  it  is  usually  found  to  be  coagulable  or  com- 
pletely coagulated ;  which  must  of  course  be  due  to  the  presence  of 
fibrin.  He  further  states,  that  when  this  vein  is  opened  in  a  living  ani- 
mal, although  the  blood  which  at  first  flows  gives  no  indication  of  the 
presence  of  fibrin,  yet  if  it  be  allowed  to  flow  for  three  or  four  minutes, 
some  fibrin  makes  its  appearance,  and  after  seven  or  eight  minutes  it  is 
present  "in  notable  quantity."  Bernard  makes,  on  this  subject,  the 
following  singular  remark :  "  The  blood  of  the  renal  vein  coagulates^ 
though  it  contains  no  fthnny  I  leave  it  to  chemists  to  decide  whether 
the  first  branch  of  the  proposition  does  not   invalidate  the  last. 

Having  thus  shown  with  what  large  allowance  we  must  receive  the 
assertion  that  the  fibrin  disappears  from  the  blood  which  traverses  the 
liver  and  the  kidney,  I  next  inquire  what  has  become  of  this  lost  fibrin  ? 
—  for  we  must  at  least  admit,  I  suppose,  a  diminution  oi  it.  It  has 
not  been  excreted  by  those  glands  —  for  neither  the  bile  nor  the  urine 
contains  a  trace  of  this  principle:  nor  do  they  contain  any  ingredient 
which  can  by  any  reasonable  presumption  be  ascribed  to  its  decomposi- 
tion. There  is  no  more  reason  for  assuming  any  such  destructive  change, 
than  for  supposing  that  the  fibrin  is  consumed  in  nourishing  the  organs 


Selected  Articles^  Abstracts^  <&c.  299 

in  question,  or  (more  probably)  that  it  undergoes  some  unknown  change 
of  condition,  attended  with  the  loss  of  the  characteristic  property  of 
coagulation,  by  which  it  is  usually  recognized.  Perhaps  it  may  revert 
to  the  condition  of  albumen.  F.  Simon's  comparative  analysis  of  the 
blood  of  the  renal  vein,  and  the  arterial  blood  of  the  same  animal, 
renders  this  a  very  plausible  supposition;  for  he  found  that  while  the 
blood  of  the  vein  had  lost  the  greater  part  of  its  fibrin  {not  al\  as  he 
is  made  by  some  writers  to  say),  it  had  gained,  albumen  in  about  equal 
amount.  According  to  the  same  chemist,  the  blood  of  the  hepatic  veins 
also,  while  containing  less  fibrin  than  that  of  the  portal  vein,  contains 
a  decidedly  larger  proportion  of  the   albumen. 

The  idea  promulgated  by  Bernard,  in  his  Lectures  on  the  Blood, 
that  the  fibrin  is  consumed  in  the  liver  in  the  production  of  the  sugar 
which  he  has  proved  to  make  its  appearance  in  that  organ,  is  purely 
hypothetical,  and  rests  on  no  valid  foundation. 

The  properties  exhibited  by  fibrin  in  inflammatory  exudations,  and 
the  phenomena  of  the  repair  of  injuries,  so  far  from  affording  any  ar- 
gument against  the  doctrine  that  fibrin  is  a  plastic  material  of  the 
most  essential  importance,  furnishes  the  most  conclusive  proof  in  its 
favor. 

The  assertion  that  the  fibrinous  coagula  lining  an  aneurismal  sac  — 
those  forming  the  so-called  "polypi  of  the  heart" — and  concretions  of 
the  same  kind  in  the  midst  of  the  parenchymatous  structures,  are  inca- 
pable of  organization,  is  entirely  at  variance  with  the  positive  testimony 
of  some  of  the  highest  authorities  in  pathology.  I  take  it  to  be  also  an 
established  fjict,  that  a  coagiilum  of  bloody  whether  in  the  cavity  of  an 
artery  that  has  been  tied,  or  in  the  substance  of  the  brain,  or  elsewhere, 
may  be  organized  and  vascularized,  though  with  comparative  tardiness — 
the  presence  of  the  red  corpuscles  in  the  midst  of  the  fibrin  seeming  to 
delay  the  occurrence  of  the  vital  changes. 

But,  not  to  dwell  on  these  points,  I  refer  next  to  the  all -important 
fact,  that  in  all  inflammatory  effusions  which  manifest  a  capacity  for  or- 
ganization, and  in  the  exudations  which  serve  as  the  medium  for  the  re- 
paration of  wounds  and  fractures^  fibrin  is  an  invariable  ingredient^  and 
its  presence  is  absolutely  indispensable  to  the  occurrence  of  those  organic 
changes  which  result  in  the  development  of  new  tissue.  Here,  as  else- 
where, fibrin  exhibits  its  property  of  spontaneous  coagulation,  which,  be 
it  remarked,  is  always  the  first  step  in  the  organizing  process.  The 
term  coagulaMe  lympli^  so  constantly  applied  to  these  plastic  exudations, 
has  familiarized  our  minds  to  the  fact. 

It  is  true  that  this  "lymph"  (which  consists  essentially  of  the 
•* plasma"  of  the  blood,  or  liquor  sanguinis^  exuded  from  the  vessels, 
contains  other  solid  ingredients  besides  fibrin.  A  considerable  propor- 
tion of  albumen  is  there  with  some  fatty  matter,  and  various  salts,  es- 


300  The  Peninsular  and  Independent. 

pecially  phosphates.  Sometimes,  too,  a  few  red  corpuscles  of  the  blood 
are  present,  either  entire,  or  in  a  disintegrated  state.  But  though  an 
exudation  contain  all  tlie  other  ingredients,  if  no  fibrin  be  present,  not 
the  slightest  tendency  to  organization  is  ever  manifested.  Thus,  serous 
eflfusions  into  the  pleura  or  peritoneum,  which  contain  every  element 
that  coagulable  lymph  does,  except  fibrin,  never  give  rise  to  the  forma- 
tion of  false  membranes :  nor  is  there  any  instance  of  a  mere  serous 
exudation  serving  for  the  reparation  of  an  injured  tissue.  A  true 
^''blastema''''  is  always  more  or  less  rich  in  fibrin.  This,  in  the  exercise 
of  its  distinctive  property,  first  concretes  upon  the  parts  from  which  it 
was  effused:  then,  by  the  agency  of  nucleated  cells,  or  nuclei,  which 
make  their  appearance  in  the  blastema,  fibres  are  formed ;  and  finally, 
by  the  extension  of  vessels  into  it  from  the  adjacent  living  parts,  the 
organization  of  the  new  tissue  may  be  said  to  be  virtually  completed. 

It  deserves  to  be  particular!}'-  remarked,  too,  that  the  degree  of  plas- 
ticity of  the  exudation  depends  much  on  the  qnal'itu  of  the  fibrin  — 
and  this,  in  its  turn,  is  intimately  connected  with  the  condition  of  the 
organism  at  large,  and  of  the  blood  in  particular.  When  there  is  suflB- 
cicnt  vigor  of  constitution,  and  the  blood,  besides  a  due  proportion  of 
^  other  ingredients,  is  rich  in  fibrin,  and  this  fibrin  exhibits  in  a  perfect 
degree  its  property  of  coagulation,  then  the  exudation  enters  readily  upon 
the  career  of  development.  But  in  unhealthy  states  of  the  system,  when 
the  fibrin  of  the  blood,  however  abundant,  is  defective  in  qualit}'',  the 
exudations  into  which  it  may  happen  to  enter,  arc  (to  use  the  language 
of  Dr.  AViLLiAMs)  cither  "  cacoplastic"  or  "aplastic"  —  that  is  to  say, 
either  not  at  all  organizable,  or  exhibiting  this  property  in  a  very  low 
degree. 

I  know  it  has  been  urged  that  effusions  which  contain  fibrin,  may 
nevertheless  be  without  any  tendency  to  organization.  Thus,  in  some 
cases  of  drops}',  the  fluid  is  fibrinous,  as  is  proved  by  its  spontaneous 
coagulation  when  exposed  to  the  air ;  and  yet  no  false  membranes  are 
formed  from  such  effusions.  This,  however,  may  be  ascribed  either  to 
the  small  amount  of  fibrin  in  the  fluid,  or  to  the  presence  of  some  cause 
interfering  with  the  exercise  of  its  peculiar  endowments.  The  fact 
nevertheless  remains,  and  can  not  be  denied  or  evaded,  that  the  presence 
of  a  due  proportion  of  fibrin  is  the  indispensable  condition  of  an  organ- 
izable exudation. 

It  is  argued,  however,  that  the  organization  of  a  fibrinous  blastema 
is  always  of  a  very  low  grade,  resulting  in  the  development  of  nothing 
higher  or  more  complex  than  a  simple  fibrous  tissue.  "This,  almost  of 
itself,"  remarks  Dr.  Handfield  Jones,  "is  a  proof  that  fibrin  is  not 
the  peculiarly  organizable  or  plastic  element  that  it  has  been  considered 
to  be." 

This   must    certainly   be  regarded   as  a  rather   extraordinary  state- 


Selected  Articles^  Abstracts^  (&c.  301 

ment.  It  is  true,  indeed,  that  the  coagulable  lymph  effused  either  on 
inflamed  serous  membranes,  or  between  the  lips  of  a  wound,  always 
at  first  forms  by  its  organization  a  fibrous  or  areolar  tissue.  But  docs 
the  process  necessarily  stop  there  ?  By  no  means.  The  ultimate  destina- 
tion of  the  new  structure  depends  much  upon  the  nature  of  the  adja- 
cent living  parts.  "All  lymph,"  says  Mr.  Paget,  "has  some  tendency 
to  assume,  sooner  or  later,  the  characters  of  the  tissue  in  or  near  which 
it  is  seated,  or  in  place  of  which  it  is  formed."  And  thus  there  may 
be  developed  from  a  plastic  exudation,  not  only  the  above  named  simple 
tissue,  but  blood  vessels,  elastic  tissue,  mucous  membrane,  serous  mem^ 
brane,  skin,  cartilage,  bone,  adipose  tissue,  lymphatic  vessels,  even  ner- 
vous tissue:  for  divided  nerves  may  heal,  and  re -acquire  their  functions 
perfectly  in  the  course  of  a  few  weeks  —  and  we  have  good  authority 
for  saying  that  nerve  fibres  have  been  more  than  once  seen  in  inflam- 
matory adhesions. 

Now,  what  warrant  is  there  for  excluding  fibrin  from  any  partici- 
pation in  these  ulterior  developments  of  the  blastema  ?  Why  regard  it 
as  useless,  and  albumen,  the  fatty  principles,  &c,,  alone  efficient,  when 
we  know  that  in  the  outset,  they,  in  the  absence  of  fibrin,  are  wholly 
destitute  of  the  least  capacity  for  organization?  Would  it  not  be  more 
consistent  to  say  that  the  principle  which  takes  the  first  stejj,  also  takes 
an  important  part  throughout?  Such  is  surely  the  prima  facie  conclu- 
sion, and  I  know  of  nothing  which  invalidates  it.  I  am  acquainted  with 
no  fact  relating  to  the  organization  of  new  formations  which  gives  any 
real  countenance  to  Mr.  Simon's  opinion,  that  the  fibrin  of  the  blastema 
affords  merely  a  "scaffolding"  or  mechanical  support  for  the  other  ele- 
ments, and  takes  no  part  itself  in  the  development  of  cells  and  fibres, 
and  in  the  various  subsequent  changes.  What  single  reason  is  there  to 
show  that  albumen  takes  the  leading  part  in  all  these  phenomena?  If 
any  should  lay  stress  on  the  fact  that  fibrin  is  inadequate  to  the  perfect 
repair  of  the  muscular  tissue  when  wounded,  it  maj'-  be  answered  that 
it  is  not  more  inefficient  than  other  animal  principles  in  this  particular 
—  the  fact  being  that  losses  of  the  muscular  tissue  are  never  repaired 
by  a  new  production  of  the  same  kind  of  tissue. 

We  have  every  reason  to  infer  that  the  same  materials  w^hich  are 
employed  in  the  regeneration  of  the  tissues,  are  also  those  which  are 
applied  to  the  repair  of  their  daily  waste :  for  it  is  admitted  that  the 
two  processes  are  but  modifications  of  one  and  the  same  function  of 
nutrition.  If  fibrin  is  an  essential  means  of  tissue  formation  in  the  one 
case,  it  must  equally  be  so  in  the  other.  It  is  not  easy  to  see  how  the 
justice  of  this  conclusion  can  be   disputed. 

Dr.  Carpenter  has  advocated  an  opinion  on  this  subject  in  the 
later  editions  of  his  works,  which  is,  to  say  the  least,  paradoxical ;  viz. 
that  fibrin  is  applied  to  the  nutrition  of  the   "  fibro  -  gelatinous  tissues " 


302  The  Peninsular  and  Index)cndent, 

(fibrous,  areolar,  &c.),  but  takes  no  part  in  that  of  the  higher  structures. 
He  maintains  on  the  one  hand,  that  fibrin  is  a  vitalized  principle,  as 
proved  by  its  possessing  '*the  power  of  spontaneously  passing  (under 
certain  conditions)  into  an  organized  tissue";  but  on  the  other,  that  is 
"the  special  pabulum  of  those  connective  tissues,  whose  physical  offices 
in  the  economy  are  so  important,  while  their  vital  endowments  are  so  lowy 
He  thus  assigns  the  only  proximate  principle  which  he  regards  as  truly 
vitalized,  to  the  nutrition  of  some  of  the  least  vitalized  structures.  There 
is  surely  here  a  glaring  inconsistency. 

Dr.  Cakpentek's  idea  seems  to  have  been  suggested  by  the  fact,  that 
fibrin,  in  undergoing  spontaneous  coagulation,  assumes  a  more  or  less 
distinct  filamentous  arrangement,  which  reminds  one  of  the  structure  of 
the  white  fibrous  tissue.  But  he  seems  to  have  forgotten  that  a  coa- 
gulum  of  fibrin,  however  perfectly  "fibrillated,"  is  not  fibrous  tissue. 
The  production  of  this  on  the  surface  of  an  inflamed  membrane  or  a 
wounded  part,  is  a  subsequent  affair,  being  effected  by  the  development 
of  nucleated  cells,  which  then,  by  particular  changes  of  form,  undergo 
transformation  into  true  fibres.  It  would  be  remembered  too,  that  fibrous 
tissue  consists  not  of  fibrin,  but  of  gelatin. 

On  the  whole,  there  does  not  appear  to  be  any  satisfactory  reason 
for  limiting  the  histogenetic  uses  of  fibrin  to  the  fibrous  and  areolar 
structures.  Its  peculiar  "vital"  endowments,  which  distinguish  it  so 
remarkably  fiom  other  organic  compounds,  would  rather  claim  for  it  a 
higher  destination. 

The  principal  arguments  in  favor  of  the  hypotheses  which  I  have 
been  combatting,  have  now  been  reviewed,  and  found  (if  I  mistake  not) 
wholly  inconclusive.  Some  of  them  would  invite  a  more  extended  dis- 
cussion, but  T  must  hasten  to  a  close.  I  can  not  conclude,  however, 
without  calling  attention  to  a  few  other  points  in  the  history  of  fibrin, 
which  appear  to  bear  strongly  on  its  physiological  relations. 

1.  Fibrin  is  a  constituent  of  the  chyle.  Evident  indications  of  it 
are  found  in  the  fluid  drawn  from  lacteals  of  an  animal  in  full  digestion, 
at  their  very  issue  from  the  intestine;  but  its  quantity  progressively 
increases  by  the  transformation  of  albumen,  and  its  characters  become 
more  perfectly  developed  as  the  chyle  moves  along  the  vessels  towards 
the  thoracic  duct,  and  through  it  into  the  venous  system ;  and  a  further 
increase  takes  place  as  the  blood  passes  from  the  venous  to  the  arterial 
side  of  the  circulation.  We  may  affirm,  therefore,  that  the  2'>roportlon  of 
fibrin  increases  as  the  j)roducts  of  digestion  a^jproach  the  ])oints  where 
materials  are  needed  for  the  nutrition  of  tissue :  and,  we  may  ask,  if 
fibrin  be  an  excrementitious  product,  why  should  it  appear  in  the  chyle 
directly  after  its  absorption?  We  can  not  account  for  its  presence  here 
by  the  waste  of  tissue,  nor  can  we  reasonably  suppose  the  occurrence  of 
a  "retrograde  metamorphosis" — a  destructive  change  in  the  products  of 
digestion  as  soon  as  they  are  absorbed. 


Selected  Articles^  Abstracts^  <$:c.  303 

2.  Fibrin  is  normally  found  only  in  the  nutritive  fluids  of  the  eco- 
nomy—  the  blood,  chyle,  and  lymph.  It  is  not  a  constituent  of  any 
excretion  —  as  are  all  those  ingredients  of  the  blood  which  are  admitted  to 
be  excrementitious  —  such  as  carbonic  acid,  urea,  uric  acid,  creatine,  &c. 

3.  Fibrin  is  nature's  agent  for  the  arrest  of  licemorrhage.  When 
vessels  are  divided,  the  coagulation  of  the  blood  is  the  means  by  which 
occlusion  is  mainly  effected,  and  the  flow  permanently  arrested.  If  the 
blood  contained  no  fibrin,  and  were  therefore  not  coagulable,  hemorrhage, 
even  from  the  slightest  wound,  could  never  be  arrested  by  the  efforts 
of  nature.  But  for  the  same  protective  property,  every  separation  of  a 
gangrenous  part  would  be  attended  with  bleeding.  Effusions  of  fibrin 
is  also  the  means  by  which  suppuration  is  circumscribed,  and  prevented 
from  assuming  that  diffuse  character  which  is  sometimes  so  destructive. 
In  these  several  particulars  fibrin  performs  offices  which  are  signally  con- 
servative.  Can  we  say  as  much  for  any  of  those  products  of  wear  and 
tear  which  constitute  the  true  offal  of  the  system  ? 

It  has  been  aptly  remarked  that  the  organism  hears  an  inc7'ease  of 
Jibrin  better  than  a  diminution.  Witness  the  comparative  gravity  of 
sthenic  inflammation,  and  the  severer  grades  of  typhoid  fever.  Not  so 
with  any  organic  compound  of  the  excrementitious  class.  The  accumu- 
lation of  these  in  the  blood  is  the  signal  of  urgent  peril. 

4.  Is  it  mere  fancy  that  sees  in  the  spontaneous  coagulation  of  fibrin, 
and  the  definite  disposition  which  its  particles  usually  assume  in  soli- 
difying, the  indication  of  a  special  tendency  to  organization  ?  And  is 
it  unwarrantable  to  argue  therefrom,  the  possession  by  this  principle  of 
a  certain  degree  of  vitality?  I  know  the  chemico-phj^siological  school 
of  the  present  day  repudiate  in  toto  this  ancient  doctrine  of  Hunter. 
They  see  in  fibrin  a  mere  chemical  compound  like  albumen  or  gelatin — - 
not  more  animalized  than  they — and  regard  its  coagulation  as  a  mere 
physical  consolidation,  really  peculiar  only  in  the  conditions  under  which 
it  takes  place.  But  as  these  same  philosophers  reject  altogether  the  in- 
tervention of  vital  forces  in  the  operations  of  life,  regarding  the  living 
organism  as  swayed  wholly  by  the  same  physical  and  chemical  laws 
which  control  dead  matter,  it  is  not  from  them  that  we  are  to  expect  an 
impartial  answer,  when  any  question  of  vitality  arises.  But  if  we 
recognize  such  a  thing  as  vitality  at  all  —  if  we  regard  organization  as 
the  invariable  index  and  accompaniment  of  life  —  if  we  admit  vitality  in 
the  egg,  because  under  certain  external  conditions  it  becomes  developed 
into  a  complex  organized  being  —  we  must  equally  allow  that  a  fibrinous 
effusion  upon  a  living  surface  is  vitalized :  for,  although  external  to  the 
vessels  which  circulate  the  blood,  and  withdrawn  from  the  sphere  of 
action  of  the  nerve  force,  it  becomes,  by  virtue  of  its  own  inherent 
properties,  the  seat  of  a  process  of  organization,  which  results  in  the 
development  of  living  tissues,  more  or   less   perfectly  resembling  those 


304  Tlie  Peninsular  and  Independent. 

of  which  the  organism  was  originally  constituted :  and  as  the  plastic 
power  which  determines  all  these  remarkable  imitations  of  natural  devel- 
opment pertains  especially  to  fibrin,  the  presence  of  which  is  their 
iine  qua  non^  the  recognition  of  vitality  in  it  is  not  only  allowable,  but 
unavoidable.  Its  passage  from  a  fluid  state  to  that  of  a  definitely  arrang- 
ed coagulum,  is   the  first  manifestation  of  that  vitality. 

All  attempts  to  ascribe  this  coagulation  to  the  operation  of  mere 
chemical  or  physical  influences,  have  failed.  It  is  a  change  which  fibrin 
always  undergoes  of  its  own  accord,  when  it  is  not  kept  moving  in 
contact  with  liviiaj  jmrtH,  whatever  be  the  external  conditions  in  other 
respects.  When,  in  the  course  of  the  circulation,  the  plasma  of  tho 
blood  is  effused  from  the  capillaries  into  the  midst  of  the  tissues  for 
their  nutrition,  the  fibrin,  being  now  at  rest^  is  free  to  pass  to  the  solid 
state,  and  enter  into  combination  with  the  tissue  or  tissues  of  which  it 
is  the  appointed  food. 

What  those  tissues  are,  we  can  not  in  the  present  state  of  the 
science  declare.  If  we  can  not  atfirm  positively  that  the  muscular  is 
one  of  them  (or  the  only  one),  on  the  other  hand,  the  differences  be- 
tween fibrin  and  the  substance  of  muscle  are  not  so  great  as  to  au- 
thorize us  positively  to  deny  it.  It  was  with  no  hope  of  solving  this 
problem  that  I  undertook  the  investigation  of  this  subject.  AVhat 
I  have  attempted  to  prove  is,  first,  that  fibrin  is  not  a  product  of  vital 
decay,  but  a  principle  destined  for  the  nutrition  of  tissue ;  secondly, 
that  its  agency  in  this  respect  is  not  restricted  to  the  tissues  of  the 
lowest  grade.  Further  than  this  we  can  not  go,  without  venturing  into 
the  domains  of  speculation.  ^Vc  have  no  just  ground  for  affirming 
that  fibrin  is  the  only  immediate  tissue -forming  ingredient  of  the  blood 
—  that  the  albumen  (for  example)  which  abounds  there,  must  pass 
through  the  form  of  fibrin  before  combining  with  any  living  structure; 
the  probabilities  are  all  against  such  an  exclusive  view.  But  that  fibrin 
is  a  specially  and  eminently  organizalle  or  histogenetic  material  —  this 
I  am  convinced,  is  a  truth  which  can  not  be  successfully  controverted. 
To  this  extent,  at  least,  I  am  still  content  ''■stare  super  antiquas  r/a*." 


ABSTRACTS  AND  SELECTIONS  for  the  PEMXSULAR  A\D  L\DEPEM)Ex\T. 


By  M.  A.  Patterson,  M.  D.,  Tecumseh. 


ADHESIVE  PLASTER  IN    MAINTAINING  COUNTER  -  EXTENSION  IN    THE 
TREATMENT  OF  OBLIQUE  FRACTURES  OF  THE  LOWER  EXTREMITY. 

In  the  report  of  surgical  practice  in  the  Pennsylvania  Hospital, 
continued  in  the  April  30th  No.  of  the  Med.  and  Surgical  Reporter,  it  is 
stated  that  Dr.  Neill,  the  surgeon  on  service,  spoke  as  follows:     "If  there 


Selected  Articles^  Abstracts^  <&c.  305 

is  anything  that  the  hospital  is  calculated  to  teach  it  is  the  proper  treat- 
ment of  fractures."  Fractures  may  be  as  well  managed  in  that  hospital 
as  in  similar  institutions,  but  if  we  except  the  adoption  of  adhesive  bands 
for  maintaining  extension,  a  method  by  no  means  novel,  no  material 
change  has  been  made  during  the  last  forty  years  in  their  apparatus  for 
dressing  oblique  fractures  of  the  thigh  bone. 

A  similar  apparatus,  modified  by  Dr.  Buck,  has  been  used  in  the  New 
York  Hospital  for  more  than  twenty  years,  in  which  the  Desault  and  Phy- 
sick  splint  was  originally  introduced  as  a  substitute  for  the  double -inclined 
plane. 

The  Burge's  plan  is  regarded  by  some  intelligent  surgeons  as  a 
decided  improvement ;  approaching  the  ideal  of  Desault  nearer  than  any 
previous  method,  "  by  making  the  tuberosity  of  the  ischium  the  point 
cV  a'pui^''  and  obviating  undue  pressure  upon  the  groin.  It  is  also  urged 
in  favor  of  tlie  Burge's  splint  that  the  patient  may  assume  a  sitting 
posture,  at  his  pleasure,  during  the  process  of  his  cure.  But  Dr.  Lente, 
a  surgeon  of  no  small  experience  in  this  department  of  practice,  remarks : 

The  fact  seems  to  be  that  neither  the  groin  nor  the  tiiberosity  is  fitted 
to  hear  alone  the  presHiive  of  the  counter-extension  in  cases  of  considerable 
shortening,  and  tlierefore  of  great  tension  in  the  application  of  the  ex- 
tending power.  It  is  therefore  my  object,  in  the  further  modification  of 
the  New  York  Hospital  apparatus,  to  distribute  the  pressure  on  these  two 
points. 

Dr.  Lente's  proposed  modifications  are  ingenious,  and  may  answer  a 
valuable  purpose;  but,  if  Dr.  Gilbeut's  views  are  correct,  the  mere  modi- 
fication of  the  splint  is  not  an  object  of  the  first  importance.  The  trouble 
usually  arises  from  the  friction,  and  long  continued  pressure  of  the  un- 
adherent  counter- extending  bands  upon  a  comparatively  small  extent  of 
surface,  whether  that  surface  be  over  the  tuberosity  of  the  ischium  or 
the  perineum. 

Until  within  a  few  years  it  was  found  exceedingly  diflScult,  in  very 
many  cases,  to  sustain  the  requisite  extension,  without  injury  to  the  tissues 
underlying  the  ordinary  extension  bands ;  now  the  use  of  adhesive  plaster, 
with  the  attachment  of  Lente's  wooden  block  at  the  extremity  of  the 
loop,  to  prevent  undue  pressure  upon  the  malleoli,  seems  to  be  all  that 
is  desired,  so  far  as  extension  is  concerned. 

If,  then,  adhesive  plaster  has  been  found  so  useful  in  maintaining  ex- 
tension, why  will  it  not  answer  equally  as  well  for  counter -extension? 
For  the  practical  solution  of  this  question,  as  intimated  in  the  last  No.  of 
this  Journal,  we  are  indebted  to  Dr.  Gilbert,  who  has  communicated  the 
results  of  his  experience  on  this  subject  in  a  paper  read  before  the  Col- 
lege of  Physicians  of  Philadelphia.  From  this  paper,  as  published  in  the 
American  Journal  of  the  Medical  Sciences^  we  quote  as  follows: 

The  adhesive  plaster  counter-extending  bands  become  firmly  adherent 
to  a  large   extent  of  integument,  consequently  there  can  be  no  friction 

Vol.  II.  — u. 


306  The  Peninsular  and  Independent, 

upon  its  surface;  and  through  this  extensive  union  with  the  skin  pressure 
is  widely  and  evenly  diffaf^ed.  In  the  use  of  anv  of  the  ordinary  unattach- 
ed, counter-extending  means,  the  extent  of  suifacc  occn[)ied  at  the  seat  of 
pressure  does  not  ex<^eed  eight  square  inches  ;  a  fractional  part  only  of 
which  sustains  its  greatest  intensit}',  viz.,  th;it  which  overlies  the  tuher 
ischii,  the  edge  of  its  ascending  ramus,  and  a  narrow  space  of  the  body 
of  the  pubis.  The  extent  of  surface  to  which  the  adhesive  plaster  counter- 
extending  bands  are  attached,  on  the  other  hand,  amounts  to  about  one 
hundred  square  inches,  over  all  of  which  the  tension  and  pressure  arc 
equally  distiilnited.  \n  the  use  of  the  former,  all  the  tissues  lying  upon 
the  points  of  bone  mentioned,  endure  constant  pressuie,  amounting  often 
to  constriction;  in  the  use  of  the  latter,  through  the  elasticity  of  the  skin, 
and  the  extensive  distribution  of  the  tractive  power,  pressure  is  slight  and 
painless.  In  the  use  of  the  former,  friction  is  produced  continually  by 
the  movements  of  the  body  or  limb  ;  in  the  use  of  the  latter,  friction  is 
impossible.  The  former  glides  over  the  surftc.^,  and  acts  as  a  ligature; 
the  latter,  being  adherent,  can  not  act  thus.  The  former  docs  not  fix  the 
pelvis;  the  latter  holds  it  firmly,  and  keeps  all  the  puts  steady  from  the 
chest  to  the  foot.  The  former  requiies  ihe  <iaily  attention  of  the  surgeon 
to  relieve  suffering  and  prevent  abrasion ;  the  latter  requires  no  such 
attention,  unless  the  bands  loose  their  attachment  which  ordinarily  docs 
not  occur  more  than  once  during  the  whole  period  of  treatment.  In  short, 
by  the  adhesive  counter-extending  bands,  pressure  is  completely  neutraliz- 
ed, friction  can  not  occur  so  long  as  they  remain  adherent,  perfect  quietude 
of  the  fragments  is  maintained  ;  the  union  consequently  lequires  less  time 
and  less  attention  from  the  surgeon,  and  the  patient  is  entirely  free  from 
the  annoyance  and  suffering  inseparable  from  the  oidinary  methods,  no 
matter  how  great  the  power  used  to  overcome  the  nmscular  contractions  or 
how  protracted  the  periods  required  for  union  in  complicated  cases." 

Dr.  Gilbert  uses  a  common  board  splint,  extending  "along  the  out- 
side of  the  limb  from  below  the  armpit  opposite  the  nipple  to  about  six 
inches  below  the  foot."  Anterior  and  posterior  counter -extending  bands 
of  adhesive  plaster,  two  and  a  half  inches  wide,  cross  each  other  just 
before  they  pass  through  the  mortice  holes  at  the  upper  extremity  of  the 
splint.  These  bands  arc  applied  so  as  to  cross  at  the  upper  part  of  the 
thigh  and  perineum ;  and,  when  fixed,  a  horizontal  adhesive  strip,  say 
three  inches  wide,  is  made  to  encircle  *'  more  than  half  of  the  pelvis 
immediately  below  the  christa  ilii,  for  the  purpose  of  more  securely  bind- 
ing the  counter- extending  bands  to  the  surface  and  increasing  the  extent 
of  attachment  of  the  counter -extending  means."  It  must  be  obvious 
that  the  latter  may  be  increased  at  will,  as  Dr.  G,  remarks, 

Although  the  anterior  and  posterior  counter -extending  bands  are 
usually  quite  sufficient,  yet  any  additional  amount  of  adhesive  plaster 
may  be  applied,  in  order  to  diffuse  the  tractive  force  still  more  vvidjly. 

TVe  are  assured  by  Dr.  Gilbert  that  he  has  thoroughly  proved  the 
superiority  of  the  adhesive  plaster  over  all  other  modes  of  effecting 
counter -extension,  and  that  it  is  applicable  to  every  conceivable  case  of 
oblique  fracture,  "  not  only  of  the  thigh  but  of  the  leg."  If  this  is  so, 
the   ordinary  straight  splints,   a  few  strips   of  adhesive  plaster,  a  little 


Selected  Articles^  Abstracts^  Sc.  307 

wadding,  a  roller  for  the  leg,  many  tailed  bandage  for  the  thigh,  some 
cotton  cloth,  a  small  wooden  block  to  place  in  the  loop  of  the  extension 
band,  a  tourniquet,  or  even  a  roller  perforated  with  holes  to  receive  wooden 
pins,  with  which  to  regulate  the  extension,  constitute  the  essentials,  at 
once  cheap,  simple,  painless,  and  eflScient,  for  dressing  these  troublesome 
fractures. 

Dr.  Gilbert  recommends  the  use  of  a  fracture -bed,  which  he  thug 
describes : 

It  consists  of  a  frame  three  and  a  half  feet  wide  and  six  feet  long, 
made  of  one  and  a  quarter  or  one  and  a  half  inch  plank,  four  inches  wide, 
joined  by  mortise  flatwise.  Over  this,  sacking  or  strong  canvas  is  tightly 
drawn,  and  secured  by  tacks.  A  hole  is  made  in  the  centre,  of  a  conve- 
nient size  for  the  passage  of  the  alvine  evacuations.  A  sheet  is  thrown 
over  the  bed,  with  an  opening  to  correspond;  pillows  are  placed  upon 
its  upper  end,  and  the  bed  is  fully  furnished.  This  is  preferable  to  any 
of  the  complicated  and  expensive  beds  in  use,  because  it  possesses  all  the 
properties  required  in  a  fracture-bed,  and  yet  it  is  so  cheap  and  simple  as 
to  place  it  within  the  reach  of  every  one,  in  any  locality.  It  imparts  the 
evenness  and  firmness  of  a  mattress  to  the  softest  bed  of  down  or  feathers; 
the  patient  can  have  his  evacuations,  without  the  least  disturbance  of  the 
fractui'C,  hy  raising  the  frame  and  resting  it  upon  stools  or  chairs;  during 
the  time  the  bed  upon  which  it  was  placed  may  be  changed  and  made  up. 

Dr.  Gilbert  does  not  claim  to  be  the  inventor  of  this  bed;  indeed  it 
has  been  used  in  some  localities  for  several  years.  The  writer  has  found 
it  a  most  valuable  contrivance,  not  only  as  a  fracture -bed,  but  in  all 
cases  of  helplessness  arising  from  rheumatic  disease  of  the  lower  extremi" 
ties,  or  other  causes. 


THE  UTERIXE  SPECULUM. 

A  well  known  poet  has,  rather  sneeringly,  said  — 

"  Physic,  like  music,  hatli  fashion's  decree." 

Since  the  invention  of  the  speculum,  and  the  general  circulation  of  Dr, 
James  Henry  Bennetts  book,  uterine  diseases  have  become  alarmingly  pre- 
valent, if  we  may  credit  the  statements  of  those  who  are  striving  to  make 
the  treatment  of  real  or  supposed  lesions  of  this  organ  an  actual  specialty, 
A  female  can  no  longer  complain  of  a  pain  in  the  side  or  back,  or  a  weari- 
ness of  the  limbs,  or  a  little  nervousness,  especially  if  troubled  with  a  slight 
leucorrhoeal  discharge,  without  being  informed  that  she  has  this  fashionable 
disease;  and  this  opinion  must  be  verified  by  an  immediate  speculum  ex- 
amination. It  is  a  humilitating  fact  that  the  innermost  recasses  of  womanly 
modesty  have  been  boldly  invaded,  without  a  shadow  of  necessity,  by  these 
specialty -mongers,  and,  that  reports  of  cases  of  uterine  diseise  have  in^ 
creased  in  a  ratio  proportionate  to  the  multiplication  of  speculums. 

Honest  and  well  informed  physicians  everywhere  admit  that  forms  of 
uterine  disease  exist,  in  which  the  use  of  a  speculum  is  indispensable ;  but 


308  The  Peninsular  and  Independent. 

these  cases,  in  our  country  practice,  liappily,  are  rare  ;  much  more  so  than 
one  would  suppose  from  reading  some  modern  essays  on  the  subject. 

It  should  be  remembered  that  Dr.  Benmet  acquired  his  practical  views 
and  principles  amidst  the  outcasts  of  society — a  class  of  females,  and  a  class 
of  cases,  came  under  his  observation  which  are  rarely  met  with  beyond  the 
precincts  of  overgrown  towns  and  cities;  and  even  there — in  the  school  of 
Bennet's  own  pupilage — a  world  -renowned  surgeon  has  declared  that  the 
speculum  can  be  dispensed  witli  "in  nine  cases  out  of  twelve."  If  such 
is  the  fact  in  a  leading  hospital  of  Paris,  how  much  less  fre(iuent,  in  the 
same  proportional  number  of  cases,  should  the  speculum  be  resorted  to  in 
a  comparatively  nn*al  population  where  simple  ulceration  of  the  uterus, 
and,  more  especially,  malignant  diseases  of  that  organ,  are  of  such  rare 
occurrence. 

The  following  article  from  the  pen  of  one  of  the  most  gifted  and  hon- 
orable physicians  in  our  country  should  be  read  with  attention.  It  is  a 
laudable  effort  to  dispel  the  growing  medical  and  popular  delusions  with 
which  the  Uterine  Speculum  has  been  invested  by  idealists  and  spe- 
cialists : 

From  the  Virginia  Medical  Journal. 

On  the  Speculum   Vagina'. — By   John  P.    Mettauer,   M.  D.,    LL.  D.,    of 

Virginia. 

The  employment  of  this  instrument,  of  late  years,  in  the  exploration 
and  treatment  of  uterine  affections,  has  become  almost  as  common  as  the 
stethoscope  and  percussion  in  the  diseases  of  the  thoracic  organs.  Even 
inexperienced  practitioners,  who  have  barely  laid  aside  the  swathings  of 
their  pupilage,  presume  to  employ  it,  and  speak  authoritatively  of  the  mode 
of  applying  it,  as  well  as  of  the  diseases  demanding  its  use.  They  seem  to 
regard  the  operation  as  a  thing  of  little  impoitance,  as  far  as  female  deli- 
cacy is  concerned,  and  to  believe  that  poor  woman  should  submit  to  it, 
even  if  a  disease  of  the  uterus  is  only  suspected  to  exist,  that  might  possi- 
bly render  the  speculum  necessary  hereafier. 

Every  enlightened  and  humane  })hysician  will  concede  that  a  necessity 
will  sometimes  arise  for  the  employment  of  the  speculum,  as  well  as 
other  modes  of  exploration,  repulsive  to  female  delicacy.  In  such  cases  a 
sacrifice  of  delicacy  becomes  a  duty,  and  sensible  women  unhesitatingly 
submit  to  its  wise  and  sacred  behests. 

The  writer  has  undertaken  this  communication  for  the  purpose  of  show- 
ing that  the  speculum,  in  the  investigation  and  treatment  of  uterine  dis- 
eases, has  been  needlessly  employed,  and  its  value,  as  a  means  of  diagnosis, 
greatly  abused.  That  the  instrument  is  entirely  unnecessary  in  a  large 
majority  of  uterine  diseases,  the  writer  s  experience  abundantlj'"  testifies. 
His  experience  with  the  speculum,  too,  has  long  since  satisfied  him  that  the 
evidence  furnished  by  it  is  often  unsatisfiictory,  and  not  to  be  relied  on ; 
nay,  in  some  instances,  it  is  actually  deceptive,  by  reason  of  the  changes 
caused  in  the  state  of  the  os  and  cervix  uteri,  by  the  pressure  of  the  in- 
strument on  them.  It  has  frequently  been  the  case,  in  the  hands  of  the 
writer,  that  the  pressure  of  the  speculum  has  so  changed  the  color  and 
presenting  surfjice  of  those  parts,  as  actually  to  defeat  the  objects  of  the 
examination;  and  such  will  often  be  the  case  in  engorgement  of  the  uterus, 
and  when  there  is  malposition  of  it  from  retro-  or  anti-version.  Generally, 
in  determining  as  to  the  existence  or  non-existence  of  induration,  engorge- 


Selected  Articles^  Abstracts^  d^c.  309 

ment,  the  deviations  of  position,  internal  ulceration,  and,  very  frequently, 
of  ulceration  of  the  os  itself,  no  matter  how  carefully  and  skillfully  used,  it 
affords  little  if  any  information  of  a  reliable  and  useful  nature.  Even  when 
the  three  or  four  bladed  instrument  is  employed,  the  operation  and  results 
will  be  obnoxious  to  these  objections  in  a  great  degree,  and  they  are  the 
only  reliable  forms  of  vagino  -  uterine  spsculums  in  displaying  the  parts  to 
be  examined,  and  are  also  more  readily  and  easily  introduced ;  yet,  little 
difficulty  will  be  encountered  in  the  use  of  any  of  the  speculums  now  in 
use,  even  with  a  mere  novice,  who  has  carefully  studied  and  learned  the 
form,  course,  and  depth  of  the  vagina,  the  highly  wrought  and  fanciful  ac- 
count of  such  difficulties,  published  in  the  Monthly  Stethoscope  and  Medi- 
cal Reporter,  No.  2,  Vol.  2,  for  1857,  to  the  contrary  notwithstanding. 

It  is  not  pretended  that  the  speculum  is  useless,  or  absolutely  unne- 
cessary in  vaginal  and  uterine  diseases.  Far  otherwise  —as  the  writer  has 
employed  it  in  those  diseases  in  some  instances  with  the  best  results.  It 
is  to  the  officious  and  indiscriminate  employment  of  it  that  he  objects,  and 
to  the  exclusion  and  neglect  of  the  more  reliable  and  delicate  mode  of  ex- 
amination by  the  "toucher." 

The  speculum  has  not  found  general  favor  in  France,  although  much 
employed  in  that  country.  At  the  head  of  its  opponents  there,  the  name 
of  the  distinguished  Vkli'rau  stands  conspicuous  ;  and  it  is  matter  of  grat- 
ulation  to  the  wi-iter  to  find  his  views  supported  by  such  high  authority ; 
yet  he  had  entertained  those  views  and  carried  them  out  in  practice  years 
before  he  was  aware  that  Velpeau  had  expressed  similar  opinions  and  ob- 
jections. 

It  is  probable  that  the  physicians  of  this  country  and  France  more 
generally  and  indiscriminately  employ  the  speculum  than  any  others  in  the 
civili/x'd  world;  and  it  is  probable  also  that  the  taste  for  using  it  is  due,  in 
a  degree,  if  not  wholly,  to  the  cliniques,  as  well  as  to  the  hospital  practice 
connected  with  the  medical  schools  of  those  countries,  where  female  deli- 
cacy and  exposure  are  regarded  with  little  concern,  as  the  subjects  of  the 
use  of  the  speculum  are  derived  from  the  most  most  degraded  classes  of 
society,  with  whom  modesty  is  only  known  by  name.  In  many  instances, 
the  writer  has  met  with  women  laboring  under  organic  diseases  of  the 
uterus,  who  declared  to  him  that  they  would  sooner  take  their  chance  to 
live  or  die  with  the  disease,  than  submit  to  the  use  of  the  speculum  ;  and 
all  arc  more  or  less  opposed  to  it,  even  those  who  finally  submit  to  its  em- 
ployment. Really,  it  is  not  to  be  wondered  at,  that  a  modest,  delicate 
woman  should  feel  unwilling  to  submit  her  person  to  such  a  revolting  ex- 
posure ;  and  the  writer  candidly  owns  that  he  has  never  yet  applied  the 
speculum,  or  even  examined  by  the  toucher,  without  being  more  or  less 
abashed  and  disconcerted,  by  reason  of  the  exposure  the  operation  neces- 
sarily imposes  on  females.  Even  the  ordinary  modes  of  investigation  by 
question  and  answer  often  greatly  shock  a  modest  female,  and  in  a  degree 
in  some  instances,  embarrass  the  diagnosis  of  her  diseases. 

^Vhen  organic  disease  of  <"he  uterus  exists,  and  the  rational  symptoms 
fail  in  furnishing  the  requisite  amount  of  information  necessary  to  form  a 
satisfactory  diagnosis,  nearly  every  intelligent  woman  will  consent  to  a 
physical  examination,  if  made  sensible  of  the  necessity  for  it,  especially  if 
proposition  to  do  so  is  delicately  presented ;  and  such  being  the  case,  it  is 
the  duty  of  the  physician,  as  far  as  is  consistent  with  safety,  to  save  his 
female  patients  all  needless  shock  of  feeling  from  indelicate  questions  or 
personal  exposure. 

Entertaining  such  views  of  this  delicate  subject,  the  writer  some  ten 
years  since  directed  his  attention  to  the  investigition  of  org inic  diseases 
of  the  uterus,  guided  by  the  toucher,  chiefly;  and  after  repeated  trials, 


810  The  Peninsular  and  Independent. 

aflfordinj!;  ample  experience,  he  unhesitatingly  states  that  the  information 
it  furnishes  is  far  more  reliable  and  satisfaetoiy  than  that  derived  from  any 
form  of  speculum,  in  determining  as  to  llie  existence  and  nature  of  such 
diseases.  In  numerous  instances,  during  the  time  above  stated,  he  has 
tested  the  correctness  of  his  diagnosis  in  uterine  diseases  guided  by  the  taxis. 
Most  of  the  examples  presented  ulceration  of  the  os,  ))ut  in  many  cases  the 
cervix  was  also  implicated  more  or  less  exensively.  Ten  of  them  exhibited 
the  OS  patulus,  exceeding  in  size  a  Spanish  dollar,  and  deeply  ulcerated, 
the  cervix  indurated  considerably  beyond  the  interior  boundary  of  the 
corresponding  border  of  the  ulcer,  and  the  general  health  greatly  im- 
paired. 

After  carefully  examining  into  the  condition  of  the  os  and  cervix  uteri 
by  the  toucher,  he  was  enabled  to  detect  ulceration  with  great  certainty, 
as  well  as  induration,  engorgement,  and  all  of  the  deviations  of  position. 

An  ulcerated  os  uteri  piesents  to  the  experienced  touch  the  same  feel 
as  an  ulcer  on  the  exterior  of  the  body ;  and  an  accompanying  induration 
of  the  surrounding  parts  is  a  very  common  attendant  of  such  ulceration, 
as  it  is  also  of  many  external  ulcers.  Induration  of  the  cervix,  however, 
is  decidedly  more  apt  to  accompany  intra-cervical  ulceration;  and  as  it  is 
uniformly  met  with  in  such  ulceration  of  the  cervix,  clearly  ascertained  to 
exist,  as  well  as  frequently  in  ulceration  of  the  os  likewise,  it  may  safely  be 
inferred  that  it  represents  ulceiation  in  all  those  cases  in  which  the  cervix 
is  inaccessible  to  the  touch,  when  indurated,  without  ulceration  of  the  os. 

In  deciding  as  to  the  existence  of  induration  of  the  os  or  cervix  uteri, 
the  speculum  is  absolutely  useless.  Even  in  ulceration,  the  information  it 
impaits  is  unsatisfactory  and  unreliable.  In  engorgment  and  intlanima- 
tion,  it  furnishes  no  information  that  is  not  deiivable  fiotn  the  toucher, 
elucidative  of  those  conditions,  and  is  far  more  offensive  to  the  feelings  of 
a  delicate  woman  than  the  investigation  by  the  taxis. 

The  discharge  said  to  be  characteristic  of,  and  peculiar  to  ulceration 
of,  the  OS  and  cervix,  is  not  by  an}-  means  constant  in  appearance,  nor  does 
it  furnish  conclusive  evidence  in  all  cases  that  ulceration  does  exist  when 
met  vsith.  If  present,  and  just  issuing  from  the  os  uteri,  either  in  its 
semifluid  or  ropy  condition,  the  speculum,  if  then  applied,  would  only 
prove  that  the  morbid  seciction  unecjuivocally  proceeded  fiom  the  os  uteri. 
The  discharge  of  this  diseased  product  externally,  however,  affords  as  satis- 
factory evidence  of  the  existence  of  ulceration  of  the  os  uteri,  as  if  actually 
seen  escaping  from  the  uterine  cavit}',  because  its  characters  are  sufficiently 
marked  to  remove  all  doubt  of  its  identity. 

Although  furnishing  pretty  satisfactory  evidence  of  the  existence  of 
organic  diseases  of  the  uterus,  of  itself,  the  revelations  of  the  toucher 
should  invariably  be  taken  in  connection  with  the  other  symptoms  usually 
met  with  in  such  diseases,  in  forming  a  diagnosis.  The  ulcerated  os  and 
cervix,  when  accessible  to  the  touch;  the  induration;  the  peculiar  dis- 
charge; pelvic  and  dorsal  pains;  inability  to  stand  long  at  a  time;  fre- 
quently, abdominal  pains;  disordered  digestion;  nervousness;  depression 
of  spirits,  and  the  peculiar  desponding  expression  of  countenance  termed 
*'facies  uterine,"  when  taken  together,  leave  little  room  to  doubt  as  to  the 
existence  of  ulceration  of  the  os  and  cervix  uteri. 

The  speculum  will  be  demanded  in  those  cases  in  which  the  os  uteri  can 
not  be  reached  by  the  finger,  as  then  no  other  leliable  plan  could  be  adop- 
ted for  exploring  and  treating  such  examples.  Foitunatcl}^  these  latter  in- 
stances are  rarely  to  be  met  with,  as  the  writer  has  only  witnessed  two  out 
of  over  a  hundred  cases  treated  by  him  in  ten  years.  It  will  also  be  re- 
quired in  scirrhus  uteri,  when  the  indurated  cervix  is  to  be  excised;  and 
when  adhesions  between  the  os  or  cervix  and  vagina  exist.     And  it  will  be 


Selected  Articles^  Abstracts^  c&c.  311 

indispensable  in  cauterizing  the  uterus  with  the  incandescent  iron,  and  in 
leeching  or  scarifying  the  organ. 

For  the  purpose  of  cauterizing  the  os  and  cervix,  the  writer  employs 
the  nitrate  of  silver,  and  the  acid  nitrate  of  m3rciiry,  conveyed  to  the  parts, 
concealed  by  a  canula  directed  by  the  index  finger  of  the  right  hand;  and 
the  operation  should  be  repeated  once  in  three  or  four  days,  or  after  longer 
intervals,  if  the  previous  operation  is  followed  by  prolonged  bleeding,  until 
the  cure  is  perfected.  The  nitrate  of  silver  is  best  adapted  to  the  mild  or 
slight  examples  of  ulceration;  while  the  acid  nitrate  of  mercury  should  be 
used  when  the  ulcers  are  deep  and  extensive,  and  especially  if  the  cervix 
is  decidedly  implicated.  Tt  is  best,  however,  to  begin  the  treatment  with 
the  nitrate  of  silver;  and  if  amelioration  seems  tardj",  then  to  employ  the 
acid  nitrate  of  mercury  in  alternation  with  the  caustic  silver. 

The  position  most  convenient  to  the  operator  for  examination,  as  well 
as  for  the  application  of  remedies,  is  on  the  left  side,  with  the  thighs  flexed 
on  the  trunk,  and  the  legs  on  the  thighs.  The  person  should  invariably 
be  covered,  and  the  nates  placed  near  the  border  of  a  bed.  In  this  posture, 
the  parts  cnn  generally  be  reached  and  examined  with  the  index  finger  of 
the  right  hand  with  entire  convenience ;  and  is  also  the  best  for  the 
application  of  the  speculum,  as  well  as  the  cauterizing  agents  employed 
through  it. 

The  first  trials,  in  the  use  of  the  caustic,  upon  the  plan  advocated  in 
this  paper,  will,  in  all  probability,  be  attended  with  some  difficulty;  but 
gentle  efforts,  repeated  again  and  again  deliberately,  will  soon  impart  the 
requisite  dexterity  of  manipulation  to  insure  success;  and,  after  learning 
how  to  apply  the  remedy,  the  ease  with  which  it  can  be  done  will  astonish 
both  patient  and  physican. 

A  crayon  formed  of  the  nitrate  of  silver,  or  the  stick  itself,  may  be 
used,  applied  as  already  intimated;  and,  for  the  application  of  the  acid 
nitrate  of  mercury,  a  short,  full  camel's  hair  brush,  or  mop,  saturated  with 
the  undilutcu  solution,  answers  best.  The  canula  should  be  fully  ten 
inches  in  length,  of  proper  calibre  to  contain  the  crayon,  or  mop,  and  open 
at  both  ends,  so  as  to  allow  the  handle  of  the  crayon  to  project  sufficiently 
beyond  the  free,  or  outer  extremity,  so  as  to  be  held  and  wielded  by  the 
operator's  left  hand;  and  it  may  be  formed  of  silver  or  glass;  the  latter 
material  the  writer  employs,  and  decidedly  prefers. 

To  guard  against  vaginal  irritation,  from  accidental  diffusion  of  either 
of  the  caustics  over  its  surfiice,  after  being  applied  to  the  uterus,  a  weak 
solution  of  common  salt  should  invariably  be  injected  into  the  vagina  im- 
mediately after  any  cauterization  —  using  for  the  purpose  a  female  glass 
syringe  —  taking  care  at  the  same  time  that  this  saline  solution  is  effect- 
ually applied  to  the  upper  portion  of  the  passage  immediately  around  the 
cervix  uteri.  After  this,  the  vagina  may  be  abluted  daily  with  simple  water 
or  mucilaginous  infusions,  such  as  slippery-elm  or  flaxseed  teas,  applied 
tepid  or  cool,  as  may  be  preferred  by  females.  The  saline  wash  may  also 
be  used  tepid  or  cool,  according  to  the  fancy  of  different  patients. 

The  bowels  should  be  kept  in  a  soluble,  easy  condit  on,  using  for  the 
purpose,  when  necessary,  mild  aperients  especially  gentle  aloetic  prepara- 
tions. When  induration  of  the  cervix  exists,  and  if  the  habit  is  angemic, 
the  iodide  of  iron  will  be  proper.  If  anaemia,  without  induration,  is 
present,  and  more  especially  should  there  be  nervous  debility,  and  marked 
depression  of  spirits,  frequently  tending  to  deep  despondency,  the  phos- 
phate of  iron  will  be  indicated.  It  will  sometimes  be  necessary  to  resort 
to  vegetable  tonics  in  these  cases ;  and  in  many  instances  nothing  answers 
better  than  good  porter.  The  cold  infusion  of  wild  cherry  bark  (prun. 
virgin.)  will  very  often  supersede  all  other  vegetable  tonics ;  and  the  cases 


312  The  Peninsular  and  Independent. 

most  likely  to  beVjcncfitcd  by  it  are  those  attended  with  undue  nervousncFS, 
as  well  as  debility.  When  the  liver  is  torpid,  and  bowels  refuse  to  respond 
to  the  action  of  aperients,  the  nitro-muriatic  acid  mixture  will  be  found  sig- 
nally beneficial.  The  diet  should  invariabl}^  be  simple,  and  moderately 
nutritious. 

It  will  greatly  promote  recover}',  to  require  patients  to  remain  in  bed, 
or  in  a  recumbent  posture,  during  treatment;  and  for  months  after  re- 
covery, every  species  of  traveling  will  be  hurtful.  The  utmost  care  should 
be  taken  to  guard  patients  against  exposure  to  variable  temperature. 
Catarrhal  disturbances  invariably  aggravate  uteiine  diseases  of  every  kind, 
and  in  none  do  they  prove  more  hurtful  than  in  ulceration  and  induration 
of  the  OS  and  cervix. 


COMPRESSED    SPONGE. 

During  the  last  two  years  some  interesting  articles  have  appeared  in 
the  N.  Y.  Journal  of  Medicine^  descriptive  of  the  utility  of  compressed 
sponge  as  a  surgical  appliance,  in  cases  in  which  firm  and  continued 
pressure  may  be  indicated.  The  last  and  most  complete  essay  on  this 
subject  is  from  the  pen  of  Dr.  J.  P.  Batciieldok  ;  who  has  the  credit 
of  first  suggesting  its  value  for  the  compression  and  consequent  absorption 
of  morbid  products. 

Dr.  Batciieldok's  directions  for  preparing  the  compressed  sponge,  and 
applying  it  in  cases  of  mammary  abscess,  are  as  follows : 

The  softest  pieces  of  sponge  should  be  selected,  each  piece  being  large 
enough  to  cover  the  entire  breast.  The  sponge  should  be  carefully  washed, 
to  remove  any  gravel,  shells,  etc.,  it  may  contain  ;  and  when  thoroughly 
dried  it  is  compressed  for  a  long  time  under  a  heavy  weight  or  between 
the  lips  of  an  ordinary  carpenter's  vise.  The  sponge,  when  thoroughly 
pressed,  should  be  bound  as  tirmly  to  the  breast  as  the  patient  will  allow, 
by  means  of  a  bandage  passing  several  times  around  the  body  above  and 
below  the  other  breast,  a  piece  of  lint  being  placed  between  the  breast  and 
the  sponge,  to  prevent  the  latter  from  iiritating.  It  is  then  soaked  with 
cold  water,  and  the  bandage  preventing  the  sponge  from  expanding  out- 
w^ardly,  its  expansion  makes  the  desired  pressure  on  the  breast. 

The  patient  usually  complains  of  pain  for  ten  or  fifteen  minutes  after 
the  application.  The  temperature  of  the  water  dressing  is  soon  raised  to 
that  of  the  body,  and  thus  we  have  the  essential  elements  of  a  poultice, 
—  heat  and  moisture — without  the  inconvenience  of  an  ordinary  poultice. 
This  soft  yet  firm  compression  adapts  itself  evenly  and  equally  to  the 
whole  breast,  and  the  sponge  not  only  forces  out  the  matter,  but  absorbs 
it.  The  sponges  are  to  be  kept  wet  duiing  the  whole  time  of  their  appli- 
cation. The  patient  soon  becomes  accustomed  to  them,  and  the  alleviation 
of  suffering  is  so  great,  as  to  cause  her  to  request  the  continuance  of  the 
treatment.     The  sponges  should  be  renewed  daily. 

Dr.  Batcheldou  also  proposes  the  use  of  sponge  as  a  Tent ;  for  which 
purpose  he  directs  two  ways  to  prepare  it :  — 

1.  By  winding  a  piece  of  clean,  fine  sponge,  well  moistened  with 
water,  with  a  thread  or  small  cord,  and  letting  it  remain  till  thoroughly 
dry,  when  it  will  be  fit  for  use  on  the  removal  of  the   thread ;    2.   By 


Selected  Articles^  Abstracts^  <$)c.  313 

saturating  a  piece  of  sponge  with  a  solution  of  gum  arabic,  weak  or  strong 
according  to  the  particular  use  which  is  to  be  made  of  the  tent,  and  then 
winding  it  with  a  small  cord,  as  fine  pack-thread,  which  is  to  be  removed 
when  dr}'-,  and  the  tent  made  smooth  with  a  sharp  knife,  and  adapted  in 
size  and  shape  to  the  use  which  is  to  be  made  of  it.  It  should  always 
be  prepared  with  the  mucilage  when  designed  for  dilating  the  canal  of  the 
cervix  uteri ;  or  to  be  used  in  any  other  part  where  moisture  might 
occasion  premature  expansion,  ?*.  e.  before  it  can  be  properly  inserted;  also 
when  it  is  desirable  to  avoid  rapid  dilatation,  which  sometimes  causes 
considerable  pain  or  uneasiness.  When  the  tent  can  be  introduced  with 
facility,  the  mucilage  should  be  dispensed  with.  To  facilitate  the  winding, 
the  piece  of  sponge  should  be  transfixed  with  an  awl,  which  must  be 
removed  as  soon  as  the  winding  is  finished.  When  the  tent  is  to  be  used 
for  dilating  the  canal  of  the  cervix  uteri,  or  a  stricture  of  the  rectum,  or 
in  any  other  internal  part  from  which  it  is  to  be  withdrawn,  it  will  be 
expedient,  before  winding,  to  carry  a  needle  armed  with  a  strong  thread 
through  the  centre  of  the  piece,  from  base  to  apex  and  back.  These  free 
portions  of  the  thread,  twisted  together,  will  form  a  cord  sufficiently  strong 
for  retraction. 

In  the  form  of  a  tent  or  by  external  compression,  compressed  sponge 
has  been  applied  by  Dr.  B.,  with  decided  benefit,  for  dilatation  of  the 
cervix  uteri  in  cases  of  sterility,  difficult  menstruation,  and  for  the  relief 
of  other  affections  of  the  part  or  organ ;  dilatation  of  sinuses ;  fistula  in 
ano ;  dilatation  of  the  meatus  auditorius ;  ulcerations  of  nasal  cavities  and 
bones ;  dilatation  of  strictures  of  the  rectum  or  urethra ;  dilatation  of  the 
female  urethra;  hemorrhoidal  tumors;  morbid  growths  of  bone  or  soft 
parts  ;  swelled  testicle ;  caries  and  necrosis  ;  syphilitic  vegetations  ;  non- 
malignant  tumors;   enlarged  joints;    as  a  styptic  in  hemorrhage. 


NOVEL  SUBSTITUTE  FOR  A  EFMALE  CATHETER.    By  T.  W.  W.  Smart,  M.R  C.S. 

The  letters  of  Dr.  Duke  and  Mr.  Park  in  I'he  Lancet  of  12th 
and  19th  instant,  have  brought  to  my  remembrance  a  case  which  oc- 
curred in  my  practice  many  years  since,  in  which  I  made  use  of  a 
"novel  substitute."  Visiting  one  day  a  female  patient  suffering  with 
paralysis,  at  the  distance  of  six  or  seven  miles  from  my  residence,  I 
found  her  laboring  under  the  retention  of  urine.  Unfortunately,  I  had 
no  female  catheter  in  my  pocket,  and  so,  under  the  stimulus  of  ne- 
cessity, I  adopted  the  following  expedient: — Whilst  reflecting  on  what 
was  to  be  done,  I  perceived  in  on  e  corner  of  the  bed  -  chamber  a 
bundle  of  gleaned  corn,  and  the  thought  suggested  itself,  can  not  I 
extemporize  a  catheter  in  one  of  those  stalks  of  wheaten  straw?  So, 
selecting  a  well -adapted  specimen,  I  reduced  it  to  a  proper  length, 
and  having  shielded  the  sharp  edge  with  a  coaling  of  sealing  wax,  in- 
troduced it  without  any  difficulty,  and,  to  my  great  satisfaction,  relieved 
the  bladder. 


314  The  Peninsular  and  Independent. 

The  moral  I  would  draw  from  these  substitutions  would  be  in  the 
shape  of  a  bit  of  advice  to  my  younger  professional  brethren :  never 
in  country  practice  go  without  your  case  of  pocket  instruments,  for  the 
want  of  them  may  sometimes  put  you  to  great  inconvenience. 

[London  Lancet. 


ANTIDOTE  FOR  PnOSPIIORIE3. 

Poisoning  by  Phos{)horus  is  becoming  common  from  the  facility  of 
procuiing  lucifer  matches.  It  is,  therefore,  important  that  the  antidote 
which  has  of  late  been  found  the  most  eflicacious,  should  be  extensively 
known. 

Messrs.  Antoniella  and  Boksavelli  have  shown  by  numerous  expe- 
riments on  animals  —  1st.  That  fatty  matters  should  not  be  employed 
in  poisoning  with  phospliorus,  as  these  matters,  far  from  preventing  its 
action  on  the  viscera,  on  the  contrary  increase  its  energy  and  facilitate 
its  diffusion  through  the  economy :  2d.  That  calcined  magnesia,  sas- 
pendcd  in  boiled  water,  and  administered  largely,  is  the  best  antidote; 
and  at  the  same  time  the  most  appropriate  purgative  to  facilitate  the 
elimination  of  the  toxic  agent:  3d.  That  acetate  of  potash  is  extremely 
useful  when  there  is  dysuria  in  poisoning  with  phosphorus:  4th.  That 
the  mucilaginous  drinks  which  are  given  to  the  patient  should  always 
be  prepared  with  boiled  water,  so  that  these  beverages  may  contain  as 
little  air  as  possible.  [Med.  Xevcs. 


RESPIRATORY    ^roVEMENTS    OF    THE    INFANT     IN    THE    UTERUS,     PER- 
CEPTIIU.E  BV  AUtfCULTATIOX.    By  Dr.  B.  Souoltzk,  of  Berlin.    Tranalatod 

from  the  Gazette  Midicvue. 

The  attempts  at  respiration  of  the  infant  in  the  uterus,  when  the 
placenta  is  detached,  are  well  known,  but  these  movements  have  not  yet 
been  proven  by  the  stethoscope.  The  author  having  been  called  to  a 
woman  in  labor  for  the  fourth  time,  found  the  cord  prolapsed.  During  his 
attempts  to  reduce  and  pass  the  cord  above  the  head  of  the  fcjetus,  he  felt 
movements  of  the  child,  throwing  its  head  backwards,  and  opening  its 
mouth  at  regular  intervals.  Mr.  Schultze  retained  the  hand  in  the  uterus, 
placed  his  car  over  this  region  and  heard  between  the  sounds  of  the  heart 
a  gurgling  noise,  similar  to  that  which  is  sometimes  heard  in  the  intestines, 
but  coinciding  with  the  movements  of  the  mouth.  The  infant  was  born 
asphyxiated,  and  epidermic  cells,  fine  hair,  and  meconium,  coming  from 
the  amniotic  fluid,  were  found  in  the  air  passages,  evidently  inhaled  by 
he  efiforts  at  respiration.  [Savannah  Journal  of  Medicine. 


Ilrarmartutiral  g^prtmnU* 


••  • 


The  Ginseng:  Excitement. 

The  newspapers  having  teemed  of  late  with  paragraphs  concerning 
an  unusual  excitement  among  the  citizens  of  Minnesota,  who  were  turn- 
ing out  "«/i  viasse,^^  to  dig  the  roots,  it  occurred  to  us  that,  having  sub- 
scribers in  the  Ginseng  district,  we  might  obtain  reliable  information 
from  them ;  and  the  result  of  addressing  one  of  them  is  embodied  in 
the  following  letter : 

Faribault,  Rice  Co.,  Minnesota,  July  1st,  1859. 
Mr.  Frederick  Stearns: 

Dear  Sir, — Yours  of  the  IGth  of  June  was  duly  received.  In  that 
letter  you  request  me  to  give  you  some  statistics,  commercial  and  other- 
wise, of  Ginseng;   and,  in  answer,  would  submit  to  you  the  following: 

It  is  found  only  in  timbered  land,  selecting  such  soil  as  produce  the 
Sugar  Maple,  Basswood,  Butternut,  and  Black  Walnut,  and  where  the  sur- 
face of  the  land  is  rolHng  or  undulating.  Such  lands  in  our  State  are 
not  generally  very  heavily  timbered. 

That  portion  of  our  State  where  it  is  most  to  be  found  is  in  what  are 
termed  the  Big  Woods,  lying  between  the  town  of  Faribault  on  the  east, 
and  the  South  Bend  of  the  St.  Peter's  River  on  the  west,  and  from  that 
line  extending  down  the  river  in  the  direction  of  St.  Paul's.  The  distance 
across  this  timber  from  Faribault  to  Mankato  is  about  forty  miles ;  but 
as  you  pass  down  the  river  it  grows  narrower,  and  disappears  altogether 
near  the  town  of  Shacopee,  some  thirty  miles  above  St.  Paul's.  It  is  not 
all  over  this  piece  of  timber  that  the  Ginseng  grows,  but  only  on  such 
portions  as  are  above  indicated,  and  these  will  not  comprise  but  about 
one  -  fourth  part  where  it  will  grow  in  sufficient  quantity  to  make  it  profit- 
able to  gather  it. 

The  points  at  which  it  has  been  carried  on  chiefly,  are  Faribault, 
Mankato,  and  St.  Peter's.  Small  places  in  the  timber,  and  on  the  St.  Pe- 
ter's River,  have  done  something,  but  these  principally. 

The  root  is  dug,  and  carried  as  dug,  to  a  particular  point,  chosen  for 
its  convenience,  where  it  is  properly  washed  and  dried.  Some  have 
steamed  the  root,  and  then  put  it  on  trays  in  a  tight  room,  where  the 
thermometer  ranges  from  one  hundred  to  one  hundred  and  twenty ;  while 


316  The  Peninsular  and  Independent. 

others  lay  them  on  a  scaffold  for  several  days,  in  the  sun,  and  then  finish 
them  in  the  dry -house. 

The  first  look  the  handsomest,  and  I  think  command  the  highest 
price  in  the  market,  while,  to  my  mind,  the  latter  method  leaves  the  root 
in  its  most  natural  state.  The  green  root  has  commanded  prices  varying 
from  si.x  to  ten  cents,  and  in  a  few  instances  even  more  —  the  average 
being  about  eight  cents.  It  has  taken  from  four  to  four  and  a  half  pounds 
of  the  green  root  to  make  one  of  the  dry,  but  I  am  told  that  in  the 
fall  of  the  year  it  takes  only  about  three. 

The  amount  of  the  dried  root  that  has  been  shipped  from  this  place, 
as  near  as  I  can  learn  has  been  between  twenty -one  and  twenty -two 
thousand  pounds,  and  that  sent  from  the  different  points  along  the  St 
Peter's  to  St  Paul,  to  be  shipped  has  not  exceeded  eighteen  thousand. 
The  time  spoken  of  the  shipment  from  St  Paul  was  about  the  20th  of 
last  month. 

I  am  informed  that  it  has  been  found  in  the  vicinity  of  Crow  River, 
some  distance  above  St  Paul,  but  have  not  learned  to  what  extent.  Up 
to  the  time  spoken  of  there  had  been  no  shipment  made  of  (Jinseng  from 
that  locality,  and  the  presumption  is  that  the  amount  will  be  small. 

The  e.xpectations  of  large  shipments  being  made  to  the  cities  on  the 
seaboard  has  had  the  tendency  to  depress  the  market  price  there,  and  that 
in  turn  has  had  the  effect  to  entirely  stop  the  trade  throughout  the  State. 
Every  town,  large  or  small,  in  the  vicinity  of  those  locations  where  it 
grew,  were  more  or  less  engaged  in  it ;  but  since  the  news  of  the  price 
having  declined  reached  us,  every  operator  has  declined  buying,  and  no 
more  roots  are  brought  into  the  market. 

The  larger  share  of  the  roots  prepared  for  market  have  been  shipped ; 
and  should  the  price  continue  as  it  is,  very  little  more  will  be  collected 
and  dried  for  shipment. 

This  is  as  fair  a  statement  as  I  can  give ;   and  you  can  make  such  use 

of  it  as  you  may  think  best 

Most  Respectfully  Tours, 

AV.  II.  Stevens,  M.  D. 

Ginseng  is  very  abundant  throughout  this  State,  and  there  is  no  rea- 
son why  it  should  not  be  profitably  collected  at  present  ruling  rates.  It 
is  unfortunate  for  the  Minncsotians  that  they  chose  the  wrong  season 
to  collect  it,  as  it  should  not  be  dug  until  after  the  blossoming  and 
ripening  of  the  seed  of  the  plant  —  say  from  August  to  October. 

The  most  sensible  method  of  curing  it  would  be  in  the  open  air, 
but  under  shade.  F.  S. 


CHICKWEED. 

Mr.  Heixtzelman  made  the  investigation  of  the  medical  property  of 
the  Anagallis  arveiisis,  or  Chickweed,  the  subject  of  a  thesis  read  before 
the  College  of  Pharmacy,  Philadelphia. 


Pharmaceutical  Department.  317 

Besides  gum,  albumen,  resin,  etc.,  he  found  a  minute  portion  of 
volatile  oil,  of  strong  odor,  pungent  acrid  taste,  sp.  gr.  0987,  soluble  in 
alcohol,  less  in  ether,  inflammable,  burning  with  a  bright  flame  diffusing 
its  peculiar  odor,  poisonous  (four  drops  causing  intense  headache  and 
nausea,  which  lasted  twenty -four  hours,  accompanied  during  the  whole 
time,  by  pains  throughout  the  nervous  system). 

This  plant  has  formerly  been  held  in  high  estimation  as  a  remedy 
for  hydrophobia,  but  has,  like  a  thousand  others,  fallen  into  disuse. 

Chickweed  produces,  in  small  doses  (say  one  to  two  drachms  in  form 
of  powder),  profuse  perspiration,  soothes  pain,  &c.,  ;  but  in  larger  doses 
it  produces  all  the  effects  of  a  narcotic  poison  upon  the  frame  and  ner- 
vous system.  \Am.  Jour.  Pharmacy. 

ON  THE  ADMINISTRATION  OF  MEDICINE  TO  CHILDREN. 

M.  Wahu  having  nuich  to  do  with  the  diseases  of  children,  wishes  to 
impress  upon  practitioners  the  importance,  in  the  case  of  important  medi- 
cinal substances,  of  having  them  administered,  whenever  practicable,  in 
their  own  presence.  He  also  states  some  of  the  means  he  adopts  to  enable 
certain  medicines  to  be  more  easily  got  down.  Thus  the  subnitrate  of  his- 
mutfi,  in  large  doses,  which  is  of  such  value  in  diarrhoea  and  the  gastro- 
intestinal affections  of  children,  often  subsides  to  the  bottom  of  the  spoon 
when  given  in  brotli  or  milk  ;  and  it  is  much  more  readily  taken  also  by 
children  of  about  two  years  old  when  given  in  chocolate  prepared  with 
water,  and  thickened  with  tapioca  or  crumbs  of  bread.  In  this  way  seventy 
grains  and  more  may  be  given  night  and  morning.  In  the  same  way  iron 
can  be  very  readily  given.  Ratany  and  catechu^  two  precious  drugs,  the 
action  of  which,  when  in  small  doses,  is  soon  manifested  in  children,  can 
also  very  readily  be  given  in  this  chocolate  panada.  Chocolate  made  with 
either  milk  or  water,  and  flavored  with  canella  or  vanilla,  is  usually  very 
readily  taken  by  children,  and  its  dark  color  ficilitates  the  mixing  of  numerous 
colored  medicinal  substances,  which  would  be  observed  by  the  little  patients 
were  they  given  in  milk,  broth,  or  any  infusion.  Ratany  and  catechu  may  also 
be  well  triturated  and  mixed  with  quince  jelly,  the  flavor  of  which,  while 
masking  that  of  other  substances,  is  very  agreeable  to  children.  Sulphate 
of  soda  and  sulphate  of  magnesia  are  substances  very  diflBcult  to  get  even 
adults  to  take.  The  sulphate  of  soda  may  often  be  administered  to  chil- 
dren, by  dissolving  10  parts  in  150  of  unsalted  beef- tea,  and  waiting  until 
the  child  is  sufficiently  thirsty  to  swallow  a  cup  of  liquid  almost  without 
tasting  it.  For  adults,  the  best  means  is  to  dissolve  the  sulphate  of  soda  or 
magnesia  in  exactly  the  quantity  of  hot  water  necessary  for  its  complete 
solution.  This  is  allowed  to  get  cold,  and  a  glass  of  pretty  strong  lemonade 
is  prepared.  Holding  a  glass  in  each  hand,  that  containing  the  salt  is 
rapidly  drunk,  and  then  the  lemonade  is  slowly  drunk — masking  the  de- 
testable taste  of  the  purgative,  and  supplying  enough  fluid  to  prevent  its 


318  Tlie  Peninsular  and  Independent. 

proving  too  initating.  Corsican  mosa  is  another  substance  which  children 
take  with  difficulty  ;  but  if  an  infusion  be  made  and  strained,  and  then 
added  to  unsalted  beef- tea,  it  will  be  readily  swallowed.  Calomel  is  one 
of  the  most  difficult  medicines  to  give,  when  children  are  too  young  to 
swallow  pills,  which  is  the  case  under  six  years  of  age.  Incorporating  it 
in  honey  is  the  best  means — rinsing  the  mouth  afterwards,  to  prevent  any 
adhering  to  the  gums.  It  should  never  be  given  in  currant,  or  any  other 
jelly  :  a  death  having  occurred  a  few  years  since  from  the  conversion  of  the 
calomel  given  in  currant  jelly  into  a  bichloride.  It  is  safest  to  prohibit  any 
acid  drink  being  taken  on  the  day  that  calomel  is  given.  Ipecac  may  be 
given  cither  in  the  chocolate  panada  or  in  honey.  When  it  is  impossible 
to  give  any  medicinal  substance  by  the  mouth,  it  may  be  administered  by 
the  rectum,  taking  care  first  to  empty  the  gut  by  tepid  water  or  an  emol- 
lient decoction,  and  that  the  bulk  of  the  medicated  enema  do  not  exceed 
from  four  to  six  ounces,  so  that  it  may  be  retained  and  and  absorbed. 

[DruggisW  Circular. 

^SCULIX  IX  INTERMITTENT  FEVER. 

MoiciiON  publishes  the  results  which  a  Dr.  Monvenoux  has  obtained 
by  the  administration  of  yEsculin  (bitter  extract  of  the  vEsculus  H. 
horse  chestnut)  in  intermittent  fever. 

The  medicine  was  prescribed  for  thirty -two  patients,  of  which 
twenty -eight  were  laboring  under  the  fever  and  four  under  intermittent 
neuralgia;  of  the  former  twenty -two  were  cured  —  the  remaining  six 
rcquiiing  the  sulphate  of  quinia;    of  the  latter,  two  were  cured. 

The  aesculin  was  given  in  doses  of  one  or  two  grains  during  the 
apyrexia.  [  Virg.  Med.  Jour. 


CHROMATE  OF  TOTASn  IN   TVARTS. 

M.  Blascuko  recommends    the   following   formula  as  one  of  certain 
operation,  even  in  old  standing  and  inveterate  warts: 

Chromate,  gr.  l^o,  l^^d  3  j.     M.     To  be  rubbed  in  night  and  morning. 
[Z'  Union  Med.  1859,  and  Med.  News  &  Lib. 

POWDERED  BLUE  MASS. 

Mr.  RiTTENHOusE  offcrs   in  The  Druggist    the  following  formula  for 

powdered  blue  mass,  which  he  had  found  after  repeated  trials,  to  furnish 

a  satisfactory  product: 

Take    of    Mercury 1  oz.  Troy. 

Pulv.  Licorice  Root  3^  oz.    " 

Pulv.  Rose  Leaves  .         .         .         .         .  3  i- 

White  Sugar  1  oz.  3  3  . 

Water  f3ij. 


Pharmaceutical  Department.  319 

Mix  half  an  ounce  of  sugar  and  two  drachms  licorice  root  in  a  mortar, 
add  the  mercury,  then  the  water  gradually ;  triturate  the  materials  rap- 
idly, until  the  mercury  is  extinguished  (which  can  be  readily  done  in  five 
minutes),  then  add  the  remainder  of  the  ingredients,  and  mix  thoroughly; 
spread  the  damp  powder  upon  paper  for  a  few  hours  to  dry.  Powder  and 
sift  it.  This  formula  has  the  advantage  of  producing  a  preparation  iden- 
tical  with  the  Pil.  Ilydrarg.  of  the  U.  S.  P.,  in  composition  and  strength, 
and  is  easily  prepared. 


•  ♦  • 


AMERICAN   PnARMACElTICAl  ASSOCIATION. 

The  Seventh  Annual  Meeting  of  the  "  American  Pharmaceutical  Asso- 
ciation," will  he  held  in  the  city  of  Boston,  Mass.,  on  Tuesday,  the  13th 
day  of  September  next,  at  3  o'clock  p.  m. 

The  objects  of  the  Association  and  the  conditions  of  membership  are 
explained  in  the  following  extracts  from  the  Constitution. 

iNKTICLE  I, 

This  Association  shall  be  called  the  American  Pharmaceutical  Associa- 
tion. Its  aim  shall  be  to  unite  the  educated  and  reputable  Pharmaceutists 
and  Druggists  of  the  United  States  in  the  following  objects: 

1st,  To  improve  and  regulate  the  drug  market,  by  preventing  the  im- 
portation of  inferior,  adulterated,  or  deteriorated  drugs,  and  by  detecting 
and  exposing  honje  adulteration. 

2d.  To  establish  the  relations  between  druggists,  pharmaceutists,  phy- 
sicians, and  the  people  at  large,  upon  just  principles,  which  shall  promote 
the  public  welfare  and  tend  to  mutual  strength  and  advantage. 

3d.  To  improve  the  science  and  the  art  of  Pharmacy  by  diffusing 
scientific  knowledge  among  apothecaries  and  druggists,  fostering  pharma- 
ceutical literature,  developing  talent,  stimulating  discovery  and  invention, 
and  encouraging  home  production  and  manufacture  in  the  several  depart- 
ments of  the  drug  business. 

4th.  To  regulate  the  s)\stem  of  apprenticeship  and  employment  so  as 
to  prevent,  as  far  as  practicable,  the  evils  flowing  from  deficient  training  in 
the  responsible  duties  of  preparing,  dispensing,  and  selling  medicines. 

oth.  To  suppress  empyricism,  and,  as  much  as  practicable,  to  restrict 
the  dispensing  and  sale  of  medicine  so  regularly  educated  druggists  and 
apothecaries. 

i;;^  ARTICLE   II.— Of  the  Members. 

Section  1.  Every  pharmaceutist  or  druggist  of  good  moral  and  profes- 
sional standing,  whether  in  business  on  his  own  account,  retired  from  busi- 
ness, or  employed  by  another,  who,  after  duly  considering  the  objects  of  the 
Association  and  the  obligations  of  this  Constitution,  is  willing  to  subscribe 
to  them,  is  eligible  to  membership. 

Section  2.  The  mode  of  admission  to  membership  shall  be  as  follows  : 
Any  person  eligible  to  membership  may  apply  to  any  member  of  the  Exe- 
cutive Committee,  who  shall  report  his  application  to  the  said  Committee. 
If  after  investigating  his  claims  they  shall  approve  his  election,  they  shall 
at  the  earliest  time  practicable  report  his  name  to  the  Association,  and  he 
may  be  elected  by  two  -  thirds  of  the  members  present,  on  ballot.     Should 


The  Peninsular  and  IndependeJit. 

an  application  occur  in  the  recess,  the  members  of  the  Committee  may  give 
their  appioval  in  writinjr,  which,  if  unanimous,  and  endorsed  by  the  Presi- 
dent, sliail  constitute  him  a  member,  and  the  fact  be  reported  to  the  Asso- 
ciation at  the  next  succeedin";  meetin":. 

Section  3.  No  person  sliall  become  a  member  of  this  Association  until 
he  shall  have  signed  the  Constitution,  and  paid  his  annual  contribution  for 
the  current  year.  All  persons  whe  become  members  shall  be  considered  as 
permanent  members,  but  may  be  expelled  for  improper  conduct  by  a  vote 
of  two-tnirds  of  the  members  present  at  any  annual  meeting. 

Section  4.  f^very  member  shall  pay  into  the  hands  of  the  Treasurer 
the  sum  of  two  dollars  as  his  yearly  contribution,  and  is  liable  to  lo.se  his 
right  of  membership  by  neglecting  to  pay  said  contribution  for  three  suc- 
cessive years.  Members  shall  be  entitled,  on  the  payment  of  three  dollars, 
to  receive  a  certificate  of  mcmbeiship  signed  by  the  President,  ^'ice  -  Presi- 
dent and  Secretary,  covenanting  to  return  the  same  to  the  proper  officer  on 
relinquishing  their  connection  with  the  Association, 

Section  5.  Every  local  Pharmaceutical  Association,  shall  be  entitled  to 
five  delegates  in  the  annual  meetings;  who,  if  present,  become  members  of 
the  Association,  on  signing  the  Constitution,  without  being  balloted  for. 

JouN  L.  KiDWELL,  Pres." 
Oeorgetown,  D.  C,  June  25th,  18j9. 


-•♦-•- 


KEWS    ITEMS. 

The  power  of  straw  as  a  conductor  of  electricity  has  been  utilized  in 
the  south  of  France,  no  less  than  eighteen  communes  in  the  neighborhood 
of  Tarbes  having  been  provided  with  conducforL"  composed  of  straw.  Ex- 
periments show  that  an  electrical  shock  su^iiciently  powerful  to  kill  an  ox 
may  be  discharged  by  a  single  straw. 

Mr.  Jacob  Ecll,  of  London,  Eng.,  the  President  of  the  Pharmaceutical 
Society,  died  on  the  11th  ult.  lie  bcfjueathed  the  best  of  his  pictures  to 
the  English  nation.  Among  them  are  several  by  Sir  Edward  Landseer,  and 
a  small  "Horse  Fair"  by  Kosa  Bonheur. 

The  City  Press*^  a  London  paper,  states  that  there  are  in  that  city  12 
hospitals  for  general  purposes  ;  40  for  special  purposes ;  34  dispensaries, 
giving  relief  to  365,950  persons  every  year.     Income  £300,000. 


We  are  indebted  to  the  courtesy  of  the  officers 
of  the  State  Medical  Society  of  Iowa,  for  a  copy  of  the 
Proceedings   of  last   meeting,   June   15th,    1859. 

TO    DUXJGGISTS. 

THE  HALF -INTEREST  of  an  OLD  ESTABLISHED  DRUG  STORE,  doing 
an  excellent  business.     Any  one  "vvbo  can  come  well  recommended,  and  hav- 
ing $2,000  CASH,  ^Yill  meet  ^vith  an  opportunitj'  rarely  to  be  met  with.     Apply  to 

F.  HALE,  4G  BeeJcman  St.,  Kew  York. 


THE 


PENINSULAPi  ASD  INDEPENDENT 


MEDICAL  JOUEML. 


Vol.  II.  DETROIT,  SEPTEMBER,  1859.  No.  6. 


©rigiiuil  C0mmunir(tti0it5  n^  %xn5hthn. 


ART.  XXIII.-Ethcr  and  Chloroform. 


By  H.  0.  Hitchcock,  M.  D. 


Is  the  similarity  in  the  effects  of  chloroform,  sulphuric 
ether,  and  other  aneesthetics  of  this  class,  to  the  effects  of 
carbonic  acid  gas,  upon  the  animal  economy,  evidence  that 
carbonic  acid  gas  is  the  efficient  anaesthetic  agent  in  them 
all.? 

That  carbonic  acid  has  ansesthetic  properties  is  unques- 
tionable. The  numerous  experiments  recently  made  with 
it  as  a  local  anaesthetic,  and  (he  assumed  similarity  of 
phenomena  in  cases  of  death  from  this  agent  to  those  in 
persons  dead  from  chloroform  or  ether,  have  led  some  to 
believe  and  teach  that  carbonic  acid  is  the  only  really  effi- 
cient anaesthetic  agent  in  them  all.  I  have,  therefore, 
been  at  some  trouble  to  give  an  analysis  of  the  symp- 
toms and  post-mortem  appearances  of  thirty -three  persons 
who  have  died  from  the  effects  of  chloroform,  or  chloric 
ether,  and   seven   persons  dead  from  carbonic  acid  gas. 

Vol.  II.- V. 


322  TJie  Peninsular  and  Independent. 

I  am  aware  that  the  cases  (especially  of  the  latter 
class)  are  too  few  to  warrant  any  positive  deductions, 
and  deaths  from  other  anassthetics  than  chloroform  have 
been  but  few,  and  the  record  of  none  of  them  has  fallen 
in  my  way.  I  have  found,  as  will  be  noticed,  a  great 
scarcity  of  cases  in  which  the  effects  of  carbonic  acid  have 
been  well  recorded  in  the  symptoms  and  post-mortem 
appearances.  We  may,  however^  approximate  to  the  truth; 
and,  if  nothing  more,  this  paper  may  set  us  more  vigi- 
lantly on  the  inquiry  after  it. 

The  symptoms  of  the  thirty- three  persons  dead  from 
chloroform  are  given  with  unfortunate  brevity  in  the  ar- 
ticle from  which  I  have  made  this  analysis ;  and  our 
reasoning  in  this  part  can  not  be  as  satisfactory  as  it 
otherwise  would  be.'-' 

Symptoms. 
Of  these  thirty -three  cases  there  was  noticed 
The  face  pale  in 

The  face  afterwards  becoming  red,  or  livid,   in 
Musculir  rigidity,  and  convulsive  movements  in 
Muscular  relaxation  in 
Respiration  ceased  gradually  in 
Respiration  embarrassed  or  irregular  in 
Respiration  continued  after  pulse  had  ceased  in 
Respiration  not  specified  in 

Froth  or  foam  at  mouth  (not  specified  in  others)  in 
Heart's  action  ceased  suddenly  in 
Ileart's  action  not  mentioned  in 

The  Length  of  Time.,  after  the   Commencement  of  the  Inhala- 
tion., at  tchich   the   thirty -three   Cases  died, 

5  persons  are  said  to  have  died  instantly. 

4  persons  within  2  minutes. 

4  persons  within  5  minutes. 

4  persons  within  10  minutes. 

2  persons  within  30  minutes. 

4  persons  "very  suddenly,"  or  "very  soon." 


9 

cases. 

4 

4 

4 

11 

4 

7 

16 

3 

IT 

14 

*  New  Yorlc  Journal  of  Medicine^  May,  1853. 


Hitchcock  on  Ether  and  Chloroform.  323 

1  person  "in  a  few  minutes." 
1  person  uncertain. 
6  persons  not  stated. 
1   person  "in  about  3  hours." 
1  person  "in  a  few  months," 
[Probably  "months"  should  here  read  "minutes."] 

So  that  of  the  twenty -six  persons,  the  time  of  whose 
death  is  stated,  all  but  two  died  within  less  than  half 
aa  hoar,  and  one -half  of  them  within  five  minutes. 

Quantity  of  Chloroform  used  in  each  of  these  thirty -three  Fatal 

Cases. 

In  11  cases,  one  drachm  or  less  was  used. 

In  5  cases,   two  drachms  or  less. 

In  1  case,  three  drachms  or  less. 

In  2  cases,  3  ss.  was  used. 

In  4  cases,   |  1  and  more. 

In  10  cases,  quantity  not  stated. 

In  1  case,  several  doses. 

Now,  as  in  nearly  all  these  instances  the  anaesthetic 
was  administered  by  a  sponge,  or  cloth  of  loose  fabric, 
it  is  not  probable  that  the  first  eleven  cases  could  really 
have  inhaled  more  than  one -half  a  drachm  —  probably 
much  less,  on  account  of  evaporation,  and  the  saturation 
of  the  sponge  or  cloth.  Certain  it  is,  that  several  of 
them  did  inhale  but  a  few  drops  of  the  agent.  And  it 
is  also  true  that  those  who  took  the  smallest  quantities 
died  quite  as  quickly,  and  with  just  as  characteristic 
symptoms,  as  those  who  took  the  largest. 

Post-mortem  inspection  was  had  in  only  nineteen 
cases  out  of  the  thirty  -  three,  and  the  appearances  are 
not  given  with  so  much  definiteness,  nor  to  such  extent, 
as  could  be  desired;  but  I  have  analyzed  them  as  well 
as  I  was  able. 

It  is  reported  that 

The  Brain^   in  5  cases,  was  healthy, 
in  1  case,  firm, 
in  1  case,  soft  and  slightly  oedematous. 


324  TJie  Peninsular  and  Independent. 

The  Membranes^   in  3  cases,  were  congested. 

Ihe  Sinuses^   in  1  case,  held  much  uncoagulated  blood, 
in  1  case,  held  less  blood  than  usual. 
And   in  7  cases,  nothing  said  of  brain  or  its  raombranes, 
2he  Lungs^    in  10  cases,  were  congested. 

in  3  cases,  were  emphysematous, 
in  2  cases,  were  tuberculous, 
in  1  case,  were  "  very  black." 
in  2  cases,  were  healthy, 
in  1  case,  were  collapsed. 

In  no  case  were  the  lungs  spoken  of  as  remarhdbhj 
congested;  and  in  almost  one -half  the  cases  we  are  led 
to  infer  that  no  congestion  at  all  existed. 

The  Hearty  in  12  cases,  was  "flaccid"  or  "flabby." 
in     1  case,  was  healthy, 
in     1  case,  was  moderately  firm, 
in     7  cases,  was  empty. 
>^  in     G  cases,  there  was  blood  in  the  right  cavities — most  in 

ventricles. 
in     1  case,  the  auricles   were   empty,    and   about  1  oz.  of 

blood  in  each  ventricle, 
in     4  cases,  the  condition  of  the  heart  is  not  mentioned. 
The  Bloody  in  15  cases,  was  fluid. 
in     5  cases,  was  dark. 

in     1  case,  fibrinous  clots  found  in  the  heart, 
in     1  case,  was  thick. 

in     2  cases,  the  condition  of  the  blood  is  not  mentioned. 
The  Liver,    in     1  case,  was  congested — not  mentioned  in  all  the  othere. 
2he  Kidneys,    in     4  cases,  were  congested. 
•    in     1  case,  was  diseased. 

in  14  cases,  were  not  mentioned. 
The  Spleen,  in     1  case,  was  congested. 
The  Veins^  in    3  cases,  contained   air. 

General  JSummarT/  of  the  Symptoms  produced  hy  Fatal  Inha- 

latio7i  of  Chloroform. 

Excitement — cessation  of  motion — pupils  dilated — sphinctus  relaxed — 
face  pale — lips  congested — breathing  becomes  slow,  and  often  stertorous — 
surface  cold — pulse  gradually  sinks,  but  in  some  cases  with  such  rapidity 
as  to  induce  syncope.  Violent  convulsions  have,  in  some  cases,  super- 
vened. 


Hitchcock  on  Ether  and  Chloroform.  325 

As  persons  who  die  from  the  effects  of  carbonic  acid  gas, 
or  coal  gas,  are  not  often  seen  until  dead,  or  nearly  so,  I  can 
only  give  a  summary  of  the  symptoms  as  given  in  Yolume 
XV.  of  the  British  Foreign  Medical  Revieiv  : 

Vertigo — cephalogia— nausea,  with  vomiting— disturbed  intellect— loss 
of  consciousness— general  weakness  and  depression — partial  paralysis — • 
convulsions — and  the  usual  phenomena  of  asphyxia. 

The  time  at  which  the  seven  cases  of  which  I  now  present 
the  report,  died,  I  have  not  marked  definitely  ;  but  it  was 
several  hours  in  all  of  them. 

Of  the  quantity  of  carbonic  acid  breathed  in  each  case 
we  can  not  speak  with  any  certainty  ;  as  we  have  no  data 
from  which  to  calculate  it. 

Post-mortem  Appearances. 

In  5  cases,  the  brain  and  spinal  cord   congested — the  vessels  of  the  pia 

mater  specially  gorged.  J 

Jn  3  cases,  consideiable  effusion  of  coagulated  blood  between  the  dura 

mater  and  the  bony  canal. 
In  3  cases,  the  air  passages,  from  base  of  tongue  to  capillary  bronchial 

tubes,  were  strongly  injected. 
In  2  cases,  mucous  membrane  of  air  passages  injected  and   echymosed. 
In  5  cases,  this  mucous  membrane  covered  with  thick  viscid  froth,  with 

streaks  of  blood. 
In  5  cases,  the  parenchyma  of  lungs  was,  throughout  its  whole  extent, 

of  a  bright  red   color,   contrasting  strongly  with   the  dark  color  of 

the  surface  of  the  organs. 
In  5  cases,  blood  was   coagulated  in  the  heart,  particularly  in  the  right 

side. 
In  4  cases,  liver  gorged  with  blood,  of  a  deep  red. 
In  2  cases,  the  blood  is  said  to  have  been  fluid. 
In  2  cases,  the  blood  was  florid. 
In  2  cases,  the  muscles  were  florid. 

In  2  cases,  intestinal  mucous  membrane  was  injected,  and  in  many  spots 
echymosed. 

Of  the  proportions  of  carbonic  acid  to  the  atmospheric 
air  that  can  be  breathed,  there  are  conflicting  statements  and 
opinions. 

It  is  said  that  the  gas,  mixed  with  twice  its  bulk  of  air, 


326  The  Peninsular  and  Independent, 

can  be  respired,  ^'' for  a  while"  without  fatal ^  effects.  On 
the  other  hand,  ten  per  cent,  of  carbonic  acid  is  said  to 
produce  death  blowly  in  animals  respiring  an  atmosphere  bo 
vitiated.  On  the  best  estimate  that  I  have  been  able  to  make 
from  published  experiments,  30  cubic  inches  is  about  the 
average  amount  of  air  inhaled  at  each  regular  inspiration. 
After  an  individual  has  come  somewhat  under  the  influence 
of  chloroform  it  is  probable  that  60  or  even  70  cubic  inches 
would  not  be  an  over-estimate.  One  drachm  of  chloroform 
contains  carhon  sufficient  to  give,  when  all  used,  G5G28  cubic 
inches  of  carbonic  acid.  One -half  drachm,  then,  is  capable 
of  giving  33  cubic  inches  in  round  numbers. 

Now,  it  is  not  at  [all  probable  that  the  half- drachm 
would  be  inspired  as  vapor  in  less  than  ten  inspirations, 
which  would  give  us  3  cubic  inches  to  each  inhalation  ;  or 
10  per  cent,  of  the  atmosjDhere  taken  in  in  an  ordinary 
inspiration,  and  only  5,  or  even  4,  per  cent.,  when  the 
inspirations  become  longer  and  fuller. 

Hence,  I  think  we  may  safely  reason  that  carbonic  acid 
gas  is  not  the  cause  of  the  fatal  effects  in  the  use  of 
chloroform,  and  in  so  far  we  may  answer  the  question 
proposed,  that  it  is  not  the  evident  anaesthetic  agent  in 
chloroform. 

If  the  cases  be  considered  in  which  only  a  few  drops 
of  chloroform  can  be  supposed  to  have  been  inhaled,  the 
truth  becomes  still  more  certain.  Moreover,  when  we  con- 
sider the  certainty  that  all  of  the  inspired  vapor  is  not  ab- 
sorbed, and  the  great  improbability  that  all  that  is  absorbed 
becomes  decomposed  and  gives  instantly  its  full  comj)lement 
of  carbonic  acid,  it  seems  almost  to  have  been  demonstrated 
that  our  conclusion  is  correct. 

Although  there  is  some  similarity  in  symptoms,  5^et  it 
appears  to  me  there  is  difference  sufficient  to  show  that  the 
two  agents  are  only  similar ,  but  not  identical.  > 

But  even  if  the  symptoms  in  the  two  cases  were  m  or 


Hitchcock  on  Ether  and  Chloroform,  327 

exactly  atllke,  tlie  suddenness  with  which  the  patients  died 
from  chloroform  would  be  proof  positive  that  the  two  agents 
are  indeed  different. 

Our  conclusions  thus  far  are  eminently  supported,  it 
seems  to  me,  by  the  post-mortem  appearances.  Death 
from  chloroform,  according  to  my  judgment,  begins  at  the 
heart,  while  carbonic  acid  affects  much  more  the  lungs, 
and  is  a  more  slowly -acting  poison  to  the  nervous  system. 

It  appears  to  me,  then,  that  we  are  warranted  in  giving 
a  decided  answer  to  the  question  with  which  we  started, — 
That  there  is  no  evidence,  from  the  similarity  of  symptoms 
and  2^ost- mortem  appearances  of  persons  dying  or  dead  from 
chloroform  and  carbonic  acid,  to  warrant  us  in  concluding 
that  the  efficient  agent  in  chloroform  and  anaesthetic  ethers 
is  identical  with  carbonic  acid. 

Kalamazoo,  August  2d,  1859. 


ART.  XIIV.— The  Xormal  Hypcrtropliy  of  the  Heart  during  Gestation 

and  Its  Pathugenic  Importance. 


By  Dr.  Larcher.     Translated  by  A.  Sager,  M.  D. 

The  vascularity  of  an  organ  is  in  direct  proportion  to  the  importance  of  its  functio^a. 

Serres. 

It  is  the  function  which  determines  the  organ,  and  not  the  organ  which  determines 
the   function.  Milne  Edwards. 

Before  asking  the  attention  of  the  scientific  world  to 
the  result  of  our  researches,  especially  now,  when  the  vast 
field  of  human  anatomy  has  been  so  thoroughly  gleaned 
that  scarcely  anything  remains  ^o  be  discovered,  and  little 
remains  to  be  said,  either  in  regard  to  the  structure  or  the 
functions  of  organs,  we  must  confess  to  no  little  hesita- 
tion, and  hav3  often  asked  ourselves  whether,  in  announ- 
cing a  new  f?^.t,  and  proclaiming  a  physiological  law  before 


328  Tlie  Peninsular  and  Independent. 

unknown,  we  mi^ht  not  be  chargeable  with  temerity.  Act- 
ing however  under  a  clear  conviction,  and  in  the  hope  of 
adding  a  grain  of  sand  to  the  vast  edifice  of  science,  we 
have  decided  to  submit  our  work  to  public  criticism. 

Our  remarks  upon  this  subject  will  be  divided  into  two 
parts.  In  the  first  part,  wo  will  present  the  anatomical 
fact  which  we  have  discovered,  point  out  its  generality, 
and  its  ])hysiological  consequences;  in  the  second  part,  in- 
dicate its  pathogenetic  relations  and  importance. 

I. 

The  physiological  law  which  constitutes  the  subject 
of  this  mjm  )lr  w,i.s  discovered  many  years  since.  It  may 
be  stated  concisely  as  follows,  viz: 

Tho,  heart,  in  the  human  species,  normally  hecomes 
hypertrophied  during   gestation. 

Our  position  as  Interne  at  the  Maternity  Hospital  of 
Paris,  in  1826-7,  placed  us  in  the  most  favorable  circum- 
stances for  detecting  the  hypertrophy  of  the  left  ventricle 
during  gestation,  and  also  for  ascertaining  its  influence. 

The  cases  that  fell  under  our  observation  were  females 
b3tween  the  ages  of  18  and  3.3  years,  and  were  so  numer- 
ous that  every  imaginable  variety  of  temperament  and  or- 
ganization were  represented  in  turn.  Some  had  been  ill  a 
long  time  prior  to  accouchement,  others  only  for  a  brief 
period,  but  much  the  greater  number  had  been  in  perfect 
health  previous  to  parturition;  and  nearly  all  had  fallen 
victims,  more  or  less  promptly,  to  puerperal  fev^er.  No  in- 
ternal disorder,  no  lesion  of  other  organ  had  therefore  pre- 
ceded or  induced  hypertrophy  of  the  heart.  We  are  there- 
fore led  to  this  rigorous  conclusion,  that  the  condition  of 
the  heart  was  physiological  and  necessary,  and  could  have 
been  induced  only  by  the  condition  of  gestation. 

Our  observations  have  been  so  numerous  as  to  leave  no 
room  for  reasonable  doubt.      They  were  extended  to  about 


Hypertrophy  of  the  Heart  during  Gestation.  329 

130  cases,  and   these   constitute   the   basis  of  our  remarks, 
and  their  deductions. 

In  admitting  as  a  type  and  as  a  point  of  comparison 
the  relative  thickness  of  the  walls  of  the  two  ventricles, 
as  laid  down  by  L^nnec,  and  generally  accepted,  we  find 
that  the  parietes  of  the  left  ventricle  should  have,  in  the 
normal  state,  a  little  more  than  twice  the  thickness  of  the 
right  ventricle. 

But  during  gestation,  and  for  a  short  time  after,  the 
aortic  ventricle  is  manifestly  hypertrophied ;  the  thickness 
of  its  walls  is  augmented  from  one- third  to  one- fourth; 
the  right  ventricle  and  the  auricles  remaining  of  their 
usual  thickness.  The  left  ventricle  alone  becomes  thicker, 
firmer,  and  more  intensely  red,  than  under  other  circum- 
stances. 

What  may  be  the  consequences  of  this  hypertrophy, 
whether  regardt^d  from  a  physiological  or  a  pathological  point 
of  view,  it  will  not  b3  difficult  to  appreciate. 

In  the  physiological  condition,  this  temporary  hyper- 
trophy of  the  gestative  female  impresses  greater  energy  upon 
the  circulatory  movement,  which  here,  as  in  other  cases  of 
hypertrophy,  is  revealed  by  ausculation,  as  the  bruit  de 
soufflet  ;  and  this  augmented  muscularity  of  the  heart  enables 
the  organism  to  provide  for  the  wants  of  two  organisms 
simultaneously. 

On  the  contrary,  in  a  pathological  condition,  this  normal 
hyperthrophy  becomes  an  aggravating  circumstance,  and,  as 
we  shall  hereafter  see,  may  either  augment  or  originate 
divers  functional  lesions. 

Before  we  pursue  further  this  exposition  of  our  researches, 
we  think  it  may  be  useful  to  exhibit  to  our  readers  the 
various  vicissitudes  through  which  —  what  we  will  venture 
to  call  our  discovery  —  has  already  passed. 

Whatever  degree  of  importance  may  be  conceded  to  this 
physiological  law,  it  reposes  on  the  evidence  of  facts,   the 


330  Tlie  Peninsular  and  Independent. 

generality,  and  especially  the  uniformity  of  which,  places  it 
beyond  all  doubt.  But  it  has  suffered  the  fate  of  all  new 
ideas.  It  has  encountered  hindrances  and  opposition  ;  and, 
before  taking  rank  among  established  truths,  it  must  pass 
through  several  ])hases. 

In  1828  our  colleague  and  friend  Dr.  Meniere  published 
a  memoir  in  the  Archives  de  g^nerales  de  M^dicine^  entitled: 
"  Observations  and  Ruliections  upon  Cerebral  Hicmorrhage, 
either  occurriiiL^^  before,  duririg,  or  after  Parturition."  On 
page  521  we  find  this  notice,  commemorative  of  our  obser- 
vationSj  viz.  : 

This  memoir  was  nearly  published  when  we  received  from  our  friend 
and  colleague,  M.  Lai{Ciif.k,  a  note  which  appeared  to  us  too  iin[)ortaut 
not  to  be  employed  in  our  work;  it  is  indeed  so  closely  connected  with 
it  as  apparently  to  constitute  it^  foundation.  It  relates  to  an  observation 
made  upon  a  great  number  of  females  who  died  at  various  periods  of 
gestation,  or  soon  after  pirturition.  In  nearly  all  the  subjects  placed 
under  these  circumstances,  the  lefc  ventricle  was  evidently  hypertrophied. 
According  to  L^ennec  the  left  ventricle  should  slightly  exceed  twice 
that  of  the  right  ventricle.  From  tlie  researches  of  M.  Lakchek  it  appears 
that  this  proportion  is  constantly  augmented  during  the  puerperal  state, 
and  the  augmentation  is  varied  from  one-fourth  to  more  than  one-third. 

Admitting  this  fact,  we  see  at  once  what  consequences  flow  from 
it, — That  the  hyi)C'i  trophy,  whether  cause  or  effect  of  the  plethora,  gives  a 
degree  of  energy  to  the  circulation  that  will  explain  the  accidents  of 
gestation.  The  same  cause  that  presides  over  the  physiological  progress 
of  gestation  and  its  consequences,  gives  rise  also  to  the  pathological 
conditions  with  which  our  attention  has  been  occupied.  Most  of  the 
explanations  given  in  the  course  of  these  researches  are  thus  confirmed. 
We  ought,  however,  to  state  that  in  the  autopsies  we  have  made,  or  have 
witnessed,  under  like  circumstances,  we  have  rarely  noticed  an  augmen- 
tation of  the  thickness  of  the  left  ventricle.  It  is  true,  having  given  our 
chief  attention  to  the  condition  of  other  organs,  the  fact  of  hypertrophy 
may  have  been  overlooked.  M.  Scqedel,  who  for  two  years  made  the 
autopsies  of  puerperal  females,  did  not  make  the  same  observations  as 
M.  Lakcher;  but  that  does  not  constitute  a  real  objection.  Those  who 
make  autopsies  know  how  easily  certain  lesions  escape  detection  when 
not  specially  searched  for.  We  must  therefore  exainine  the  statement 
with  all  the  care  that  its  importance  merits ;  and  the  time  is  not  distant 
when  we  shall  be  able   to  form  a  more  definite  opinion  in  respect  to  it. 


Hypertrophy  of  the  Heart  during  Gestation.  331 

In  1833,  Dr.  Eochoux  refused  to  recognise,  in  the  con- 
dition of  gestation,  a  predisposing  cause  of  apoplexy,  rejected 
the  opinion  expressed  by  Dr.  Meniere,  as  well  as  the  anato- 
mical fact  first  stated  by  myself,  upon  which  Dr.  Meneire 
was  inclined  to  base  his  opinion ;  and  that,  too,  without 
examination. 

But  we  will  adduce,  in  opposition  to  the  incredulity,  and 
even  reprobation,  of  Dr.  Rochoux,  two  series  of  facts  which 
have  at  different  times  been  brought  forward  to  corroborate 
our  observations,  and  justify  to  their  kind  reception  by  Dr. 
Meneire. 

In  1837,  Dr.  Jacquemier,  then  Interne  of  the  Maternity 
of  Paris,  ascertained  the  existence  of  a  hruit  de  soufflet  in  the 
precordial  region,  and  mentioned  the  fact  in  his  inaugural 
thesis. 

But  it  is  well  known  that  the  hruit  de  soufflet  implies, 
as  stated  above,  hypertrophy  in  the  organ  that  gives  rise  to  it. 
It  therefore  establishes  the  existence  of  the  law  announced ; 
and,  in  fact,  when,  in  1826-7,  we  were  charged  by  Professors 
Chaussia  and  Denrux  with  the  obstetric  service  at  the 
Maternity,  every  day  furnished  occasion  to  observe  the  co- 
existence of  the  precordial  hruit  de  soufflet  and  hypertrophy 
of  the  left  ventricle  revealed  by  autopsy. 

On  the  other  hand,  desirous  of  testing  the  correctness  of 
our  law,  in  1846,  Dr.  Beau  submitted  the  question  to  a  new 
examination,  and  has  stated  the  result  of  his  researches  in  his 
important  work  on  the  sounds  of  the  arteries,  which  we  here 
quote  : 

As  an  appendix  to  the  history  of  this  form  of  apoplexy  Dr.  Meniere 
has  added  a  note  of  M.  Larcher,  in  which  that  physician  announces  the 
observation  of  the  hypertrophy  of  the  heart,  and  especially  of  the  left 
ventricle,  during  pregnancy.  In  our  view,  this  fact  is  not  at  all  surprising, 
as  we  have  shown  that  the  arterial  sounds  imply  a  dilatation  of  the  heart, 
with  a  more  or  less  decided  hypertropliy  of  the  organ. 

Wishing  to  test  by  examination  the  fact  stated  by  M.  Larcher,  I 
requested  M.  DucuESr,  Interne  of  the  lying-in  department  in  1843,  to  give 


332  The  Peninsular  and  Independent. 

special  attention  to  this  question  of  pathological  anatomy  by  accurate 
measurements  of  the  hearts  of  such  as  should  succumb  after  parturition. 
In  compliance  with  my  request,  M.  Dlckest,  whose  name  is  well  known 
to  science,  made  most  accurate  researches  on  this  subject.  Regretting 
that  the  extent  of  the  statistical  results  furnished  are  too  extensive  for 
publication  entire  in  this  place,  I  will  submit  only  the  principal  results 
obtained. 

The  table  is  formed  fiom  100  cases,  between  the  ages  of  20  and  30 
years;  the  measures  being  taken  through  the  thickest  part  of  the  left 
ventricle.  The  maximum  thickness  was  'OlS  of  a  metre  (7-10  of  inch) 
in  5  cases.  In  only  one  was  it  found  to  be  '022  of  metre  (,^  in.)  The 
lowest  was  "Oil  metre.  In  the  greater  number  it  was  010  metre;  and  the 
average  of  all  the  cases  was  '015  metre  (fo  in.  nearly.) 

If  now  we  compare  this  average  measurement  with  '010  metre(ju-|-  in.) 
that  given  by  lijzoT  as  the  average  nominal  thickness  of  the  left  ventricle 
in  the  female,  it  will  be  found  to  exceed  it  by  one-half.  It  followh^ 
therefore^  that  the  heart  of  females  daring  gestation  is  affected  icitk 
hypertrophy,  and,  that  the  previous  ohsertatioiis  of  M.  Laucher  must  be 
considered  correct. 

Thanks  to  Dr.  Beau  for  his  care  in  determining  the  exact 
mathematical  limitations  of  our  law  by  rigid  anatomical 
data,  and  for  the  conscientious  researches  of  M.  Ducrest 
upon  this  important  medical   question. 

We  have  i")reviously  stated  that  this  law  was  deduced 
from  data  furnished  by  130  cases  observed  at  the  Mater- 
nity of  Paris  in  1826-7;  and  here  are  100  cases  in  addi- 
tion, observed  fifteen  years  afterwards  at  the  same  Hospital, 
and  under  the  same  circumstances,  with  most  rigorous  care ; 
and  these  confirm,  in  all  points,  our  prior  results. 

In  view,  then,  of  these  two  series  of  correlative  facts, 
we  think  that  the  hypertrophy  of  the  heart  of  females  during 
gestation  as  a  normal  condition,  is  abundantly  proven. 

It  has  lono'  been  known  that  the  f^ravid  uterus  was 
augmented,  not  only  in  volume,  but  also  in  the  thickness 
of  its  parietes.  It  is  also  known  that  this  condition  is  only 
temporary ;  that  the  parietes  of  the  organ  represent  a  hollow 
muscle,  similar  to  those  of  other  viscera  of  organic  life,  and 
that  the  arrangement  of  the  several  planes  of  fibres  have 
been  accurately  described  by  Madame  Boivin. 


Hypertrophy  of  the  Heart  during  Gestation,  333 

It  has  also  been  observed  that  the  size  of  the  vessels  of 
the  uterus  during  gestation  was  augmented  five  or  even  ten 
fold  ;  the  same  is  also  true  of  those  of  the  mammary  glands 
at  the  close  of  gestation. 

But  prior  to  this  we  were  ignorant  of  the  remarkable 
law  of  coincidence  between  the  hypertrophy  of  the  heart  and 
of  the  uterus  during  pregnancy. 

What,  indeed,  is  more  remarkable  than  that  simultaneity 
of  development  ?  —  than  that  superabundance  of  life  in  the 
organ,  which  contains  the  product  of  conception,  and  in  the 
organ  which  moves  the  blood  necessary  for   its  growth  ? 

Let  it  be  observed,  also,  how  everything  here  is  har- 
monized, and  seems  to  concur  to  the  same  result,  and  not 
forget  that,  in  the  pregnant  female,  plethora  is  not  a  more 
or  less  common  accident,  but  a  constant  phenomenon  —  a 
necessary  physiological  condition. 

It  may  be  here  necessary  to  reply  to  an  objection  that 
seems  to  flow  from  the  researches  of  M.  Andral  on  the 
mutation  in  proportion  of  the  elements  of  the  blood. 

What,  it  may  be  asked,  is  the  importance  that  you 
attribute  to  the  office  of  plethora  in  pregnant  females,  when 
the  results  obtained  by  Andral  proves  the  frequent,  if  not 
general,  existence  of  anemia  during  that  condition  ?  The 
contradiction,  is  we  think,  rather  apparent  than  real. 

We  must  lose  sight  of  the  fact  that  the  researches  of 
Andral  were  necessarily  made  upon  venous  blood ;  which, 
being  modified  by  the  abstraction  of  the  elements  of  nutri- 
tion, might,  perhaps,  be  expected  to  exhibit  a  diminution 
of  red  globules ;  meanwhile  a  comparative  examination  of 
the  arterial  blood  (that  which  had  been  oxygenated  and 
vivified)  was  not,  and  perhaps  could  not  be,  made. 

Therefore,  while  we  admit  the  frequent  diminution  of 
the  red  corpuscles  in  the  venous  blood  of  pregnant  females, 
as  found  by  Andral,  we  persist  in  considering  plethora  as 
a  constant,  or  nearly  constant,  condition  of  gestation.     This 


334  Tlie  Peninsular  and  Independent. 

condition  indicated  by  the  ancients,  and  generally  admitted 
at  present,  should,  we  think,  be  regarded  rather  as  a  phy- 
siological than  as  a  pathological  state. 

Such  was  also  the  opinion  of  Prof.  Desormeaux,  when 
he  thus  summed  up  the  views  of  the  best  practitioners  : 

"We  must  not  fail  to  recognise  that  this  condition  (plethora)  is  a 
constant  phenomena  of  gestation. 

This  plethora  has  its  origin  rather  in  the  augmented  activity  of 
nutrition,  than  in  the  suppression  of  menstruation. 

We  may  remark  finally^  in  connection  with  the  important 
ofHce  we  attribute  to  the  central  organ  of  the  circulation, 
that  the  action  of  the  formative  force  is  more  energetic 
in  females  than  in  men. 

It  is  evident,  therefore,  that  in  the  physiological  condition 
of  gestative  females,  plethora  on  the  one  hand,  and  hyper- 
trophy of  the  heart  on  the  other,  are  perfectly  harmonized, 
and  admirably  correspond  to  the  new  wants  of  the  organism. 

Thus  demonstrated,  is  not  this  physiological  law  in  per- 
fect accordance  with  the  principle  long  since  laid  down  by 
one  of  our  most  illustrious  veterans  of  science,  M.  Serres, 
viz.,  that  the  vascularity  of  an  organ  is  in  direct  proportion 
to  the  importance  of  its  function.^  And  does  it  not  also 
confirm  the  opinion  more  recently  and  so  well  expressed  by 
Milne  Edwards,  to  wit,  that  the  function  determines 
the  organ,  and  not  the  organ  which  determines  the  function? 

II. 

Within  its  natural  limits,  this  state  of  things  is  quite 
consistent  with  the  maintenance  of  health,  indeed  it  is  true 
expression  of  it ;  but  it  conceals  within  itself  a  necessary 
predisposition  to  vascular  congestions  and  to  hasmorrhages ; 
and  from  this  circumstance  the  pathogenetic  importance  of 
hypertrophy  of  the  heart  during  gestation,  and  after  par- 
turition, is  derived. 

In  the  regular  succession  of  puerperal  phenomena,  this 


Hypertrophy  of  the  Heart  during  Gestation.  335 

hypertrophy  of  heart,  which  has  its  origin  in  the  condition 
of  gestation  itself,  gradually  disappears  after  parturition ; 
but,  in  exceptional  cases,  it  may  be  otherwise. 

May  it  not  happen,  for  example,  that  when  gestation 
recurs  very  frequently,  and  almost,  as  it  were,  becomes 
continuous,  that  the  normal  hypertrophy,  because  temporary, 
may  become  permanent,  and  therefore   abnormal  ? 

Such,  without  doubt,  is  the  cause  of  the  various  lesions 
of  the  circulatory  apparatus,  from  the  simple  nervous  pal- 
pitations, to  persistent  hypertrophy,  either  simple  or  with 
dilatation,  so  common  among  females  who  have  borne  many 
children,  whether  premature!}^  or  in  too  rapid  succession, 
or  in  unfavorable  conditions  of  the  general  health. 

We  may  here  mention  another  consequence  of  the  normal 
hypertrophy  of  the  heart.  There  is  reason  to  suppose  that 
bronchitis,  so  common  in  pregnancy,  derives  its  character 
of  obstinacy  from  this  normal  hypertrophy. 

Should  we  not  also  attribute  the  greater  gravity  of 
pneumonia  in  gravid  females  to  the  same  causes,  and,  as 
a  consequence^  the  greater  frequency  of  abortions  and  pre- 
mature births  under  these  circumstances  ? 

Our  friend  and  former  colleague  Dr.  Grisolle,  in  1841, 
wrote,  that  when  pneumonia  occurred  in  pregnant  females^ 
it  induced  abortion  or  premature  births  in  more  than  one^ 
half  of  the  cases. 

Finally,  must  we  not  equally  admit  that  this  hyper- 
trophy, normal  though  it  be,  predisposes  to  epis taxis,  to 
the  severer  cases  of  haemoptysis,  to  the  divers  forms  of 
metrorrhagy,  and  even  to  that  rarer  but  more  formidable 
affection,  cerebral  hasmorrhage  ? 

It  is  well  known  that  simple  cerebral  hyperaemia  is 
frequently  met  with  during  gestation.  It  then  coincides 
with  polygemia  and  cardiac  hypertrophy.  Especially  is  this 
more  liable  to  occur  during  the  last  three  months  of  gestation' 

We  believe   it   to   be   demonstrated    that    this    norma 


336  The  Peninsular  and  Independent. 

hypertrophy  exercises  a  marked  influence  upon  the  duration 
and  intensity  of  congestions  and  intercurrent  inflammations, 
in  flivoring  the  tendency  to  hyperaemia  and  hasmorrhage. 

But  the  influence  of  this  organ  is  not  limited  by  t'lese 
affections  during  gestation  and  after  parturition,  and  it  is 
under  a  new  aspect  that  we  propose  now  to  consider  it. 

Thus,  when  pulmonary  tuberculization  exists,  the  heart 
may,  under  varying  conditions,  sometimes  suspend,  or,  at 
least  retard,  the  ravages  of  the  disease  ;  sometimes,  on  the 
contrary,  it  may  impress  upon  the  affection  a  more  rapid 
and  all -pervading  progress. 

Without,  in  all  respects,  coinciding  with  the  opinion 
of  the  ancients,  who  attributed  to  pregnancy  the  power  of 
suspending  pulmonary  tuberculization,  ii  common  with 
Prof.  Andral  and  most  other  practitioners,  we  believe 
that  if  it  does  not  completely  suspend,  it  may  at  least 
retard,  the  progress  of  the  disease. 

But  such  is  not  the  opinion  of  Dr.  Grisolle,  as  expressed 
in  his  memoir  on  the  influence  that  pregnancy  and  phthisis 
pulmonalis  exert  upon   each  other. 

Dr.  Grisolle,  aiming  to  weaken  the  opinion  generally 
entertained  upon  this  subject,  adduces  several  cases  of 
phthisis  which  supervened  during  the  progress  of  gestation, 
from  which  he  infers  that  pregnancy  accelerates  rather  than 
retards  the  disease. 

But,  in  the  first  place,  it  will  be  observed  that  the  terms 
of  the  question  have  been  changed.  The  question,  as  dis- 
cussed by  both  ancients  and  moderns,  relates  to  the  influence 
of  pregnancy  on  pre-existing  phthisis,  and  not  on  phthisis 
supervening  on  pregnancy.  The  difference  then,  seen  from 
this  point  of  view,  is  rather  apparent  than  real. 

Is  it  not,  indeed,  quite  conceivable  that,  on  the  one 
hand,  when  pregnancy  supervenes  upon  a  case  of  slowly- 
progressing  tuberculization,  the  more  vigorous  propulsion 
of  the  hyper trophied  heart  may  coincide  with  the  attractive 


Hypertrophy  of  the  Heart  during  Gestation.  337 

force  of  the  developing  embryo,  and  the  process  of  tuber- 
culization may,  in  consequence,  be  arrested  or  retarded  ? 
And,  on  the  other  hand,  may  it  not  be  admitted  that,  under 
exceptional  circumstances,  when  phthisis  coincides  with,  or 
supervenes  upon,  pregnancy,  it  may  assume  a  more  acute 
form,  and  hastening  its  march,  sooner  reach  a  fatal  termi- 
nation. It  may  even  happen  that  the  hgemorrhagic  molimeUj 
being  determined  to  the  lungs^  may  give  rise  to  suddenly 
fatal  haemoptysis. 

But  whatever  opinion  we  may  form  in  respect  to  the 
influence  of  phthisis  on  pregnancy,  or  reciprocal  of  pregnancy 
on  tuberculosis,  we  think  it  demonstrated  that  the  condition 
of  normal  hypertrophy  of  the  aortic  heart  tends  to  maintain 
the  equilibrium  between  the  organism  of  the  mother,  whose 
life  is  menaced  by  the  tubercular  affection,  and  that  of  the 
embryo  Avhicli  seeks  self- development. 

Yet  while  we  believe  that  in  a  great  majority  of  cases 
the  progress  of  tuberculization  is  either  suspended  or  retarded 
during  pregnancy,  w^e  are  also  of  the  opinion  that,  after 
parturition,  and  during  the  puerperal  state,  the  disease 
resumes  its  former  activity,  and  the  heart,  retaining  for  a 
]Deriod  its  hypertrophic  condition,  may  augment  the  func- 
tional and  organic  lesions  of  the  respiratory  organs. 

If  now,  our  efforts  in  search  of  truth  have  been  crowned 
with  success,  our  reward  will  be  derived,  not  so  much  from 
the  consciousness  of  having  discovered  the  facts,  indepen- 
dently considered,  as  from  the  pathogenic  deductions  and 
the  practical  indications  that  flow  from  them. 


Vol.  IL  — W. 


338 


The  Peninmiar  and  Independent. 


ART.  IXV,  —  Meteorological  Register  for  Month  of  July,  1859. 

Br  L.  S.  HoRTON,  House  Physician  to  U.  S.  Marine  Hospital. 

Altitude  of  Barometer  above  the  level  of  the  sea,  597  feet.     Latitude   42''24'N"  •   and 
Longitude.  82° 58' W.  of  Greeuvi^ich.  '  -.   <^^^ 


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iil)li0pa^|ial  "gttjsxl}. 


A  TREATISE  ON  GONORRHOEA  AND  SYPHILIS.  By  Silas  Durkep, 
M.  D.,  Fellow  of  the  Massachusetts  Medical  Society;  Member  of  the 
Boston  Society  for  Medical  Improvement,  and  of  the  Boston  Society 
of  Natural  History;  Fellow  of  the  American  Academy  of  Arts  and 
Sciences ;  Honorary  Member  of  the  Medical  Society  of  the  State  of 
New  York.  With  Eight  Colored  Plates.  Boston:  John  P.  Jewett 
&  Co.     1859. 

This  is  a  well  executed  volume  of  four  hundred  and  forty- 
two  pages  devoted  to  the  consideration  of  a  subject  of  abiding 
interest — a  subject  which  can  not  receive  too  much  attention, 
prolifiCj  as  it  is,  of  manifold  and  multiform  diseases.  The 
Work  is  the  result  of  an  essay,  which,  in  1854,  received  the 
premium  from  the  Boylston  Prize  Committee  of  Harvard 
University.  That  essay  has  increased,  and  assumed  the  very 
creditable  form  in  which  it  is  now  presented  to  the  public. 

The  many  mooted  points  in  the  pathology  of  Gonorrhoea 
and  Syphilis,  and  the  great  variety  of  treatment  which 
characterises  general  practice,  are  at  once  proof  and  illustra- 
tion of  the  darkness  which  yet  hangs  over  the  subject.  That 
darkness  can  only  be  dissipated  by  continued  observation 
and  experience,  aided  by  patient  thoughtfulness  upon  the 
facts  so  derived.  Truth  will  probably  never  be  found  in  any 
of  the  extreme  grounds  occupied  by  theorists  ;  still  the 
efforts  of  such  men  are  gradually  leading  on  to  the  attain- 
ment of  the  great  end — truth. 

The  work  of  Dr.  Durkee  is  illustrated  by  a  liberal  pro- 
portion of   cases,  which  fact  renders  it  valuable  to  a  large 


340  The  Peninsular  and  Independent. 

class  of  readers.  As  a  rule,  he  is  free  frora  extreme  views  \ 
and  his  precepts,  drawn  from  experience,  will,  with  a  few 
exceptions,  be  found  safe  guides  to  the  practitioner. 

Dr.  D.  does  not  believe  in  the  leuchorrhoeal  or  menstrual 
origin  of  gonorrhoea.  His  faith  in  that  doctrine  "is  scarcely 
equal  to  a  grain  of  mustard  seed.''  His  opinion  "  coincides 
with  that  of  Sigmund — tliat  gonorrhoea  alone  produces 
gonorrhoea.  He  does  not  admit  gonorrhoea  to  the  dignity  of 
a  venereal  affection  ;  and  expresses  a  belief  in  a  single  vene- 
real virus.  This  is,  of  course,  equivalent  to  an  expression  of 
the  old  doctrine  of  duality  of  virus.  He  speaks  of  this  point 
as  settled  beyond  all  dispute;  —  this,  of  course,  is  mere 
assumption. 

Bubo  he  regards  as  "holding  an  intermediate  position 
between  primary  and  secondary  syphilis,"  and  speaks  of  it 
as  a  "half-way  house"  between  the  two  forms  of  disease; 
but,  on  the  next  page,  he  says : 

"But  the  mere  fact  of  its  existence  is  of  no  trifling  significance.  Ik 
shows  that  the  system  is  impregnated  with  the  specific  virus  which  has, 
found  its  way  into  the  channels  of  intercommunication,  and  through  the 
meiium  of  the  blood  and  other  fluids  has  poisoned  the  whole  animal 
economy." 

This  hardly  seems  like  an  "intermediate  position."  The 
"poisoning  of  the  whole  animal  economy"  would  seem  very 
like  developing  the  secondary  or  constitutional  disease,  rather 
than  constituting  a  "half-way  house."  But  the  bubo  is 
neither  a  "half-way  house,"  nor  is  it  secondary  disease. 
The  fact  that  the  pus,  taken  directly  from  the  gland  in  the 
genuine  bubo,  will  produce  a  chancre,  shows  its  primary 
nature.  The  true  bubo  is  a  primary  form  of  syphilis,  and 
should  be  treated  as  such.     Dr.  Durkee  himself  says  : 

"The  virulent  matter  of  the  true  syphilitic  bubo  retains  its  contagious 
property,  so  long  as  it  remains  in  the  ganglion;  that  is,  it  is  inoculable.'' 

Yet,  when  he  comes  to  the  subject  of  treatment,  he  deems 
it  "  of  great  importance  that  the  bubo  should  be  dissipated  as 


bibliographical  Mecord.  341 

soon  as  possible,  without  being  allowed  to  suppurate/'  This, 
it  is  true,  is  the  general  practice ;  but  that  it  is  highly 
pernicious  there  is  no  doubt.  That  the  dissipation  of  a  true 
bubo  will  certainly  beget  secondary  syphilis,  is  as  true,  as  that 
the  introduction  of  the  virus  into  the  general  circulation  will 
poison  and  contaminate  the  whole  animal  economy.  The 
formation  of  a  true  bubo  is  but  an  effort  of  nature  to  throw 
off  the  virus  and  prevent  mischief.  The  practitioner  who 
attempts  to  dissipate  such  a  bubo,  thwarts  nature,  and,  if 
he  is  successful  in  his  efforts,  ensures  the  secondary  disease. 

Upon  the  subject  of  bubo,  Dr.  Durkee  seems  somewhat 
"mixed."  Upon  one  page  he  tells  us  that  it  occupies  au 
"intermediate  position  between  primary  and  secondary 
syphilis.''  On  the  next,  he  tells  us  that  it  shows  that  the 
wliole  animal  economy  is  poisoned ;  and  on  the  third,  that 
it  is  inoculable. 

Upon  the  subject  of  syphilization  our  author  is  sound. 
He  says : 

"I  opine  that  the  day  is  far  di=!tanfc  when  the  medical  faculty  of 
this  or  any  other  enlightened  portion  of  the  globe,  will  credit  the 
idea  that  the  waning  health  of  human  being  can  be  restored  or  bene- 
fited by  artificial  syphilization,  as  intimated  by  the  Norwegian  pro- 
fessor. Certain  it  is,  that  no  human  providence  can  calculate  or 
guard  against  the  physical  mischiefs  that  might  accrue  to  individuals 
subjected  to  this  hypothetical  and  insane  line  of  treatment.  Instances 
of  the  most  terrible  disasters,  resulting  from  it,  have  already  been 
reported.  Mr.  Lawrence,  of  London,  states  that  one  of  the  most 
troublesome  cases  of  phagedaenic  ulceration  of  the  thighs,  which  ever 
came  under  his  notice,  was  in  consequence  of  artificial  inoculation 
performed  by  a  physician.  Other  instances  are  recorded,  in  which  the 
chancrous  sores,  manufactured  by  reckless  hands,  have  refused  for  a 
long  time  to  heal  or  amend  under  any  remedial  measures.  It  may  be 
that  the  experience  of  Turenne  and  others,  will  inspire  hope  and  courage 
among  libertines  and  their  meretricious  companions,  who  hail  from  the 
dens  of  Paris  and  some  of  the  other  continental  cities,  and  who  may 
be  induced  to  submit  to  such  a  style  of  tatooing  and  mutilation;  but 
it  is  scarcely  to  be  supposed  that  the  med'cil  faculty  of  this  country 
will  ever  countenance  such  a  beastly  mode  of  treatment,  —  certainly 
4iot  until  investigations  and   experiments   shall   ripen  into  higher  com- 


342  The  Peninsular  and  Independent, 

pleteness,  and  the  sanative  power  of  the  measure  has  had  time  to 
exert  a  more  persistent  influence  than  has  yet  been  displayed  in  pa-» 
tients  who  have  resorted  to  prophylactic  syphilization.  Without  en,, 
tering  into  any  discussion  of  the  real  truth  or  fallacy  of  the  doctrines, 
broached  by  the  advocates  of  artificial  inoculation,  it  is  enough  to  say 
that  the  demoralizing  associations  and  consequences  connected  with 
the  practice  are  sufRcient  to  consign  it  to  unqualified  condemnation. 
The  most  revolting  feature  appertaining  to  syphilization,  and  the  one 
calculated  to  provoke  unmitigated  indignation,  consists  in  the  bold 
barefaced  suggestion,  that  it  may  be  employed  as  a  means  of  safety 
for  persons,  who  are  as  yet  untainted,  and  who  can  subject  themselves 
to  this  factitious  disease,  and  ever  after  be  shielded  from  infection, 
however  deeply  they  may  plunge  into  the  foul  cess -pool  of  licenti- 
ousness and  corruption.  The  next  step  in  the  march  of  improve- 
ment, peradventure,  will  consist  in  the  internal  administration  of  pure 
veneral  pus,  or  perhaps  the  molified  crusts  of  rupia,  made  into  a 
paste   or   bolus.     This   would   be   a   fitting   climax. 

"The  organs  composing  the  emunctory  system  —  that  is,  the  liver, 
the  kidneys,  the  alimentary  canal,  the  entire  circle  of  the  mucous 
membranes,  and  the  skin  with  its  millions  of  sudoriferous  and  seba- 
ceous glands  and  ducts  —  constitute  the  machinery,  —  the  channels, — 
through  the  medium  of  which,  the  S5^philitic  poison  can  be  removed 
from  the  animal  economy.  Although  the  anatomical  apparatus  we 
have  to  v^ork  with  is  situated  in  different  portions  of  the  frame,  and 
in  structure  possesses  no  special  homogeneousness  or  resemblance  in 
its  several  parts  as  above  named,  yet  as  a  group,  and  in  respect  to 
function,  they  sustain  a  close  affinity  or  relation  ;  and  fortunately,  in 
a  practical  point  of  view,  they  can  be  brought  to  do  good  service 
either  by  the  same  remedial  agents,  varying  in  quantity  and  in  modea 
of  administration ;  or  by  different  remedies  so  compounded  as  to  per 
form  a  harmonious  action,  and  leading  to  the  same  practical  results' 
And  thus  if  a  case  of  constitutional  syphilis  be  cured,  it  is  in  this 
w^ay  that  these  emunctory  forces,  inherent  in  the  system,  carry  away, 
day  by  day,  in  homoeopathic  quantities,  the  poisonous  element,  until 
the  last  particle  is  exhausted,  and  the  morbid  process  engendered  by 
its  presence   is    brought   to   its   final   rest." 

We  are  glad  to  see  Dr.  Duekee  place  himself  in  the  list-, 
of  American  authors.  As  a  practical  work  his  book  is 
generally  entitled  to  confidence ;  and  if  we  have  criticised 
his  views  and  treatment  of  hubo^  it  is  a  criticism  that  will 
apply  to  most,  if  not  all  authors,  who  have  produced  syste-. 
matic  treatises  upon  syphilis.  Gr. 


(fHt0riiiI  g^prtm^nt. 


Rush  Medical  College— Prof.  Allen. 

If  the  balance  of  the  new  appointments  in  Eush  Medica. 
College  are  as  judicious  as  that  of  Prof.  Allen  to  the  Chair 
of  Theory  and  Practice,  the  School  will  offer  attractions 
of  a  very  high  order;  and  large  classes  will  be  likely  to 
convene  annually  under  the  droppings  of  an  institution 
which  adopts  the  celebrated  Rush  as  its  patron  Saint. 
Prof.  Allen  was  identified  with  the  organization  of  the 
Medical  Department  of  the  University  of  Michigan,  and 
for  four  years  continued  his  labors  in  that  institution.  As 
a  scientific  lecturer,  he  is,  in  our  judgment,  unsurpassed ; 
at  least,  it  has  never  been  our  fortune  to  listen  to  his  supe- 
rior. His  lectures  are  always  strong,  clear,  and  convincing 
His  style  is  terse  and  axiomic.  Conceiving  in  his  own  mind 
a  clear  and  definite  idea  of  the  subject  under  consideration, 
eparating  truth  from  error,  and  reducing  facts  to  general 
philosophy,  he  never  fails  to  present  truth  with  a  clear 
and  bold  outline,  and  in  a  highly  assimilative  form.  His 
acquisition  is  fortunate  for  the  Rush  Medical  College  ;  and 
while  we  regret  that  Dr.  Allen  leaves  Michigan,  we  can 
but  commend  the  sagacity  which  secures  his  services,  and 
express  our  sincerest  wishes  for  his  personal  welfare.     Gr. 


dut^Aj  ^rtitUs,  Obstructs,  $:t. 


TRANSLATIONS  from  FOUEIGN  JOURNALS  for  the  PENINSULAR  AND  INDEPENDENT. 


By  0.  D.  Palmer,  Al.  D ,  Zelienople,  Pa. 


CASES  OF  PREMATURE  LABOR,  PRODUCED  BY  THE  UTERINE  DOUCHE. 
Communicated  to  the  "  Uuzette  Ilebduiauduire  de  Medivitie  et  de  Chuuigie  by  Dr. 
Haman. 

The  question  of  jyrematwe  laboi\  produced  by  artificial  means,  is,  in  a 
moral  point  of  view,  one  of  the  most  grave  that  may  be  given  to  the 
practitioner  of  the  Healing  Art  to  solve.  Its  importance,  the  diversity 
of  interests  put  in  action,  the  hazardous  chances  of  an  operation  of 
this  nature,  the  responsibility  which  the  physician  assumes  in  under- 
taking it,  all  conspire  to  justify  his  hesitations,  his  doubts,  even  in  the 
face  of  indications  the  most  certain. 

At  the  present  time,  even  when  the  happy  inspiration  of  a  Wurz- 
hurgJi  Professor  has  endowed  science  with  a  method  as  sure  as  unin- 
jurious,  it  is  only  with  the  greatest  reserve  that  we  can  have  resort 
to  such  a  precious  resource.  How  many  mothers — how  many  children — 
might  have  been  saved  had  we  possessed  a  knowledge  of  this  means  ? 
Many  a  time,  already,  have  I  been  compelled  to  deplore  results  in  my 
practice  that  might  have  been  spared  by  this  knowledge.  I  have 
promised  mj'self  firmly  to  use  all  the  resources  of  science  to  prevent 
them  in  future. 

I  need  not  go  far  back  in  memory,  to  find  cases  in  point,  and  will 
cite  one  that  dates  within  the  present  year. 

A  quite  young  woman,  pregnant  for  the  first  time,  was  affected 
with  a  general  nervous  condition.  I  put  all  in  action  to  prevent  acci- 
dents, but  the  affection  went  on  increasing.  I  was  called  one  day  to 
visit  this  patient,  whom  the  messenger  declared  was  dying.  I  was 
separated  from  her  habitation  by  three  long  leagues.  When  I  arrived 
she  had  ceased  to  live.  I  hastened  to  practice  hysterotomy,  and  suc- 
ceeded in  removing  from  her  body  a  foetus  of  seven  or  eight  months, 
whose  heart  was  still  beating,  although  the  mother  had  ceased  to  live 
for  two  hours. 

Could  not  an  artifically  produced   premature    birth   have   prevented 


Selected  Articles^  Abstracts,  c&c.  ^  345 

this  double  fatality?  Witness  to  the  importance  of  the  ordinary  re- 
sources of  art,  would  not  a  physician  believe  himself  authorized  to 
sacrifice  the  child,  to  assure  the  safety  of  the  mother  ? 

This  unfortunate  case  has  occasioned  painful  reflections  in  my  mind, 
and  I  do  not  expect  even  to  be  free  from  regrets.  From  this  point 
of  time  forth,  I  resolved  to  use  every  effort  to  evade  similar  misfor- 
tunes. It  is  not  that  the  ignorant  vulgar  would  even  comprehend,  and 
censure  my  unskillfulness,  under  analogous  circumstances,  but  ought  an 
honest  and  conscientious  practitioner,  be  satisfied  to  know  that  he  has 
saved  only  his  responsibilit}^  ? 

Since  that  epoch,  I  have  encountered  two  occasions  of  recurring, 
as  an  extreme  means,  to  premature  delivery^  procured  by  art.  I  have 
had  opportunity  to  convince  myself,  of  the  perfect  immunity  from  dan- 
ger of  the  method  of  Kiwisch.  The  effects  resulting  from  it,  have  been 
relatively  so  satisfactory,  that  I  can  not,  in  too  strong  terms,  invite  the 
attention  of  my  enlightened  brethren,  to  a  method,  which  is  destined, 
I  doubt  not,  to  occupy  an  elevated  rank  in  science,  and  to  render  great 
service  to  humanity. 

Many  reasons,  in  fiict,  have  hitherto  opposed  the  introduction  of 
procured  birth  into  the  hahitudes  of  practice,  if  I  may  thus  express 
myself.  In  order  to  effect  it,  formerly,  it  was  necessary  to  be  provided 
with  an  appropriate  instrumental  apparatus.  In  the  great  centres,  this 
objection  would  fall  of  itself,  but  in  the  small  localities,  this  is  no 
longer  the  same.  On  the  other  side,  nothing  can  equal  the  repugnance 
with  which  families  receive  the  mere  proposition  of  such  an  operation. 
It  needs  to  be  justified  by  very  grave  circumstances,  and  then  demands 
of  the  ph3''sician  a  certain  address,  which  is  not  possessed  by  every  one 
in  a  sufficient  degree.  Besides,  this  manoeuvre  is  not  always  destitute 
of  danger. 

In  order  to  produce  proof,  I  will  recall  the  following  case,  which 
is  still  fresh  on  my  memory  : 

I  was  called  some  months  since,  the  fourth,  to  assist  an  honorable 
colleague  at  the  bedside  of  a  pregnant  woman  in  convulsions.  This 
case  appeared  so  grave  that  we  judged  necessary  to  induce  labor.  After 
proceeding  to  dilate  the  neck  of  the  uterus,  so  as  to  make  the  appli- 
cation of  forceps  possible,  an  attempt  was  made  to  extract  the  child. 
This  result  was  not  accomplished  till  after  previously  having  perforated 
the  cranium.  The  delivery,  after  this,  was  happily  effected.  The  pa- 
tient did  not  recover  her  consciousness,  till  the  fourth  day  after  the 
delivery.  She  died  on  the  sixth,  with  metro- peritinitls.  Might  not 
the  family  have  been  authorized  to  have  held  the  performers  of  this 
operation  accountable  for  its  fatal  result  ? 

This  case  is  not  without  analogy  in  science.  These  various  reasons 
are  sufficient,  then,  to  explain  the  repugnance  with  which  the  idea  of 
provoked  labor  is  received.     Join  to  this,  the  prejudices  of  the  vulgar, 


346  The  Peninsular  and  Independent. 

the  responsibility  of  the  physician,  who  would  never  be  able  to  brave 
them  with  impunity  if  his  trials  were  unfortunate,  and  we  may  com- 
prehend why  he  so  rarely  avails  himself  of  this  last  and  most  precious 
resource,  particularly  in  small  localities^  where  progress  has  so  much 
difficulty  to  insinuate  itself. 

But  the  method  of  Kiwiscn,  realises  an  immense  progress.  No 
special  apparatus,  properly  speaking — nothing  in  it  which  may  be  suscep- 
tible of  striking  the  mind — facility  of  application,  which  nothing  ap- 
proaches—certain effect— complete  innocency— it  could  be  recommended 
by  no  more  valuable  titles.  Likewise,  I  doubt  not,  it  only  requires  the 
recommendation  of  some  authorised  person,  to  have  it  pass  into  practice 
in  a  manner  more  general  and  methodical.  Instead,  indeed,  of  being 
reserved  to  a  certain  number  of  cases,  very  circumscribed,  it  would  be- 
come applicable  to  the  pathology  of  pregnancy  itself.  By  its  benefits, 
how  many  children  might  we  not  pluck  from  death  ? — how  many  mothers 
might  we  not  preserve  to  their  families  ?  Would  that  my  words  might 
find  an  echo  with  the  masters  of  our  art.  Would  that  they  might  raise 
a  serious  and  profitable  discussion,  having,  for  effect,  to  justify  the  em- 
ployment of  such  a  method,  to  extend  its  limits,  and  to  determine  the 
conditions  in  which  we  may  believe  ourselves  authorized  to  make  use 
of  it. 

It  is  in  view  of  attracting  attention  to  the  importance  of  this  ques- 
tion, that  I  report  the  following  facts.  They  are  very  proper,  I  think, 
to  demonstrate  that  premature  labor,  artificially  produced,  merits  to  take, 
in  our  daily  practice,  a  much  more  elevated  rank,  than  that  to  which 
it  is  reduced. 

The  case  in  question,  has  been  the  subject  of  a  memoir  which  I 
presented  to  the  Society  of  Practical  Medicine,  which  in  its  meeting  of 
August  5th  last,  has  done  me  the  honor  to  admit  me  among  the  num- 
ber of  its  corresponding  members. 

The  following  is  a  summa-ry  relation  of  the  case  : 

Case.  —  Mrs.  M.  sent  for  me  to  visit  her,  towards  the  end  of  Janu- 
ary of  the  present  year.  She  had  been  confined  to  her  bed  two  weeks, 
with  an  affection  which  I  immediately  recognized  as  a  typhoid  fedei\ 
with  thoracic  complications.  She  was  about  seven  months  advanced  in 
pregnancy.  She  informed  me  that  she  previously  had  three  pregnancies 
terminate  happily  at  period.  During  the  course  of  this  last,  she  had  en- 
joyed but  very  indifferent  health.  Deeming  her  situation  as  little  dan- 
gerous, I  prescribed  an  appropriate  treatment,  and  thought  no  more  of 
the  woman. 

The  13th  of  March,  I  was  requested  anew  to    give    her   my  atten- 

*tion,    when  I  found    the  scene    had  changed    its    aspects.       An    evident 

Tiydro  -  peritoneum  had  developed  itself,  and  a  more  abundant  infiltration 

of  the  pleury  than  I  had  ever  before  witnessed.        Her  oppression  was 

extreme.     I  judged  such  a  situation  desperate.     I  directed  a  large  vesi- 


Selected  Articles.  Abstracts,  dbc.  347 


),        -^.J-iyOV/    W/^^</«, 


catory  to   be   applied    about   the   chest,   not    wishing   to   try  any  other 
remedy  this  day,  seeing  the  critical  state  of  the  patient. 

The  14th,  I  found  the  oppression  somewhat  diminished,  the  cough 
less,  and  a  marked  general  amelioration.  Encouraged  by  this  almost 
unexpected  amendment,  I  resolved  to  procure  a  premature  delivery, 
which  alone,  probably,  could  be  able  to  preserve  the  days  of  this  poor 
woman — in  truth,  she  was  so  much  exhausted  by  misery  and  the  dis- 
ease— reduced  to  such  a  state  of  emaciation — that  I  dared  entertain  but 
little  hope  for  her,  but  her  child  might  be  viable. 

To  leave  this  woman  to  the  efforts  of  nature  alone,  was  to  de- 
Vote  her  to  almost  certain  death.  There  was  then  no  ground  for  hesi- 
tation. I  proposed  the  induction  of  premature  labor,  provoked  by  aid 
vagina  -  uterine  douches  (injections  of  water  into  the  vaginas).  This 
supreme  resource,  was  with  pleasure  accepted,  by  the  distressed  family, 
and  on  the  evening  of  the  next  day,  the  first  injection  was  made.  In 
the  mean  time,  continuing  the  medication  which  had  produced  so  good 
an  effect,  I  covered  the  thorax  with  vesicatories. 

At  length,  the  18th  March,  after  the  sixth  douche,  labor  became  regu- 
larly established,  and,  after  a  duration  of  about  five  hours,  terminated 
in  the  birth  of  a  living  child.  Unfortunately  this  child,  which  appeared 
to  have  arrived  to  about  the  seventh  or  eighth  month,  showed  itself  to 
be  affected  with  congenital  hydrocephalus  ;  and  in  fact  it  died  in  forty- 
eight  hours.  Had  it  not  been  for  this  unfortunate  state  of  the  infant, 
it  would  have  been,  I  doubt  not,  indebted  for  its  life  to  this  oppor 
tune  intervention  of  art. 

As  to  the  mother,  she  was  effectually  cured  of  the  hydro  -pleury ; 
but  her  organization  was  so  much  injured,  as  not  to  be  able  to  resist- 
such  severe  proofs.  She  succumbed  the  6th  of  April  —  that  is  nineteen 
days  after  her  accouchment. 

I  think  it  would  be  impossible  to  procure  a  premature  labor,  under 
more  unfavorable  circumstances.  A  woman  exhausted  by  an  affection^ 
terrible  in  itself,  and  complicated  by  a  serious  effusion  into  the  larger 
cavities — a  constitution  deteriorated  by  all  sorts  of  privations — this  was 
the  state  in  which  I  wished  to  try  a  desperate  effort.  Now,  I  am  able 
to  certify  that  I  never  assisted  at  an  accouchment  more  purely  physio- 
logical. Not  the  least  accident  arrived  to  disturb  the  labor,  or  to  mar 
its  consequences.  Some  days  before  her  death,  I  wished  to  ascertain 
the  state  of  the  uterus;  I  found  nothing  belonging  to  it  that  was  not 
in   the  natural  order  of  things. 

This  result,  as  satisfactory  as  it  was  possible  to  be,  relatively  speak 
ing,  was  very  proper  to  confirm  me  in  my  views  in  regard  to  the  bene- 
fits   to   be   obtained  by  procuring  premature  delivery.       Very  recently, 
having    found   a    second    occasion    to    make  a  useful  application  of  this 
method,  I  confidently  resorted  to  it. 

[Here   follows   the  report  of  another   case,  by  the   same  author,  in 


348  The  Peninsular  and  Independent. 

which  premoMre  labor  was  induced  by  repeated  injections  of  water  into 
the  vagina,  whilst  the  patient  was  in  a  comatose  sta<e.  The  process 
resulted  in  a  favorable  delivery,  followed  by  recovery  of  the  woman. 

Dr.  LuMPE  has  also  reported,  in  the  "  Oesterreichische  ZeiUchrift 
far  Practische  Heillcunde^  "  two  interesting  cases  of  premature  delivery, 
induced  by  art,  where  the  attending  physician  and  teeming  women  both 
had  reasons  sufficient  to  convince  them  that  labor  at  full  term  M'ould 
endanger  the  lives  of  mothers  and  children.  Tkanslatok. 


[From  the  London  Lancet. 

ON  AN  IMPERFECTLY  KXOWN  FUNCTION  OF  THE  PANC  HE  AS,  name/y,  Di, 
getiiiun  i)J'  JSiirugtiious  t'uud^  with  Cutnijuralioe  Experiintnis  on  Gus.ric  and  InleS' 
tinul  Digestion^  JuLluwtd  by  a  Jew    Clinical  JJeducliuns.     Jiy    L.  Corvisakt,    M.  D. 

[The  following  important  propositions,  deduced  from  Dr.  Couvisaut's 
skilUully-coiiducted  expeiiments,  were  sent  to  us,  in  manuscript,  by  the 
author,  some  time  since,  and  we  regret  that  vei-y  great  pressure  of  mat- 
ter prevented  these  valuable  contributions  to  science  being  inserted  be- 
fore.^— Jb'd.  L.] 

General  Propositions,  forming  the  Summary  of  an  Essay ^  puMished 
with  the  ahoce  titie^  and  read  before  the  Academy  of  Medicine  of 
Paris;  the  first  part  in  1857,  and  the  second  in  February^  1858. 

Very  little  is  know  about  the  manner  in  which  the  animal  or 
nitrogenous  food  is  digested  in  the  bowel;  and  science  has  not  ad- 
vanced one  step  since  the  discovery  of  Pui^kinje  and  Pappenheim  (18^6) 
respecting  the  dissolving  action  which  the  pancreatic  juice  may  exer- 
cise on  such  food  —  a  discovery  which  has  indeed  remained  almost 
unnoticed. 

The  physiological  and  experimental  investigations  on  the  second 
digestion  (intestinal  digestion),  of  which  I  have  given  an  account  (in 
the  before-mentioned  essay),  have  led  to  the  following  important  re- 
sults: These  are  twofold: — One  group,  of  a  physiological  and  direct 
character,  are  deduced  from  actual  experiments.  The  other,  of  a  patho- 
logical and  indirect  nature,  are  deductions  or  corollaries,  which,  as  it 
feeems   to  me,  throw    some   light   on  clinical  medicine. 

I.  — Physiological  Propositions. 

1.  Nitrogenous  food  is  digested  both  by  the  stomach  and  the 
pancreas. 

2.  The  pancreas  is,  as  it  were,  a  supplementary  organ,  whose 
action,    after   copious   meals,  is   added  to   that  of  the   stomach. 

3.  Both  digestions  are  of  the  same  nature,  as  any  article  of  food 
subjected  to  either  is  transformed  into  the  self-same  nutrimentive  pro- 
duct (albuminose   or   peptone). 

4.  The  pancreatic  juice  has  peculiar  reactions  under  the  influence 


Selected  Articles^  Abstracts^  c&c.  349 

of  heat  or  certain  agents,  which  reactions  the  gastric  juice  does  not 
present.  As  this  difference  in  the  juices  is  found  when  they  are  both 
charged  with  peptone^,  after  digestion,  it  has  erroneously  been  sup- 
posed that  the  peptones  also  differed.  This  pardonable  error,  being 
pointed  out,    will   hardly   again  be   fallen    into. 

5.  When  an  article  of  nitrogenous  food,  or  a  portion  of  it,  has 
undergone  a  thorough  gastric  digestion,  the  pancreatic  juice  no  longer 
acts  upon   it,    and   does   not  transform   it   into  another   peptone. 

6.  The  pancreatic  juice  is  intended  to  act  upon  that  part  of 
albuminoid  substances  which  has  left  the  stomach  before  being  trans- 
formed  into  albuminose. 

7.  The  amount  of  action  of  the  pancreas  may,  in  certain  cases, 
be   equal    to  that  of  the   stomach. 

8.  If  the  mere  quantity  of  secreted  fluid  were  alone  taken  into 
account,  the  stomach  might  be  looked  upon  as  the  more  powerful, 
for  the  gastric  juice  is  ten  times  more  abundant  than  the  pancreatic 
juice;  but  the  latter  is,  to  make  up  the  difference,  ten  times  richer 
in   ferment   (pancreatine). 

9.  The  gastric  juice  has  the  advantage  of  a  prolonged  contract 
and  stirring  with  the  food;  but  the  pancreatic  juice  has,  on  the  other 
hand,  the  faculty  of  acting  upon  azotized  aliments  equally  well,  either 
in  an  alkaline,  neutral,  or  acid  state;  it  also  acts  three  times  quicker 
than   the   gastric  juice. 

10.  Every  thing  is  so  disposed  in  the  duodenum,  that  the  pan- 
creatic juice  acts  immediately  it  comes  in  contact  with  the  food ;  and 
every  thing  is  so  arranged  in  the  stomach  that  a  large  part  of  the 
food  is  transformed  into  peptone,  the  remaining  part  being,  at  the 
very  least,  so  prepared,  as  rapidly  to  undergo  the  pancreatic  diges- 
tion. 

11.  This  preparation,  which  varies  according  to  the  quality  and 
quantity  either  of  the  food  or  the  gastric  juice,  &c.,  consists  some- 
times in  a  simple  imbibition,  sometimes  in  a  dissevering  or  an  extreme 
division,  and  sometimes  in  a  solution.  Pancreatic  digestion,  being  for- 
cibly very  rapid,  is  usefully  assisted  by  this  preparation,  the  stomach 
acting  respecting  the  pancreas  in  the  same  manner  as  the  teeth  do 
in  gastric  digestion. 

12.  It  is,  however,  to  be  noticed  that  the  pancreatic  juice  is 
able  to  accomplish,  unassisted,  the  digestion  of  food  wich  has  not 
been  subjected  to  that  gastric  preparation  or  division,  in  the  same 
way  as  the  gastric  juice  can  digest  food  without  extraneous  help. 
Hence,  pieces  of  albuminoid  substances,  being  directly  placed  into  the 
intestine  in  a  raw  state  —  that  is  to  say,  without  any  preparation  — 
are  perfectly  and  completely  digested,  the  process  being,  howevar 
somewhat  slow.  The  pancreatic  juice  can,  by  its  own  unassisted  en- 
ergy,   carry   on   the    digestion   of  nitrogenous   food,    without  requiring 


350  The  Peninsular  and  Independent. 

the  adjunction  either  of  the  intestinal  juice  or  the  bile,  to  gain  di- 
gestive properties.  The  digestion  of  azotized  food,  performed  in  glass 
jars  over  the  water  bath,  by  means  of  the  pancreatic  juice  or  isola- 
ted  pancreatine,    goes   on  in   the   same  manner   as  in    the   duodenum. 

13.  When  the  gastric  and  pancreatic  juices  are  separated,  and  act 
in  succession,  each  performs  its  function  completel}'',  and  the  quantity 
of  albuminose   produced  may    thus    be   doubled. 

14.  But  it  is  a  remarkable  fact,  that  when  these  two  digestive 
ferments  meet  in  a  state  of  purity,  the  two  digestions  are  no  longer 
freely  carried  on.  The  mixture,  far  from  doubling  the  produce,  may 
reduce  it  to  naught,  for  pepsine  and  pancreatine  destroy  each  other 
under  these  non-physiological    circumstances. 

15.  Nature,  in  the  normal  state,  prevents  this  conflict,  by  three 
distinct  means  —  Istly,  by  the  pylorus,  which  separates  the  two  fer- 
ments; 2dly,  by  the  very  gastric  digestion  through  which  pepsine  ex- 
hausts and  abolishes  itself  in  the  formation  of  peptone ;  3dly,  by  the 
bile,  which  destroys  the  activity  of  the  gastric  ferment,  as  has  been 
shown  by  Pappenheim. 

16.  Bile  does  not  precipitate  the  peptone  produced  by  the  in- 
fluence of  the  stomach  so  as  to  destroy,  digestion  and  necessitate  its 
being  again  begun.  On  the  contrary,  the  bile  itself  is  precipitated 
by  the  acid   of  the  gastric  juice   or  of  the  chyme. 

17.  The  nature  of  the  nitrogenous  food  has  much  to  do  with 
the  quantity  of  peptone  which  the  two  successive  digestions  can  pro- 
duce for  the  requhements  of  the  economy.  I  have  thus  found  in  my 
experiments,  that  whilst  musculine  and  caseine  yielded  almost  one 
ounce  of  perfect  peptone,  albumen,  or  gelatigenous  textures,  though 
given  in  the  same  quantity,  yielded  hardly  half  an  ounce. 

18.  At  the  outset,  gastric  or  pancreatic  digestion  destroys  the 
most  characteristic  properties  of  the  various  albuminoid  substances. 
It  liqueties  insoluble  ones,  deprives  albumen  of  its  coagulability,  and 
caseine  of  its  property  of  coagulating  by  rennet.  It  also  deprives 
gelatine  of  its  property  of  turning  into  jelly,  and  musculine  of  being 
precipitated  by  chloride  of  sodium,  &c.  In  short,  it  transforms  all  the 
substances   into   albuminose   and   peptone. 

The  different  kinds  of  albuminose,  although  their  individual  reac- 
tions are  much  less  marked  than  those  of  albuminoid  substances 
whence  they   are   derived,    have,    nevertheless,    distinct    characters. 

19.  The  nature  of  peptones  varies  as  the  nitrogenous  substances 
from  which  they  are  derived.  This  variety  satisfies  the  diflPerent 
(plastic?)  requirements   of  the  economy. 

20.  The  peptones  which  are  most  alike  and  most  diflScult  to 
distinguish  from  each  other,  are,  the  albumen-peptone,  musculine-pep- 
tone,  and,  strange  to  say,  gelatine-peptone ;  just  as  if  the  articles  of 
food  from  which   these  peptones    are   derived  were  less  different  from 


Selected  Articles^  Abstracts^  (&c.  351 

each  other  than  is  generally  supposed.  Fibrine-peptone  and  caseine- 
peptone  are  more  easily  distinguished  from  each  other,  and  from  the 
substances  above  named.  From  the  slight  differences  existing  between 
azotized  articles  of  food,  or  peptones,  there  arises  a  kind  of  unstable 
equilibrium,  favorable  to  the  work  of  assimilation  performed  by  the 
tissues   of  the  body. 

21.  The  generic  character  of  peptones  is,  that  they  are  always 
soluble  in  water,  be  the  latter  acid,  neutral,  or  alkaline,  which  cir- 
cumstance secures  an  easy  circulation  in  the  organism.  Heat  does 
not  coagulate  peptones,  and  hardly  any  of  them  are  precipitated  by 
acetate  of  lead.  Besides,  they  resist  insoluble  metallic  combinations 
a   great  deal   better   than   nitrogenous   articles    of  food. 

22.  Peptones  form  a  genus,  as  well  defined  as  the  albuminoid 
genus.  It  is,  however,  evident,  that  by  the  progress  of  science,  their 
nature  will  eventually  be  more  exactly  determined  than  can  be  done 
at   the   present   period. 

23.  Some  phj^siologists  persist  in  the  erroneous  belief  that  the 
stomach  merely  swells  or  divides  the  food  without  dissolving  it.  How 
can  they,  however,  withstand  the  testimony  of  the  .  scales,  w^hich  plain- 
ly show  that,  even  where  the  weight  of  the  food  is  considerable, 
every  albuminoid  article  of  food  subjected  to  the  action  of  the  stomach 
is  not  merely  divided,  but  dissolved,  passes  thrugh  the  filter,  and  is 
absorbed  by   the   membranes ! 

24.  Others  have  maintained  that  the  gastric  juice,  acting  on  ni- 
trogenous food,  produces  only  gelatine.  They,  however,  lose  sight  of 
the  fact,  that  the  characters  which  place  gelatine  in  a  peculiar  albu- 
minoid class,  have  never  been  discovered  in  the  chyme  after  a  diges- 
tion of  fibrine,  caseine,  musculine,  or  albumine,  even  w^hen  the  chyme 
was  neutralized ;  and  that,  moreover,  gelatine  itself  completely  loses 
its  specific  characters,  in  consequence  of  undergoing  digestion  in  the 
gastric  juice. 

25.  Others,  finally,  resting  on  the  hypothesis,  that  the  albumen 
of  the  blood  is  nothing  but  the  digested  matters  themselves,  maintain, 
that  the  peptones  are  reduced  to  albumen,  by  losing  their  acidity  — 
viz.  by  being  neutralized.  Such  an  error  can  hardly  exist,  except 
albumen  and  fibrine  be  alone  taken  into  account,  excluding  all  other 
aliments ;  as  an  incomplete  digestion  of  the  albumen  and  fibrine  may 
lead  to  confusion.  Crude  albumen,  in  fact,  always  partly  escapes  gas- 
tric digestion ;  ill-digested  fibrine  is  transformed  into  albumen  only 
(caseiform) ;  these  two  cases  excepted,  if  experiment  be  made  on  the 
produce  of  concrete  and  washed  albumen,  of  caseine,  musculine,  or 
gelatine,  regularly  digested  by  the  stomach,  no  doubt  can  any  longer 
be   entertained.     These  gastric  peptones  never  contain  any  albumen. 

26.  The  peptones,  either  received  or  produced  by  the  pancreatic 
juice,   do  not,  any  more  than  the  latter,  form  any  new  albumen,  and, 


352  Tke  Peninsular  and  Independent. 

whether  they  be  primarily  or  consecutively  acid,  alkaline,  or  neutral, 
do  not  increase  b}""  an  appreciable  weight  the  coagulable  albumen 
which  the  pancreatic  juice,  pure  and  without  peptone,  normally 
contains. 

27.  During  the  three  hours  which  follow  a  meal  (when  digestive 
solution,  transformation,  and  absorption  are  not  much  advanced),  the 
blood  of  the  vena  portae  (compared  to  the  venous  blood  generally) 
does  not  become  charged  with  a  noticeable  quantity  of  nitrogenous 
matter  through  digestive  absorption ;  whilst,  on  the  other  hand,  the 
elements  of  the  blood,  globules  and  fibrine,  become  changed  into 
albumen  (caseiform)  by  a  commencement  of  digestion,  either  in  the 
intestine  or  the  water  bath,  under  the  influence  of  the  alkaline  pan- 
creatic juice. 

28.  Now,  if  it  be  considered  that,  during  the  first  three  hours 
of  digestion  —  Istly,  The  pancreatic  juice  poured  into  the  duodenum 
ramains  therein  in  a  pure  and  active  state;  2dly,  That  this  jiiice 
cin  pass  into  the  vena  portge  (for  absorption  by  the  mesenteric  veins 
is  not  suspended);  3dly,  That  this  same  juice  can  act  in  such  an 
alkaline  medium  as  the  blood.  If,  moreover,  it  be  considered  that 
during  those  very  three  hours,  a  large  portion  of  the  globules  and 
fibrine  of  the  blood  of  the  vena  portse  is,  weights  remaining  equal, 
transformed  in  that  vein  into  albumen  (which  is  a  commencement  of 
transformation  similar  to  that  which  they  would  have  undergone  in 
the  intestine  under  the  influence  of  this  same  pancreatic  juice),  we 
can  hardly  refuse  our  assent  to  the  hypothesis  of  a  true  iiitra-venous 
digestion^    which   hypothesis   I   confidently   put   forward. 

29.  No  actually  differential  character  has  ever  been  pointed  out 
between  nitrogenous  matters  which  go  by  the  name  of  extractive,  and 
the  albuminose,  which  is  generated  by  gastric  or  pancreatic  digestion. 
Now,  it  should  be  noticed  that  the  lacteals,  the  rena  portce^  and  the 
hepatic  reins  which  are  its  continuation,  or,  in  other  words,  the  vessels 
which  most  directly  receive  the  product  of  digestion,  —  are  by  far 
richer  in  extractive  matter  (albuminose)  than  the  rest  of  the  blood. 
It   may,   moreover,    be   noted   that   they  are   also   richer   in    glucose. 

30.  Nutritive  richness  of  the  hepatic  vessels  (albuminose  and 
glucose  being  contained  in  them)  may  be  explained  by  the  gastro-intestinal 
absorption,  to  which  is  energetically  added  prolonged  intra-venous  di- 
gestion,   although   the   liver   has   no  share  in   the   process. 

II.  —  Corollaries^   'Gel  Pathological  Deductions. 

A.  We  may  take  it  as  almost  certain  that  there  exists  (as  re- 
gards albuminoid  aliments)  a  duodenal  dyspepsia,  caused  by  the  vi- 
tiation, insufficiency,  or  absence  of  the  pancreatic  juice,  the  symptoms 
of    which    appear    only   from    the    second  or   third  hour  of   digestion. 


Selected  Articles^  Abstracts^  cBc.  353 

with  a  deeper-seated  pain  than  is  felt  in  gastric  dyspepsia,  (See  Pro- 
positions 1,  2,  3,  6,7.)  The  internal  use  of  pancreatine  is  indicated*  in 
cases   of  pancreatic   duodenal  dyspepsia. 

B,  Secondary  duodenal  dyspepsia  may  be  the  result  of  an  al- 
most total  absence  of  that  kind  of  division  which  food,  under  the 
least  favorable  circumstances,  undergoes  by  means  of  the  gastric  juice 
before  that  food  has  been  transformed  into  peptone.  Pancreatic  di- 
gestion is  then  slower,  just  as  gastric  digestion  is  slower  when  the 
teeth  have  not  duly  performed  their  functions.  This  secondary  pan- 
creatic dyspepsia  may  be  cured  by  the  treatment  suited  to  the  primary 
gastric   dyspepsia, 

C,  Another  secondary  duodenal  dyspepsia  may  arise,  either  from 
an  excess  of  gastric  juice,  or  from  a  patency  of  the  pylorus;  for  in 
these  two  individual  cases  the  gastric  juice  reaches  the  duodenum  in 
unfortunately  retaining  all  its  active  properties,  which  latter  are  pre- 
judical  to  the  action  of  the  pancreatic  juice,  (See  Propositions  13,  14, 
15,  and  16.) 

D,  A  third  duodenal  dyspepsia  may  arise  from  deficient  biliary 
secretion,  this  deficiency  being  followed  by  the  same  unpleasant  effects 
as  are  noticed  in  the  two  preceding  cases,  on  account  of  the  non- 
destruction  of  the   activity  of  the  gastric  juice  in    the    duodenum, 

E,  A  peculiar  kind  of  dyspepsia,  which  might  be  called  of  the 
portal  vein,  or  hepatic,  may  arise  from  the  vitiation  of  the  intra- 
venous digestion,. 

F,  Certain  symptoms  of  dyspepsia,  gastralgia,  enteralgia,  or  he- 
petalgia,  may  erroneously  be  attributed  to  the  stomach,  the  intestine, 
or  the  liver;  these  symptoms  may  simply  be  the  result  of  the  absorp- 
tion of  a  too  abundant,  too  active,  or  too  irritating  pancreatic  juice  by 
the  vena  portae, 

G,  Bile,  when  it  reaches  the  stomach,  destroys  the  activity  of  the 
gastric  juice  within  that  organ,  whether  it  penetrates  the  cavity  pa~ 
thologically  through  the  pylorus  or  by  the  mouth  and  cardia.  The 
knowledge  of  this  fact  may  lead  to  the  employment  of  bile  to  coun- 
teract  the   morbid  superabundance    of  the   gastric  juice, 

H.     The  economy   is  supplied  with   a  variable  weight   of  peptone, 

*La8t  year  Dr.  Corvisart  made  some  clinical  experiments  on  the  therapeutic 
use  of  pure  pancreatine.  The  difficulties  he  met  with  are  recorded  ia  the  Gazette 
Hebdomadaire  of  Paris,  May  1857,  pp.  321,  322.  Dr.  G.  IIarley,  who  read  a  paper  on 
digestion  (just  twelve  months  after  the  above  date)  at  the  meeting  of  the  British 
Association  for  the  Advancement  of  Science,  seems  never  to  have  heard  of  Dr.  Cor- 
visart's  article  on  the  subject.  Dr.  Harlet  maintains,  in  oi)po8ition  to  the  latter 
physician's  statements,  that  in  the  administration  of  duodenal  ferment,  it  is  not  ne- 
cessary to  imitate  nature,  who  prevents  pancreatine  from  passing  into  the  stomach. 
For  the  causes  of  the  difficulties  met  with  by  Dr.  Corvisart,  and  the  means  to 
overcome  them,  see  Propositions  13,  14  and  15,  paragraphs  G  and  D  of  the  summary, 
and  page  51  of  the  Essay. 

Vol.  II.  — X. 


354  The  Peninsular  and  Independent. 

though  the  weight  of  diiferent  kinds  of  nitrogenous  articles  of  food 
and  digestive  force  remain  the  same,  the  weight  of  the  peptones  vary- 
ing according  to  the  kind  of  nitrogenous  food.  It  is  a  great  error  in 
hygienics  to  estecxn  the  trophic,  or  nourishing  power  of  a  nitrogenous 
article  of  food,  simply  by  the  amount  of  nitrogen  it  contains.  The 
trophic,   or  alimentary  standard  of  food,  is  not  so   easily  fixed. 

I.  When  it  is  more  urgent  to  allay  pain  and  irritation  about 
the  digestive  organs  than  to  restore  muscular  energy,  the  food  should 
consist  of  that  kind  of  aliment  which  is  most  quickly  and  completely 
dissolved,  whatever  be  the  amount  of  peptone  it  yields. 

J.  But  when  it  is  more  important  rapidly  to  restore  muscular 
force  than  to  allay  gastro-intestinal  pain,  we  should,  on  the  contrary, 
give  such  food  which,  the  digestive  force  being  the  same,  yields  the 
greatest  weight  of  peptone,  though  that  food  be  likely  to  dissolve  and 
digest   slowly.     (See  Proposition  17.) 

K.  He  who  digests  with  one  organ  only  (stomach  or  pancreas), 
is  thereby  put  on  half  allowance  as  regards  peptone;  and  he  who 
eats  only  albumen  or  gelatinous  tissue  (instead  of  caseine  or  muscu- 
line,  which  yields  double  as  much  peptone),  is  also  put  upon  half 
allowance:  and  with  a  normal  and  equal  digestive  force,  is  only  half 
nourished.     (See   Proposition  17.) 

In  the  two  preceding  cases,  an  over-activity  either  of  the  one 
organ  (first  case),  or  of  both  organs  (second  case),  may  occur,  and 
extract  from  the  food  the  full  allowance  of  peptone.  But  we  must 
not  long  trust  this  extreme  functional  exertion;  for  any  persisting  over- 
activity must  sooner  or  later  end  in  exhaustion. 

L.  We  should  not  give  for  a  long  time  one  kind  only  of  ni- 
trogenous food,  not  only  because  one  kind  of  azotized  aliment  is  not 
capable  of  repairing  the  waste  of  the  organism,  but  also  because  the 
same  article  of  food  given  exclusively  and  continuously  (for  a  week 
for  instance),  no  longer  excites  gastric  secretion,  and  no  longer  fully 
undergoes   the   digestive  transformation. 

M.  Most  of  the  peptones  upon  which  I  have  made  experiments, 
have  the  peculiarity  of  not  being  precipitated  by  neutral  acetate  of 
lead.  Now,  in  all  cases  where  the  albuminoid  matters  of  the  urine 
happen  to  be  of  the  albumin ose  kind,  they  remain  in  solution,  in 
spite  of  the  acetate  of  lead  used  to  precipitate  them.  They  therefore 
mask  the  sugar  more  effectually  than  all  other  ingredients  of  the 
urine,  when  the  potash  and  copper  test  is  employed.  The  presence 
of  sugar  may  thus  be   overlooked  when  it  really  exists  in  the  urine. 


Selected  Articles^  Abstracts^  cJtc.  .     355 


PIEOGOFFS  OSTEOPLASTIC  PROLONGATION"  OF  THE  BONES  OF  THE  LEG- 
WITH  EX -ARTICULATION  IN  THE  TIBIO- TARSAL  ARTICULATION. 


By  Gustav  C.  E.  Weber,  M.  D., 
Professor  of  Surgery  in  the  Cleveland  Medical  College,  etc.  etc. 

It  is  surprising  that  since  the  appearance  of  the  excellent  monograph 
of  PiHOGOFF  "  On  the  Osteoplastic  Prolongation  of  the  Bones  of  the  Leg 
loiih  Ex-articulation  in  the  Tibio-Tarsal  Articulation^^''  not  one  report 
of  cases  in  which  the  new  method  has  been  tested  has  found  its  way 
into  the  journals  of  this  country.  At  least,  to  our  knowledge,  some  of 
our  best  periodicals  have  not  as  yet  mentioned  this  ingenious  operation  of 
the  great  Russian  Surgeon. 

We  think,  therefore,  that  a  short  discussion,  with  a  report  of  four 
cases,  will  be  acceptable  to  bring,  at  a  rather  late  period  of  time,  a 
proceeding  to  the  notice  of  our  professional  brethren,  which  justly  deserves 
our  admiration  and  imitation. 

Pikogoff's  operation  has  been  termed  "«  modification'^''  of  Symes' 
ex-articulation  in  the  tibio-tarsal  articulation,  although  it  is  as  widely 
different  from  this  operation,  as  is  a  re-section  from  an  amputation.  The 
only  similarity,  as  will  be  seen,  of  both  proceedings,  consists  in  the 
character  of  the  flaps.  Thus  we  must  claim  a  priori,  for  Pirogoff's 
operation,  the  name  in  our  works  on  surgery  of  an  original  method^ 
■and  not  simply  an  original  variation  of  Symes'  method,  as  it  is  styled  in 
Oanstatt's  Jahresbericht   by  Sprengler. 

PiKOGOFF  met,  as  many  others  have,  with  a  number  of  disadvantages  in 
the  cases  of  ex-articulation  of  the  foot  after  any  of  the  known  plans.  In 
Symes'  operation,  he  found  the  re-section  of  the  calcaneus  very  difficult 
and  laborious.  He  saw  the  integuments  over  the  tendo  Achillis  become 
gangrenous  when  too  thin,  and  the  peculiar  dipper-like  shaped  posterior  flap 
too  often  the  seat  of  accumulated  decomposed  pus.  Baudan's  plan  of 
using  the  integuments  of  the  instep  to  cover  the  end  of  the  bone,  presented, 
what  is  generally  admitted,  still  greater  difficulties  in  obtaining  a  sound 
and  useful  stump ;  and  Roux's  external  posterior  flap,  the  concavity  and. 
the  narrowness  of  its  base  with  the  division  of  the  tendo  Achillis  at  its 
insertion,  furnishes  causes  for  tedious  cicatrization  and  bad  stumps.  Thus 
he  tried  in  the  execution  of  his  operation  to  obviate  these  disadvantages, 
and  obtain  more  readily  an  uninterrupted  process  of  repair  and  a  useful 
extremity. 

PiKOGOFF  commences  his  operation  like  Symes'  with  a  perpendicular 
incision  through  all  the  soft  parts,  from  the  external  to  the  internal 
malleolus,  round  the  sole  of  the  foot.  Then  he  connects  the  ends  of  this 
incision  by  a  second  incision,  anteriorly  slightly  convex,  in  front  of  the 
tlbio-tarsal  articulation.  Then  the  articulation  is  opened,  the  astragalus 
dislodged  by  the  division  of  the  lateral  ligaments,  and  a  narrow  straight 


356  The  Peninsular  and  Independent. 

saw  perpendicularly  applied  directly  behind  the  head  of  the  astragalus  upon 
the  OS  calcis,  and  the  larger  anterior  portion  of  the  same  removed,  together 
with  the  other  bones  of  the  foot,  in  the  line  of  the  first  incision. 
The  flaps  are  retracted,  and  their  base  dissected  from  the  adhesion  to 
the  tibia  and  fibula  sufficiently  to  allow  a  second  use  of  the  saw  for  the 
removal  of  the  malleoli.  The  operation  is  completed  by  bringing  the 
posterior  flap  (the  heel  with  the  tuberosity  of  the  calcaneus  and 
the  insertion  of  the  ten  do  Achillis)  forward  to  be  brought  into 
coaptation  with  the  cut  surfaces   of  the   tibia  and  fibula. 

This  proceeding  he  finds  indicated  in  almost  all  cases  where  Symes* 
operation  was  previously  performed,  as  in  affections  of  the  articulation, 
the  bones  of  the  tarsus,  and  in  injuries  implicating  the  metatarsal  and 
tarsal  bones.  In  these  affections,  the  tuberosity  of  the  calcaneus  will 
seldom  be  invaded,  so  that  it  can  be  used  for  the  partial  restoration  in 
the   loss   of  length   of  the  extremity,    in   the    manner   above    described. 

PiROGOFF  has  published  three  cases  in  which  he  performed  his  operation 
successfully,  and  quite  satisfactorily  to  his  patients  and  himself,  obtaining 
a  stump  ready  for  use  at  a  comparatively  shorter  period  than  after 
Symes'  operation,  the  length  of  the  extremity  being  diminished  from 
three-quarters  to  one  inch  only,  which  during  locomotion  could  hardly 
be  noticed  on  account  of  the  accommodation  of  the  pelvis. 

Objections  have  been  raised  against  this  new  operation,  many  of  which, 
no  doubt,  are  rather  grave  and  important.  First  of  all,  it  was  said  that 
the  portion  of  the  os  calcis,  which  is  left  behind,  would  necrose  and  give 
rise  to  trouble.  Then  it  was  urged  that  the  contraction  of  the  muscles 
of  the  calf  of  the  leg  would  cause  a  disarrangement  of  the  coaptation 
of  the  osseous  surfaces,  as  the  heel  has  to  describe  a  quarter  of  a  circle 
in  order  to  be  brought  forward  to  meet  the  anterior  flap.  By  this  change 
of  the  direction  of  the  axis  of  the  heel,  the  insertion  of  the  tendo  Achillis 
is  removed  from  the  point  of  origin  of  its  respective  muscles,  and  thus 
the  latter  stimulated  to  forcible  contraction. 

As  against  Symes'  mode  of  operation  it  was  said  that  divided  tendons 
and  their  sheaths  would  inflame,  and  abcesses  and  a  tedious  process  of 
repair  would  follow.  At  last,  doubts  were  entertained  as  to  a  perfect 
osseous  union  (between  the  os  calcis  and  the  cut  surface  of  the  tibia 
and  fibula),  and  as  to  the  true  usefulness  of  the  limb  dependent  thereon. 

In  regard  to  the  first  objection,  it  can  be  asserted  that  all  fears  of 
necrosis  are  entirely  unfounded.  In  none  of  the  cases  now  on  record, 
has  death  of  the  bone  occurred;  and  this  can  easily  be  explained  when 
we  consider  the  intimate  connection  of  the  periosteum  of  the  calcaneus 
with  the  cellular  tissue  surrounding  it,  and  also  that  the  posterior  tibial 
artery  is  not  divided,  but  only  the  plantar  branches.  Thus  the  nutrition 
of  the  flap  and  remaining  bone  is  not  interfered  with. 

Before  we  enter  on  the  discussion  of  the  other  objections,  we  will 
give  the  experience  of  Pirogoff  and  others  who  have  given  a  fair  unpreju- 
diced trial  to  this  operation. 


Selected  Articles^  Abstracts^  c&c.  357 

PiROGOFF  met,  in  the  execution  of  his  plan,  with  difficulty  in  the  adap- 
tation of  the  osseous  surfaces,  and  therefore  proposes  a  more  oblique 
section  of  the  calcaneus,  from  upwards  and  backwards  in  a  downward 
and  forward  direction,  so  that  the  segment  of  the  circle,  which  the 
heel  has  to  describe  for  adaptation,  is  diminished.  The  possible  inflam- 
mation of  the  sheaths  of  tendons  he  obviated  in  his  cases  by  dividing 
them  not  too  short,  so  that  they  contracted  within  the  sheath,  or  even 
escaped  entirely  posteriorly  by  the  contraction  of  the  muscles.  By  the 
application  of  a  roller,  moderatively  compressive,  the  infiltration  of  the 
canal  of  sheaths  with  secretion  from  the  wound,  and  consecutive  irri- 
tation  and   suppuration  are,  as  he  believes,  easily  avoided. 

Shuh  reports  a  case  where  Pirogoff's  operation  was  performed  by 
him  with  the  best  of  success.  A  young  man  23  years  of  age,  covered 
with  scars  from  scrofulous  sores,  had  caries  of  the  bones  of  the  tarsus  for 
20  years.  His  general  health  became  impaired,  and  amputation  in  the 
ankle  joint  necessary.  Shuh  operated  entirely  after  Pirogoff's  directions. 
He  found,  however,  that  the  contractions  of  the  muscles  of  the  calf  were  so 
violent,  that  perfect  adaptation  could  not  be  brought  about.  He  therefore 
was  obliged  to  resect  another  small  wedge-shaped  piece  from  the  portion 
of  calcaneus  left,  the  base  of  which  was  directed  backwards.  Ligation, 
of  two  small  vessels,  coaptation,  sutures,  and  strips  of  adhesive  plaster 
applied,  Ke-action  and  inflammation  slight,  the  osseous  surfaces  united, 
firmly  by  first  intention.  The  lips  of  the  wound  of  soft  parts  separated 
a  little,  and  on  the  tenth  day  after  the  operation,  a  small  abcess  formed 
near  the  inner  border  of  the  tendo  Achillis — was  opened  and  closed  again 
on  the  twenty-second  day.  Six  weeks  after  the  operation  the  whole  stump 
was  healed  with  the  exception  of  a  narrow  short  superficial  portion  along 
the  line  of  union  of  the  flaps.  The  shortening  of  the  extremity  was  so 
slight  that  it  could  hardly  be  noticed. 

0.  Weber,  of  Bonn,  operated,  on  the  12th  day  of  May,  1854,  upon  a 
man  aged  37  with  caries  of  the  tarsal  bones,  and  contraction  in  the  knee 
joint,  exactly  after  Pirogoff's  method.  He  found,  however,  great  difficulty 
in  the  coaptation  of  the  flaps,  and  had  to  follow  Shuh's  modification, 
after  division  of  the  insertion  of  the  tendo  Achillis  had  failed.  Suppu-. 
ration  was  very  extensive,  but  toward  the  latter  part  of  June,  the  stump 
was  so  far  healed  that  only  two  small  fistulous  openings  remained.  Five 
months  after  the  operation,  although  some  of  the  fistulous  openings  were 
still  present,  the  limb  could  be  used  without  causing  the  slightest  pain. 
The  shortening  amounted  to  three-fourths  of  an  inch.  In  consequence 
of  this  embarrassment  in  bringing  about  the  apposition  of  the  osseous 
cut  surfaces,  Weber  proposes  an  oblique  section  of  tibia  and  fibula,  as 
well  as  of  calcaneus  removing  of  the  former  with  their  malleoli  a  wedge- 
shaped  piece  of  the  articulating  surface. 

MiCH^Lis  complained  also  that  he  could  not  adapt  the  flaps  during  an 
operation  after  Pirogoff  which  he  performed  in  August,  1854,  for  caries 


358  The  Peninsular  and  Independent. 

of  the  tarsus,  until  a  wedge  was  removed  from  the  remaining  portion  of 
calcaneus,  although  the  diseased  articulating  surface  of  the  tibia  and  fibula 
with  malleoli  was  removed  in  an  oblique  section  from  in  front  backwards. 
In  the  fourth  night  the  delirious  and  restless  patient  tore  off  the  bandages, 
the  sutures  tore  through,  and  the  flaps  separated ;  but  still,  notwith- 
standing excessive  suppuration,  formation  of  abcess  in  the  sheath  of 
peronei,  delirium  and  chills,  the  patient  escaped,  and  after  ten  weeks, 
had  a  sound  stump,  shortened  one  inch. 

Zanders  performed  Pirogoff's  operation  upon  a  little  boy  of  13  years 
for  caries  of  tarsus  and  metatarsus.  The  calcaneus  was  divided  just 
behind  the  sustentaculum  and  could  easily  be  applied  to  the  cut  surface 
of  tibia  and  fibula.  The  limb  became  strong,  sound  and  useful  in  about 
eight  weeks,  being  shortened  about  one  inch. 

B.  Langenbeok  feared  in  his  case  the  contraction  of  the  muscles  of 
the  calf  of  the  leg,  and  commenced  the  operation  with  the  division  of 
the  tendo  Achillis.  Adaptation  was  easy  and  perfect.  After  the  operation, 
application  was  made  of  sutures ;  rollers  and  warm  water  baths  were 
used.  Union  was  almost  entirely  effected  by  first  intention.  On  the 
24th  day  the  stump  was  sound,  and  calcaneus  and  tibia  firmly  united. 
The  shortening  amounted  to  half  an  inch. 

Ullkich  also  divided  the  tendo  Achillis  before  his  operation,  used 
the  warm  water  bath,  and  obtained  partial  union  by  first  intention,  and 
a  perfectly  solid  stump  in  ten  weeks. 

Sedillot  recommended  the  establishment  of  oblique  cut  surfaces  of 
calcaneus  and  tibia  and  fibula,  also  on  account  of  the  difficulty  which  he 
encountered  in  the  coaptation?  of  the  flaps.  So  far  the  experience  of 
others.     I  will  now  recur  to  my  own  acquaintance  with  the  matter. 

[T'o  be  Contimicd.] 


ABSTRACTS  AXD^ELECTIONS  for  the  PENINSULAR  AND  INDEPENDENT. 

By  M.  A.  Pattersox,  M.  D.,  Tecumseh. 


ON  THE  USE  AND  THE  ABUSE  OP  THE  IODIDE  OF  POTASSIUM!,  AND 
OTHER  ARTICLES  OF  THE  MATERIA  MEDICA.  By  Bernard  KsLLr 
M.  D.,   Physician   to  the   New  York  Dit^pensaiy.     (Am.   Med.  Monthly.) 

The  greater  the  good,  the  greater  the  probability  of  its  being 
abused.  When  the  old  alchemists  were  in  search  of  the  philosopher's 
stone,  whereby  they  sapiently  concluded  they  could  convert  all  things 
into  gold,  whatever  new  substance  they  discovered  in  their  philanthrop- 
ic investigations,  they  soon  endued  with  panaceal  powers ;  hence  the 
great  celebrity  with  dawned^upon  Basil  Valentine's  anti-monastic  metal 
—  Stibium.  This  is  but  a  solitary  instance  of  what  might  be  cited 
of  the  wonderful  credulity  which  tinged  all  the  scientific  theories  of 
the  Middle  Ages.     The  names  which  yet  cling  with  inveterate  tenacity- 


Selected  Articles^  Abstracts^  <&c.  359 

to  many  of  our  officinal  preparations,  only  mirror  too  faithfully  the 
conceited  efficacy  imputed  to  them  by  the  ancient  physicians.  Thus 
the  old  terms,  arcanum  duplicatum^  lignum  vitce,  elixir  salutis,  pro- 
prietatis,  sal  mirabile,  &c.,  &c,,  figure  still  on  the  pages  of  our  phar- 
macopoeias. The  old  Arabian  and  Greek  pathologists  seemed  to  be 
comparatively  free  from  this  pernicious  tendency  of  ascribing  mys- 
terious powers  to  their  remedies.  Indeed,  we  do  not  know  but  that, 
m  this  respect,  they  would  bear  a  very  favorable  comparison  with 
men  of  the  nineteenth  century.  The  origin,  and  ultimate  perfection,  of 
a  science,  often  approximate  in  the  principles  which  endue  it  with 
vitality ;  it  is  only  in  the  intermediate  stages  that  errors  and  false 
speculations  distract  investigators  from  the  path  which  leads  to  just 
and  legitimate  conclusions.  The  works  of  Hippocrates  contain  most 
of  the  practical  and  important  truths  we  find  in  modern  medical 
authors. 

It  is  curious  to  note,  in  the  history  of  our  profession,  the  con- 
flicting shades  of  opinion  which  have  obtained  in  all  ages,  and  all 
climes,  respecting  the  efficacy  of  the  same  medicinal  agent  in  the 
same  disease.  To  pass  over  examples  of  antiquity,  and  select  those  of 
comparatively  recent  date,  colchicum  is  lauded  by  some  to  the  stars, 
as  a  sovereign  specific  in  gout  and  rheumatism,  by  others  deemed 
completely  inert.  Conium,  in  the  hands  of  Baron  Storck,  seldom  or 
never  failed  to  cure  scirrhous  and  cancerous  tumors,  while  others 
only  recognize  in  it  palliative  properties.  The  Rochelle  salt,  in  our 
own  times,  has  acquired  a  world-wide  reputation  in  the  treatment  of 
acute  arthritic  affections,  its  use,  in  such  cases,  being  predicated  by 
the  co-existence  of  uric  acid  in  the  urine,  which  it  is  said  to  neu- 
tralize and  render  alkaline ;  but  rheumatism,  unfortunately,  is  not  the 
only  disease  in  which  a  deficiency  of  urea  and  an  excess  of  uric 
acid  are  discovered,  the  same  thing  being  found  in  all  pathological 
conditions  in  which  the  equilibrium  between  the  respiration  and  cir- 
culation is  disturbed.  Thus,  uric  acid  predominates  in  the  urine  in 
all  fevers  and  inflammations;  more  especially  in  pleuritis  and  pneu- 
monia; the  effete  nitrogenous  matter  of  the  system  not  being  duly 
oxydized,  and  converted  into  urea.  So  that,  if  the  sal  Rochelle  prove 
curative  in  rheumatism,  it  is  not  because  in  changes  an  effect,  not 
a  cause  of  the  disease,  but  in  all  probability  because  it  allays  the 
inflammatory  excitement  by  its  refrigerant  and  purgative  properties. 
As  far  as  we  have  seen  its  efficacy  in  this  complaint,  we  can  not 
say  but  that  the  sulphate  of  magnesia,  or  tartrate  of  antimony,  would 
prove   equally,    if  not   more   curative. 

Either  medicines  vary  in  their  action  at  different  epochs;  or  dis- 
eases change  their  types,  and  grow  unaccountably  rebellious ;  or  phy- 
sicians err  egregiously  in  their  diagnosis:  else  why  this  discrepancy  of 
opinion  with  respect  to   the   virtues  of  therapeutic   agents?     Who    has 


360  The  PeniJisular  and  Independent. 

not  heard  of  the  magic  power  of  Sarsaparilla  in  anihilating  syphilis 
and  all  its  scaly  progeny?  Aladdin  and  his  wonderful  lamp  never  perform- 
ed such  feats,  wrought  such  miracles !  Its  fame  resounded  throughout 
the  length  and  breadth  of  the  land ;  gorgeous  palaces  reared  their 
proud  summits  beneath  the  touch  of  its  golden  wand ;  fierce  litiga- 
tions raged  on  it  head ;  yet  to-day,  there  is  not  one,  even  among  the 
lowliest,  to  do  it  honor.  Sic  transit  gloria  muidi!  For  the  last 
twenty  years,  medicine  has  made  gigantic  strides  towards  the  goal  of 
perfection,  by  reason  of  the  light  which  the  lamp  of  physiology  has 
thrown  upon  the  field  of  its  research.  Pathology,  as  revealed  by  post- 
mortem evidence,  has  done  a  vast  deal.  But  unhappil}'',  there  still 
exists  an  irresistible  proclivity  in  the  minds  of  physicians  to  relapse 
into  the  path  trodden  by  countless  generations,  and  consecrated  by 
antiquity.  The  stale  empiric  leaven  of  the  Middle  Ages  is  not  yet 
entirely  expunged.  Calomel,  that  fnir^  dark  remcd}',  that  two-edged 
sword,  though  not  quite  as  ftishionable  now-a-days  as  some  years  ago, 
is  still  applied  heroically  in  thousands  of  cases,  where  the  resources  of 
nature  alone  are  fully  adequate  to  the  task.  There  is  little  sense,  one 
would  imagine,  in  killing  a  mosquito  with  a  sledgehammer;  but  there 
is  still  less  sense,  and  far  worse  judgment,  in  using  this  formidable  pre- 
paration in  the  treatment  of  diseases,  where,  at  most,  the  spts.  of  min- 
dererus,  or  nitre,  or  ipecac,   would  be  indicated. 

This  brings  us  to  speak  of  an  article  of  the  Materia  Medica  which 
surpasses  in  celebrity,  and  the  extensive  range  of  its  action,  any  thera- 
peutic agent  of  ancient  or  modern  times  —  we  allude  to  the  iodide  of 
potassium.  Had  this  substance  fallen  in  the  way  of  the  inquisitive  al- 
chemists, they  would  have  doubtless  hailed  it  with  the  same  frantic 
demonstrations  of  delight,  as  did  that  philosopher  of  old,  who,  when 
the  solution  to  an  important  question  in  physics,  which  had  long  re- 
mained enshrouded  in  the  darkest  mystery,  burst  for  the  first  time 
upon  his  mental  vision,  ran  naked  through  the  streets,  regardless  of 
modesty  and  everything  around  him,  shouting  out  EureTca !  Eureka  I 
Now,  the  iodide  of  potassium,  though  a  most  valuable  remedy,  is  not 
by  any  means  the  specific  which  the  laudations  and  practice  of  many 
would  lead  us  to  suppose.  AVe  have  seen  it  given  with  a  good  deal 
of  confidence,  on  the  nart  of  the  physician,  to  patients  laboring  under 
confirmed  cardiac  disease,  with  mitral  or  aortic  regurgitation,  where 
an  anasmic  countenance  and  oedematous  limbs  seemed  to  crave  anx- 
iously for  iron;  not  that  the  latter  would  reach  the  disease  any  more 
than  the  iodide,  but  the  distressing  symptoms  of  regurgitation  and 
anasarca  are  very  sensibly  relieved  under  its  judicious  use.  Molasses, 
or  any  other  viscid  substance,  flows  through  a  narrow  aperture,  when 
propelled,  as  the  blood  is,  by  a  sudden,  energetic,  and  brisk  impulse, 
almost  with  the  same  rapidity  as  water  under  the  same  circumstances ; 
whereas,  when  this  power  is  removed,  and  both   fluids   are  left  to  the 


Selected  Articles^  Abstracts^  c£'c.  361 

agency  of  their  own  specific  weight,  there  is  a  vast  difference  in  the 
speed  with  which  each  accomphshes  its  reflux  — the  water,  though 
much  the  lighter  runner,  being  facile  princeps  in  the  race.  In  no 
other  way  can  we  account  for  the  amehoration  of  the  symptoms  in 
cardiac  disease,  especially  when  complicated  with  anaemia,  than  by  a 
knowledge  of  the  important  fact  that  the  blood  acquires  a  greater  de- 
gree of  consistence  and  viscidity  under  the  use  of  chalybeates,  and 
consequently  prevents  more  effectually  its  liquor  sanguinis  from  filter- 
ing through  the  coats  of  the  vessel,  or  promotes  its  absorption,  if  al- 
ready effused,  on  the  principle  of  exosmosis  and  endosmosis.  The  re- 
gurgitation is  also,  for  the  same  reason,  very  materially  diminished. 
The  iodide,  on  the  contrary,  possesses  the  remarkable  property  of 
attenuating  the  blood,  thereby  increasing  the  reflux  current,  and  the 
tendency  to  dropsical  accumulations  —  the  very  accidents  we  desire 
most  anxiously  to  ward  off.  To  be  sure,  under  certain  circumstances, 
it  removes  serous  effusions  by  the  action  of  its  diuretic  property,  but 
this  rule  applies  almost  universally  in  local  inflammations,  and  never 
in  dropsies  complicated  with  anaemia  and  dependent  upon  organic  car- 
diac disease.  Not  by  any  means  the  most  trivial  abuse  of  this  medi- 
cine is  its  wanton  and  indiscriminate  employment  in  all  stages  and 
forms  of  syphilis.  From  the  soft,  non-infecting  sore  to  the  indurated 
chancre,  from  the  serpigenous  to  the  phagadenic,  from  the  primary 
to  the  tertiary,  and  quaternary,  if  there  be  such  a  stage,  it  is  used 
as  the  sine  qua  non^  the  sheet-anchor  upon  which  we  are  to  rest  all 
our  safety   and  expectations. 

Now,  RicoRD  has  shown  (and  in  this  consists,  perhaps,  his  most 
imperishable  claim  to  glory)  that  there  is  but  one  variety  of  the 
primary  sore  that  requires  any  specific  treatment;  that  the  soft,  the 
phagadenic,  the  serpigenous  and  gangrenous  kinds,  far  from  needing 
mercury  or  the  iodide  of  potassium,  are,  on  the  contrary,  generally 
aggravated  by  their  internal  exhibition,  and  improve  under  the  use  of 
iron,  quinine,  and  stimulating  local  applications.  The  only  form  of 
syphilis  in  which  the  iodide  is  admissible  is  the  tertiary,  for  which 
it  may  be  well  termed  a  safe  and  certain  specific.  No  doubt  it  re- 
lieves patients  laboring  under  secondaries,  but  its  action  here  is  pure- 
ly palliative;  it  soothes  the  rheumatic  and  nocturnal  pains,  without 
reaching  their  source;  it  beguiles  the  unhappy  sufferer  into  the  de- 
lusive conviction  that  he  is  rapidly  getting  well,  while,  in  reality,  it 
protracts  and  postpones  his  radical  cure;  in  a  word,  it  is  totally 
incompetent,  though  possessing  great  virtues,  to  compete  with  the  ruth- 
less enemy  which  occupies  the  citadel.  The  disease  must  abate  con- 
siderably in  its  virulence  before  we  can  rationally  rely  upon  this  agent 
as  an  antidote;  hence  its  glorious  achievements  in  all  tertiary  forms. 
But  if  the  iodide  prove  an  unequal  match  in  combatting  syphilis  in 
the  earlier  stages,  there  are  other  maladies  over  which  it  exercises  a 
powerful  control. 


362  The  Peninsular  and  Independent. 

We  know  of  no  better  remedy  in  the  subacute  and  chronic  forms 
of  articular  rheumatism,  when  administered  in  consideraVjle  doses;  say 
from  8  to  10  grs.  for  adults,  and  repeated  every  three  or  four  hours. 
In  the  incipient  stage  of  phthisis,  before  the  tubercles  are  deposited 
to  any  great  extent,  or  previous  to  their  softening,  it  may  be  very 
advantageously  used  with  the  double  view  of  arresting  their  further 
development  and  promoting  their  absorption.  In  the  intermediate 
and  last  stages  of  the  disease,  it  can  never  ligitimately  supersede  the 
use  of  quinine,  iron,  and  cod-liver  oil.  In  chronic  pleuritis  and  the 
gray  hepatization  of  pneumonia  there  can  scarcely  be  a  more  efficient 
therapeutic.  It  seems  to  act  in  such  cases,  not  only  as  a  diuretic,  in 
removing  serous  and  other  abnormal  ell'usions,  but  also  as  a  powerful 
alterative,  in  changing  the  local  morbid  processes,  by  entering  the  cir- 
culation, and  stimulating  the  inflamed  capillaries  to  contraction,  thus 
relieving  the  engorgement  upon  which  the  phlegmasia  depends.  In  a 
word,  it  may  be  reliably  given  in  all  strumous,  subacute,  and  chronic 
inflammations,  wherever  located,  backed  up  by  stimulating  topical  ap- 
plications, when  practicable,  or  not  contra-indicated  by  the  peculiarity 
of  the   case. 


THERAPEUTIC  PROPERTIES  OF  SARSAPARILLA. 

Dr.  A.  M.  Adam,  in  speaking  of  Prof  B(ecker,  of  Bonn  ("Medical 
Notes  from  the  Continent,"  tfcc,  in  Edin.  Med.  Journal,  Oct.  1858),  states 
his  most  recent  pharmacodynamic  experiments,"  which,  I  believe,  are  as 
yet  unpublished,  have  been  made  with  sarsaparilla.  He  informed  me  that, 
after  carefully  performing  ninety-eight  experiments  with  this  drug  on  healthy 
people,  he  found  that,  contrary  to  all  our  usually  received  opinions  on  the 
subject,  it  possesses  neither  diuretic  nor  diaphoretic  properties.  Another 
series  of  twenty-six  experiments,  on  the  persons  of  uncured  syphilitic  pa- 
tients, gave  exactly  the  same  results.  B(ECKer  also  satisfied  himself  that 
sarza  does  not  increase  the  efficacy  of  the  agents,  such  as  iod.  potass.,  »S:c. 
which  are  usually  given  along  with  it;  and  the  good  results  obtained  by 
the  adminstration  of  this  salt,  dissolved  in  that  decoction  of  sarza,  are  in  no 
degree  attributable  to  any  vh-tue  in  the  solvent  fluid.  I  told  Dr.  Bcecker 
that  I  remembered  hearing  Professor  Syme,  many  years  ago,  express  his 
opinion  on  the  utter  uselesness  of  so  expensive  a  drug  as  sarza,  remarking, 
in  his  own  quaint,  forcible  style,  that  he  believed  an  "infusion  of  hay" 
would  be  just  as  good,  and  a  vast  deal  cheaper.  He  seemed  amused,  and 
said  that  he  entirely  agreed  with  Syme  ;  that  infusion  of  sarza  had  no 
greater  effect  on  the  system  than  so  much  common  tea ;  and  that  we  must 
regard  it  merely  as  a  pleasant,  but  very  expensive,  vehicle  for  the  admin- 
istration of  other  medicines." 

[Our  own  clinical  observations  have  led  us  to  the  same  conclusions  as 
have  been  arrived  at  by  the  learned  professor  of  Bonn,  as  to  the  utter  ab- 
sence of  any  therapeutic  properties  in  the  sarsaparilla.] 


Selected  Articles^  Abstracts^  dbc.  363 


THE  ENTERIC  JUICE. 

The  following  are  results  arrived  at  after  numerous  experiments  by 
Professor  Busch,  of  Bonn : 

1.  Hunger  is  constituted  by  two  sensations ;  the  first  is  represented 
by  the  nervous  system  in  general,  and  derived  from  the  impoverished  con- 
dition of  the  tissues;  the  second  originates  with  the  nerves  of  the  digestive 
organs,  indicating  their  emptiness.  The  former  is  removed  only  by  the 
required  assimilation  of  nutritive  elements,  and  not  by  merely  filling  the 
first  passages. 

2.  The  peristaltic  motion  of  the  intestines  takes  place  with  the  same 
power  within  the  abdominal  cavity  as  when  exposed  to  the  atmospheric 
air.  Its  propelling  power  equals  a  column  of  water  twenty-four  inches 
high. 

3.  The  alimentary  canal  has  its  periods  of  rest  and  action. 

4.  The  quantity  of  enteric  juice  secreted  is  invariably  small,  and  of 
alkaline  reaction.     Its  percentage  of  solids  averages  5  •47. 

5.  Enteric  juice  is  capable  of  digesting  amylaceous  and  protein  sub- 
stances. 

6.  Enteric  juice  converts  starch  into  grape  sugar. 

7.  Enteric  juice  prepares  protein  substances  for  assimilation  under 
the  phenomena  of  putrescence. 

8.  Enteric  juice  leaves  cane  sugar  unchanged. 

9.  Cane  sugar,  absorbed  as  such,  is  not  discharged  in  the  urine. 

10.  Fat,  unless  exposed  to  the  action  of  bile  or  pancreatic  juice,  is 
absorbed  either  not  at  all  or  in  insignificant  quantity. 

11.  Food  appears  between  fifteen  or  thirty  minutes  after  being  taken 
in  the  superior  third  of  the  thin  intestine. 

12.  Solutions  of  cane  sugar  disappears  in  part  before  entering  the 
small  intestine;  all  that  enters  the  latter  is  converted  into  grape  sugar. 

13.  Raw  albumen  taken  from  hens'  eggs  is  directly  absorbed  in  the 
stomach  and  the  adjoining  portion  of  the  small  intestine.  All  that  descends 
to  the  lower  portion  of  the  latter  is  unchanged. 

14.  Gum  is  not  converted  into  sugar,  but  remains  unchanged. 

15.  Gelatine  is  dissolved,  and  loses  thereby  its  coagulability. 

16.  Casein  remains  partly  dissolved  in  the  digestive  fluids. 

17.  Fat  is  entirely  emulgated  by  the  digestive  fluids  when  alkaline  or 
neutral,  but  partially  when  acid. 

18.  The  digestive  liquids  of  the  small  intestines  possess  digestive 
powers  over  protein  substances. 

19.  The  minimum  of  all  digestive  fluids  entering  the  small  intestine 
in  the  course  of  twenty-four  hours,  amounts  to  more  than  the  seventeenth 
part  of  the  weight  of  the  body.         [Med.  Times  and  Qaz.^  March  26,  1859. 


ON  JERKING   RESPIRATION   (RESPIRATION  SACCADEE).    By  Dr.  A.  Botjr- 
QADE.     (Archives  geuerales,  Novembre,  1858.)    Brit,  and  For.  Review^  April,  1859. 

Dr.  BouRGADE  is  of  opinion,  and  we  think  justly,  that  the  profession 
have  not  paid  sufficient  attention  to  interrupted  or  jerking  respiration,  as 
one  of  the  earliest  symptoms  of  pulmonary  tubercle.  He  details  nine  cases, 
and  states  that  he  has  observed  others,  in  which  jerking  respiration  heard 
at  the  apex  of  one  lung  was  the  first  auscultatory  phenomenon  indicating 


364  The  Peninsular  and  Independent. 

the  deposition  of  tubercle  subsequently  proved  by  more  palpable  symp- 
toms,and  in  part  confirmed  by  post-mortem  examination.  In  discussing  the 
rationale  of  its  production,  he  quotes  one  post-mortem  examination,  which 
absolutely  disproves  the  views  of  Messrs.  IJAirrii  and  Roger  on  this  point. 
They  hold  that  it  is  due  to  the  presence  of  the  adhesions  which  are  so 
frequently  met  with  at  the  apex  of  the  lungs  in  phthisical  subjects.  In 
the  case  in  question,  there  were  no  adhesions  at  the  apex  or  about  the 
middle  of  the  lung  in  which  the  jerking  respiration  had  been  heard.  It  is 
to  be  remembered  that  the  symptom  is  most  commonly  met  with  at 
a  time  when  no  evidence  exists  of  preceding  or  accompanying  pleurisy ; 
the  character  of  the  sound  and  the  structure  of  the  parts  in  which  it  is 
found  has  always  seemed  to  us  to  justify  our  attributing  it  to  a  partial 
constriction  of  the  smaller  bronchi,  owing  to  adjoining  tubercles  pressing 
upon  them,  the  effort  of  inspiration  causing  the  successive  opening  of  the 
obstructed  passage.  AVe  have  met  with  cases  in  which  spasm  appeared 
to  be  the  cause  of  the  constriction:  but  we  hold  with  Dr.  Bouhgade  that, 
in  the  great  majority  of  cases,  jerking  respiration  is  a  sign  of  tubercular 
deposit. 

"We  would  endorse  the  following  summary  of  observations  made  by 
Dr.  BouRGADE.  Respiration  is  jerking  when  the  respiratory  murmur 
presents  three  or  four  brief  intervals,  and  the  ausculting  ear  experiences 
the  sensation  of  a  certain  difficulty  in  the  expansion  of  the  pulmonary 
tissue  from  the  prolonged  expiratory  murmur.  The  respiratory  murmur 
otherwise  preserves  its  normal  timbre,  and  the  symptom  is  chiefly  obser- 
ved  during  inspiration;  it  occurs,  but  less  frequently,  during  expiration. 
This  change  in  the  respiratory  murmur  does  not  persist  beyond  a  limited 
period ;  a  prolonged  expiratory  murmur  follows,  or,  more  rarely,  pro- 
gressive diminution  of  the  respiratory  sound.  This  fact  probably  explains 
the  circumstances  of  the  S3'mptom  having  been  overlooked  by  many 
hospital  physicians,  who,  seeing  phthisis  chiefly  in  its  more  advanced 
forms,  do  not  meet  with  jerking  respiration  here  as  frequently  as  in 
private  or  extra-hospital  practice.  Jerking  respiration  is  commonly  limited 
to  the  apices  of  the  lungs,  which  we  should  explain  by  the  greater  resist- 
ance of  the  parieties  of  these  parts  favoring  the  pressure  of  tubercle  upon 
the  adjoining  bronchial  tubes.  When  the  patient  is  made  to  breathe 
more  fully,  the  symptom  is  not  rendered  more  palpable,  but  commonly 
disappears  altogether.  Jerking  respiration  is  not  always  continuous,  but 
at  times  presents  regular  intermissions  ;  it  may  occur  at  every  second, 
third,  or  fourth  inspiration,  sometimes  even  a  greater  intervals.  It  is 
chiefly  at  its  first  appearance  that  it  presents  this  character,  but  when 
well  marked  it  is  commonly  continuous  ;  like  other  auscultory  phenomena, 
it  may  vary  in  strength  and  precision  from  day  to  day. 

In  concluding  his  paper,  the  author,  though  attributing  much  more 
importance  to  jerking  respiration  as  an  early  sign  of  pulmonary  tubercle, 
states  he  does  not  regard  it  as  an  absolute  evidence  of  the  deposit  having 


Selected  Articles^  Abstracts,  dbc.  365 

taken  place ;  for  this  purpose  he  justly  requires  the  presence  of  collateral, 
general,  or  local  symptoms. 


RAPIDITY  OF  THOUGHT  OR  NERVOUS    ACTION".     By  M.  Ule,   Revue   Suisse. 

The  method  of  transforming  the  valuation  of  time  into  space  by  the 
rapid  revolution  of  a  cylinder,  proposed  by  Mr.  Fizeau,  has  been  applied 
to  the  measurement  of  the  rapidity  of  nervous  impulse.  Such  a  cylinder, 
rotating  1000  times  a  second,  and  divided  into  360  degrees,  may  measure 
l-3G0,000th  part  of  a  second  ;  or  rotating  1500  times  a  second,  l-540,000th 
part  of  a  second ;  and  even  this  may  be  subdivided  by  a  microscope,  so 
as  to  obtain  the  10-millionth,  or  perhaps  1 00-millionth  part  of  a  second. 
By  this  extreme  minuteness  of  subdivision  of  time,  it  is  not  difficult  to 
measure  even  the  rapidity  of  a  nervous  impulse.  If  an  electric  shock  be 
given  to  the  arm,  it  produces  a  sensation  and  a  contraction  of  the  muscles. 
Hence,  by  noting  the  interval  of  time  between  the  shock  and  the  con- 
traction, the  time  occupied  by  the  transmission  of  the  sensation  and  the 
action  of  the  brain,  hovi'ever  quick,  will  be  determined.  By  trying  the 
experiment  with  different  parts  of  the  body,  sensible  differences  have 
been  observed,  the  shock  applied  to  the  thumb  being  one-thirtieth  of  a 
second  behind  that  applied  to  the  face  ;  and  this  difference  pertains  to 
the  transmission  and  not  to  the  action  of  the  brain,  and  hence  enables  us 
to  eliminate  the  latter  in  the  experiments.  In  this  way  it  has  been  found 
by  M.  Helmdoltz  (by  whom  these  experiments  have  been  made  with  the 
most  care   : 

1.  That  sensations  are  transmitted  to  the  brain  at  a  rapidity  of  about 
ISO  feet  per  second,  or  at  one-fifth  the  rate  of  sound;  and  this  is  nearly 
the  same  in  all  individuals, 

2.  The  brain  requires  one-tenth  of  a  second  to  transmit  its  orders  to 
the  nerves  which  preside  over  voluntary  motion  ;  but  this  amount  varies 
much  in  different  individuals,  and  in  the  same  individual  at  different 
times,  according  to  the  disposition  or  the  condition  at  the  time,  and  is 
more  regular  the  more  sustained  the  attention. 

3.  The  time  required  to  transmit  an  order  to  the  muscles  by  the 
motor  nerves  is  nearly  the  same  as  that  required  by  the  nerves  of  sensa- 
tion to  pass  a  sensation;  moreover,  it  passes  nearly  one-hundredth  of  a 
second  before  the  muscles  are  put  in  motion. 

4.  The  whole  operation  requires  one-and-a-quarter  to  two-tenths  of 
a  second.  Consequently,  when  we  speak  of  an  active,  ardent  mind,  or 
of  one  that  is  slow,   cold,  or  apathetic,  it  is  not  a  mere  figure  of  rhetoric. 

\_Edin.  New  Philosophical  Journal. 


A  NEW  REMEDY  FOR  HYDROPHOBIA.    By  Dr.  Eulenbtjrg. 

On  the  24th  of  August,  last  j^ear,  Guerin-Meneville  submitted  to 
the  Paris  Academy  a  report  on  the  cure  of  hydrophobia  by  the  use  of 
powdered  cetoin,  the  French  name  for  Cetonia  aurata,  the  chemical  exam- 
ination of  which  was  entrusted  to  Berthelot  and  de  Luca.    Nothing  as 


366        -  The  Peninsular  and  Independent, 

yet  has  become  known  of  the  investigations  of  the  Academy,  The  au- 
thor having  occasion  to  obtain  some  information  regarding  the  use  of 
this  remed}',  in  some  parts  of  Russia,  states  that  the  physician  of  the 
Princess  Orloff  had  this  bug  examined  by  Bach,  of  Boppard,  who  found 
it  to  be  Cetonia  aurata,  which,  according  to  rehable  information,  has 
cured  twenty-one  mad  dogs  and  four  cases  of  hydrophobia  in  men. 

The  bug  belongs  to  the  family  of  Scarabaeides,  or  Lamellicornes  of 
Latreille ;  it  is  flat,  has  a  strong  metallic  lustre,  the  body  is  of  a  cop- 
per red,  the  upper  part  of  a  golden  green  color,  it  is  seldom  red  all 
over;  deepened,  curved  lines  run  across  the  sheath  wings,  more  or  less 
marked  with  white  spots ;  size  "G  to  '9  inches.  When  in  danger,  the 
bug  emits  from  all  points  a  grayish  mass  of  a  disagreeable  odor.  Its 
larva  lives  generally  in  the  nests  of  ants  (Formica  rufa),  and  has  been 
collected  in  July  and  August  for  the  above  purpose;  one  teaspoonful 
of  the  powder  is  said  to  be  sufficient  for  men  or  dogs.  It  is  worth 
while  to  draw  attention  to  such  a  simple  remedy. 

Empiricism  has  a  vast  field  with  hydrophobia,  and  probably  no 
where  else  has  the  attempt  been  oftener  made  to  find  a  specific  for  a 
disease.— i>r.    WachteVs  ZeitschrifV—  Wittst.     Viert.  Schr.  VIII.  85,  86. 


MODUS  OPERANDI  OF  CHLOROFORM. 

Dr.  F.  PiossEK  read  before  the  Physiological  Society  of  Greisswald* 
an  account  of  experiments  with  chloroform,  made  under  the  direction  of 
Prof.  HuNEFELD,  which  seem  to  establish  the  following  conclusions  as  to 
the  modus  operandi  of  chloroform,  beyond  a  doubt : 

Chloroform  produces  anaesthesia  by  abstracting  from  the  blood  some 
of  the  oxygen  necessary  to  the  continuance  of  the  organic  processes, 
thus  causing  impaired  nutrition  of  the  central  organs  and  nerves ;  hence 
the  insensibility  of  the  sensatory,  and  the  relaxation  of  the  motory 
nerves. 

The  oxygen  of  the  blood  probably  combines  with  the  carbon  (libe- 
rated by  the  decomposition  of  the  chloroform)  to  form  carbonic  acid, 
while  the  chlorine  and  water  of  the  chloroform  probably  form  hydro- 
chloric acid,  &c.  Into  what  combinations  this  hydrochloric  acid  may  then 
enter  with  the  ingredients  of  the  blood,  is  as  yet  unknown. 

The  other  anaesthetics,  ether,  amylene,  &c.,  act  similarly,  and  their 
modus  operandi  may  be  compared  to  the  narcotizing  or  asphyxiating  ac- 
tion of  carbonic  acid  on  nitrous  oxide.  [  Virg.  Med.  Jour, 


TREATMENT  OF  POISONING  BY  PHOSPHORUS. 

In  France,  numerous  deaths  are  annually  caused,  accidentally  and  by 
design,  from  phosphorns.  Although  this  substance  is  not  often  swallowed 
in  this  country,  yet  the  facilities  for  obtaining  it  are  so  great,  that  we 


Selected  Articles^  Abstracts^  do.  367 

commend  the  following  directions,  in  cases  of  accidents  from  phospho- 
rus, to  the  notice  of  our  readers.  They  are  by  MM.  Antonielli  and 
BoRSARELLi,  and  are  taken  from  the  Journal  de  Chimie  Medicale: 

1.  In  case  of  poisoning  by  phosphorus,  or  by  substances  containing 
it,  it  is  especially  necessary  to  avoid  fatty  substances,  which,  far  from 
opposing  the  action  of  phosphorus  on  the  organs,  increase  its  energy,  by 
facilitating  its  diffusion  in  the  system. 

2.  The  employment  of  calcined  magnesia,  suspended  in  water  which 
has  been  boiled,  and  administered  in  large  quantities,  is  the  best  antidote, 
and,  at  the  same  time,  the  most  convenient  purgative  for  expediting  the 
elimination  of  the  poison.  {Boston  Med.  and  Surg.  Jour. 


THE  EFFECTS  OF  CHALYBEATE  WATERS. 

Mr.  Stanislaus  Martin  observed,  at  Ohateau-neuf,  in  Auvergne, 
that  gallinaceous  and  ruminant  animals  were  exceedingly  fond  of  fer- 
ruginous waters,  but  that  they  exerted  the  mischievous  effect  of  dry- 
ing up  the  milk  of  the  cows.  Wishing  to  see  whether  this  effect 
extended  to  the  human  subject,  he  induced  a  young  mother  to  make 
use  of  some  of  the  strongest  of  these  waters  several  days,  and  the 
result  was,  that  if  she  had  continued  to  drink  them,  all  her  milk 
would  have  disappeared.  From  this  fact,  among  others,  he  cautions 
practitioners  against  prescribing  ferruginous  substances  for  nursing  wo- 
men, except  when  their  employment  seems  clearly  indicated. 

DIAGNOSIS  OP  MELANOTIC   CANCER. 

From  the  Wiener  Wochenschrift^  we  abstract  the  following  remarks 
of  EiSELT,  of  Prague,  on  the  diagnosis  of  this  form  of  cancer  by  chemi- 
cal reagents  on  the  urine.  Dr.  Eiselt  states  that  the  pigment  which 
enters  into  the  composition  of  Melanotic  Cancer  is  more  or  less  re  -  ab- 
sorbed, and  that  it  is  discoverable  by  chemical  analysis  in  the  urine  of 
the  unfortunates  attainted  with  this  affection. 

The  process  is  to  mix  the  urine  with  bichromate  of  potassa  [no 
quantity  is  given] ;  then,  by  the  addition  of  a  few  drops  of  sulphuric 
acid,  the  urine,  if  it  contain  the  pigment  cells  of  the  malady,  becomes 
dark,    according   to    the    proportional    amount   that    may  be  present. 

[Pacific  Med.  <&  Surg.  Journal, 

ALUM  AND  SAVIN  IN  CONDYLOMATA. 

In  those  raised  patches  of  skin,  known  as  mucus  tubercles,  or  con- 
dylomata, existing  about  the  verge  of  the  anus  and  around  the  genitals, 
but  especially  those  which  are  wide-spread  and  flat,  more  extensive  than 
prominent,  Mr.  Coulson,    at  St.  Mary's  Hospital,  has   been  remarkably 


368  The  Peninsular  and  Independent. 

successful  in  producing  the  diminution  of  tlie  swelling  and  causing  them 
to  dry  up,  by  the  application  to  a  powder  consisting  of  equal  parts  of 
alum  and  savin.  This  is  quite  painless,  and  a  cure  is  generally  com- 
pleted in  a  few  days.  \T.ondon  Lancet. 


ACUTE  OTITIS. 

It  is  well  known  that  this  painful  affection  may  occasionally  be 
promptly  relieved  by  the  application  of  one  or  more  of  the  narcotics. 
TnoussEAU,  according  to  the  Journal  Chemie  Medicale,  prescribes  the  fol- 
lowing mixture : 

^.     Extr.  Bclladon.    .....         gr.  xv. 

Aqua q.  s. 

Glycerine     ......         dr.  jss. 

A  little  cotton,  moistened  with  the  liniment,  to  be  placed  in  the  ex- 
ternal auditory  passage. 


CROUP. 

Dr.  PuDON  relates  some  cases,  as  examples  of  the  great  benefit  he  has 
derived  from  the  continuous  application  of  cold  wet  compresses  to  the 
neck,  simultaneously  with  the  administration  of  sulphate  of  copper,  in 
two-grain  doses  every  half  hour ;  sixty-four  grains  having  been  given  in 
one  case,  and  seventy  in  another. 

[Journal  far  Kinderlcranlc.  and  Med.  Jour,  of  N.  Carolina. 


IODINE  AND  MERCURIAL  OINTMENT. 

A  favorite  ointment  in  use  at  St,  Bartholomew's  Hospital  for  removal 
of  obscure  swellings,  depending  upon  inflammation  or  some  other  cause, 
is  ten  grains  of  iodine,  with  a  drachm  of  mercurial  ointment  and  an  ounce 
of  lard.  [lUd. 


POPULAR  REMEDIES  OF  RUSSIA.    By  A.  Rkx,  Chief  Phyeician  to  the  Mines  of 

Snijejiuogorsk,  iu  Siberia. 

Three  years  ago,  an  engineer  from  the  mines  of  Altai,  began  to  suffer 
with  stricture  of  the  urethra,  in  consequence  of  hemorrhoidal  congestion. 
He  was  compelled  to  return  to  the  mines  without  being  able  to  use  the 
remedies  proposed  by  his  medical  adviser.  The  bad  roads,  cold  weather, 
and  want  of  convenient  opportunities  for  the  attention  of  natural  calls,  at 
the  stations,  gave  rise  to  an  orchitis,  which  forced  him  to  stop  a  day  at  Tie- 
men,  in  order  to  apply  leeches  about  the  anus.  He  arrived  a  few  days  af- 
terwards, at  Barnaoul,  suffering  the  most  painful  ischury.  The  introduction 
of  the  catheter  gave  excessive  pain  along  the  prostatic  portion  of  the 
urethra,  and  the  therapeutical  means,  such  as  Belladonna  ointment,  leeches 


Selected  Articles^  Abstracts^  c§<3.  369 

to  the  infra  -  abdominal  region  and  anus,  etc.,  brought  no  relief.  His  suf- 
ferings increased  daily,  when  the  heps  (the  fruit  of  the  wild  dog  rose)  was 
proposed  by  some  sympathizing  bystanders,  and,  without  consulting  his 
physician,  a  handful  was  immediately  browned,  ground,  and  prepared  like 
coffee,  and  the  patient  drank  one  glassful ;  in  half  an  hour  afterwards 
he  passed  three  pounds  of  thick  turbid  urine.  I  arrived  at  the  moment 
relief  had  been  obtained.  He  ascribed  his  recovery  to  the  heps,  altogether 
denying  the  efficacy  of  the  other  remedies  he  had  used.  The  patient  soon 
recovered,  and  has  since  enjoyed  good  health. 

I  determined  afterwards  to  test  the  value  of  this  remedy  in  a  case  of 
strangury  resulting  from  rheumatic  cystitis,  and  it  proved  effective  ;  I  tried 
it  also  in  blennorrhoea,  in  which  it  showed  diuretic  properties  but  failed  to 
cure.  It  has  likewise  proved  useful  in  suppression  of  urine,  in  fevers 
accompanied  with  pain  in  the  renal  region ;  lastly  I  cured  with  it  two  cases 
of  recent  ascites.  The  white  dog  rose  grows  abundantly  on  the  mountains 
of  the  Altai,  and  the  fruit  contains  much  tannin,  and  is  popularly  used  in 
the  form  of  infusion  or  decoction  in  diarrhoea.  For  the  same  purpose  they 
use  a  decoction  of  the  pimpinella  saxifraga ;  garlic  is  also  a  favorite  remedy 
in  this  class  of  affections. 

Among  the  officinal  plants  abundant  here,  aconitum  deserves  particular 
mention.  It  is  gathered  during  and  after  flowering,  dried,  and  preserved  as 
a  remedy  for  colds.  The  following  is  the  manner  in  which  it  is  used : 
When  one  feels,  from  the  ordinary  indications,  that  he  is  "taking  cold," 
he  puts  of  this  herb  ad  lihitum  on  a  piece  of  bread,  lays  down  on  the 
warm  oven,  eats  his  medicated  bread,  and  covers  himself  with  furs ;  this  is 
followed  by  a  profuse  perspiration  and  recovery.  We  will  not  be  astonished 
at  the  excessive  dose,  when  we  reflect  that  many  persons  here  accustom 
themselves  to  mineral  poisons  to  such  a  degree  that  they  drink  large  quan- 
tities of  corrosive  sublimate  with  brandy,  or  take  it  upon  bread  with  appa- 
rent pleasure.  But  they  always  seek  when  using  such  remedies,  a  very 
warm  place,  in  order  to  encourage  perspiration.  In  popular  veterinary 
medicines  aconitum  also  plays  an  important  part. 

Pneumatosis  intestinalis  is  treated  in  the  villages,  with  dried  ant  eggs, 
which  have  a  carminative  influence  so  undoubted,  or  so  strongly  imaginary, 
that  this  agent  is  often  taken  for  amusement,  and  its  hyper  -  action  restrained 
with  alum. 

The  wood  and  bark  of  the  Juniperus  Sabina  are  used  asa  nthelmintics 
in  infusion  or  decoction. 

From  the  Kirghize  Steppe,  dried  apricots  are  imported  into  Siberia, 
and  are  useful  in  chest  complaints,  probably  on  account  of  their  sugar. 
The  remedy  is  popularly  prepared  as  follows  :  The  kernels  are  separated 
from  the  pulp,  and,  with  the  rind  crushed  in  a  mortar,  the  mass  is  placed 
together  with  the  pulp  into  an  earthen  jar.  New  quas  is  then  poured  over 
it,  and  the  jar  closed  up  with  dough,  and  allowed  to  sit  all  night  in  a  warm 
oven.  With  this  preparation  consumption  is  said  to  be  cured ;  but  among 
Vol.  II.  — Y. 


370  The  Peninsular  and  Independent. 

the  people,  every  chronic  chest  disease  is  termed  consumption.  Neverthe- 
less it  has  proved  serviceable  in  pulmonary  catarrhs  and  hemoptysis.  In 
similar  affections,  infusions  of  ccratonia  siliqua,  of  rye -flour,  &c.,  are  also 
used. 

Frequently  also,  the  following  remedy  is  used  in  these  affections :  In 
the  spring,  sprigs  of  the  Larix  Libirica  are  bound  in  bundles,  then  macer. 
ated  in  steam,  and,  while  in  the  hot  vapor  bath,  the  patient  places  them  over 
his  chest  and  face,  and  inhales  their  resinous  odor. 

The  blood  of  a  dog,  used  as  a  bath  while  yet  warm,  is  regarded  as  a 
good  restorative  of  frozen  limbs. 

Among  the  many  remedies  for  epilepsy,  beds  of  partridge  feathers  are 
much  resorted  to.  Though  it  would  be  difficult  to  explain  the  modus  oper- 
andi of  this  remedy,  it  is  highly  praised. 

[Russiafi  Med.  Gazette  and  Louisville  Med.  News. 


RED  AND  DARK  BLOOD.    By   Dr.   Blake. 

'*  One  of  the  most  interesting  physiological  discoveries  that  has  been 
made  for  some  time,  has  just  been  published  by  Bernard,  in  a  memoir  read 
at  the  Academy  of  Sciences  at  Paris,  on  the  25th  January.  The  author  ob- 
serves, '  AYe  sometimes  find  venous  blood  as  red  as  that  in  the  arteries.  I 
have  often  noticed  this  in  the  renal  veins,  but  it  is  not  confined  to  them, 
but  can  be  produced  at  will  in  any  of  the  glands  simply  by  exciting  their 
functions.'  In  an  experiment  cited  by  Bernard  it  is  stated,  '  The  sub- 
maxillary gland  furnished  quite  dark  blood  from  its  veins,  but  on  exciting 
the  gland  by  a  galvanic  current,  the  veins  furnished  red  blood.  On 
arresting  the  galvanic  current  the  blood  again  became  dark,  and  was  again 
red  on  repeating  the  galvanic  stimulus.' 

"The  observation  of  this  interesting  fact  is,  we  think,  of  great  impor- 
tance, not  so  much  as  an  isolated  fact,  but  as  tending  to  lead  to  researches 
on  the  action  of  the  nervous  system  in  secretion.  The  chemists,  we  believe, 
have  had  it  rather  too  much  their  own  way  in  the  investigation  of  physio- 
logical phenomena  during  the  last  twenty  years.  The  observation  above 
cited  proves  that  a  gland  is  something  more  than  a  simple  alembic  or  com- 
bustion tube  into  which  so  much  albumen,  fibrine,  &c.,  enter,  and  which 
turn  out  so  much  urea,  carbonic  acid,  and  water,  through  the  play  of  ordi- 
nary chemical  affinities.  The  experiment  of  Bernard  plainly  points  out 
that  a  dynamic  element  conveyed  by  the  nerves,  exerts  at  least  a  powerful 
influence  in  modifying  the  reactions." 

[Pacific  Medical  and  Surgical  Journal. 


TESTS  TO  ASCERTAIN  THE  GENUIXEXESS  OF  BALSA:M  OF  COPAIBA. 

M.  Guibourt,  being  one  of  a  commission  appointed  by  the  £cole  de 
Pharmacie  de  Paris  to  examine  and  report  on  the  quality  of  the  copaiba 


Selected  Articles^  Abstracts^  c&c.  371 

contained  in  the  capsules  manufactured  in  such  great  variety  at  the 
present  day,  took  advantage  of  the  opportunity  to  examine  the  different 
samples  of  this  drug  found  in  commerce,  so  as  to  find  the  best  means  of 
recognizing  the  purity  of  this  vegetable  product. 

Copaiba  is  not  the  product  of  a  single  tree,  but  is  drawn  from  seven  or 
eight  species  of  Copaifera  growing  in  America,  from  the  Brazils  to  Mexico 
and  the  Antilles.  Thus  it  happens,  that  this  oleo  -  resinous  balsam  may 
vary  very  much  in  its  consistence,  color,  odor,  and  even  in  its  chemical 
characters  and  composition,  and,  therefore,  we  should  be  very  circumspect 
before  pronouncing  it  to  be  adulterated. 

Having  taken  a  balsam  of  known  purity  as  the  type  of  the  best  copaiba, 
and  to  serve  as  a  guide  in  the  estimation  of  the  other  sorts,  he  adopted  the 
following  tests,  in  each  case,  as  characteristic  of  good  copaiba:  — 

One  part  of  the  balsam  mixed  with  two  parts  sulphuric  ether. 

One  part  of  the  balsam  mixed  with  two  parts  absolute  alcohol. 

One  part  of  the  balsam  mixed  with  ten  parts  spirit  of  wine. 

One  part  of  the  balsam  mixed  with  two-fifths  of  its  weight  of  pure 
strong  solution  of  ammonia,  at  60*^  Fahr, 

One  part  of  the  balsam  mixed  with  one-sixteenth  of  its  weight  of  re- 
cently calcined  magnesia,  and  triturated  some  time  in  a  mortar;  then  intro- 
duced into  a  bottle,  and  corked. 

One  part  of  the  balsam  treated  in  the  same  manner,  with  one-fourth  of 
its  weight  of  carbonate  of  magnesia. 

One  or  two  drachms  of  the  balsam  boiled  in  three  or  four  pints  of  water, 
till  the  liquid  is  reduced  to  half  a  pint. 

From  a  great  variety  of  samples,  all  treated  in  the  same  manner,  the 
Professor  deduced  the  following  conclusion :  — 

1.  A  copaiba  which  possesses  the  four  properties:  First,  of  being 
entirely  soluble  in  two  parts  of  absolute  alcohol ;  Second,  to  form  at  the 
temperature  of  GO*-'  Fahr.  a  transparent  mixture,  with  two-fifths  of  its  weight 
of  a  strong  solution  of  ammonia;  Third,  to  solidify  with  one-sixteenth  of 
its  weight  of  calcined  magnesia;  Fourth,  to  produce  a  dry  and  brittle  resin 
after  prolonged  ebullition  with  water,  is  a  balsam  which  is  certainly  pure ; 
and  those  which  present  these  four  properties  are  to  be  preferred  to  all 
others. 

2.  The  last  character  is  an  indispensable  complement  to  the  three  first, 
which  alone  are  not  sufficient  to  certify  the  purity  of  the  balsam.  On  the 
other  hand,  one  or  two  of  the  first  characters  may  be  wanting,  without  ne- 
cessarily involving  the  adulteration  of  the  balsam.  When  these  characters 
are  wanting,  we  must  try  to  discover  the  presence  of  some  foreign  sub- 
stance ;  but  unless  we  can  prove  its  presence,  we  must  not  conclude  that 
the  balsam  has  been  adulterated  —  it  may  arise  from  some  unknown  pro- 
perties in  the  variety  of  the  tree  from  which  it  is  produced. 

3.  The  characters  drawn  from  the  action  of  ammonia,  and  of  calcined 
and  carbonate  of  magnesia,  and  which  have  been  regarded  as  the  most  cer- 
tain means  of  detecting  the  adulteration  of  copaiba  by  a  fixed  oil,  are  far 
fVom  possessing  that  value  which  has  been  assigned  to  them.  The  soft 
state  of  the  resin  of  copaiba,  deprived  of  its  volatile  oil  by  boiling  in  water, 
is  a  much  more  certain  test  of  this  falsification. 

[Journal  de  Pharmacie  and  The  Druggists 


372  The  Peninsular  and  Independent, 


SENNA  LEAVES. 

Messrs.  Bley  and  Diesel  have  submitted  Senna  obovata,  S.  Alexandrina, 
and  S.  Tinnevelly  to  chemical  examination,  and  obtained  the  following  re- 
"^ult :  Volatile  oil  and  malic  acid  could  not  be  discovered  in  the  senna.  The 
leaves  of  Cassia  lanceolatte  and  of  C.  obovata  left  eleven  or  twelve  per  cent, 
of  alkaline  ashes,  in  which  chloride  of  potassium,  traces  of  lime,  magnesia, 
and  soda,  were  found  mostly  combined  with  carbonic  acid,  and  also  phos- 
phoric and  silicic  acids.  Senna  leaves  also  contain  a  peculiar  yellow  resin, 
probably  the  same  which  Feneulle  obtained  in  the  impure  state  from  senna 
pods.  Messrs.  Bley  and  Diesel  call  it  Chrysoretin.  The  brown  resin  and 
brown  extractive  matter,  which  was  called  by  Lassaigne  and  Feneulle, 
Cathartin,  can  not  be  completely  separated  from  each  other.  Pectin,  gum- 
my extractive  matter,  chlorophylle,  and  a  small  quantity  of  fat,  were  also 
found. 

Although  the  authors  were  not  able  to  isolate  the  active  principle,  3''et 
they  are  of  opinion  that  Alexandrian  senna  is  more  active  than  either  the 
obovata  or  Tinnevelly  senna,  because  it  yields  a  larger  quantit)''  of  a  spirit- 
uous extract,  having  a  superior  odor  and  taste.  This  property  is  used  as 
a  measure,  for  spirit  of  wine  also  dissolves  almost  all  the  constituents  which 
water  takes  up  from  the  leaves.  At  the  same  time,  it  is  observed  as  a  stri- 
king circumstance  that  the  alcoholic  extract  of  half  an  ounce  of  senna 
(which  had  been  perfectly  exhausted  by  spirit  of  wine)  produced  only  nau- 
sea and  uneasiness,  and  could,  therefore,  contain  but  little  of  the  active  prin- 
ciple. As  regards  experiments  concerning  the  efficacy  of  the  individual 
constituents  of  senna,  we  have  the  following  results: — The  chrysoretin,  in 
doses  of  from  thirty  to  fort3'-five  grains,  remained  without  efl'ect;  the 
brown  resin,  in  doses  of  from  fifteen  to  eighty  grains  did  not  operate  upon 
the  bowels,  but  merely  caused  nausea,  and,  in  larger  doses,  vomiting.  In 
large  doses  of  sixty  grains  it  appeared  to  operate  as  a  diuretic,  and  could 
be  detected  after  a  short  time  in  the  urine,  in  consequence  of  the  color 
which  it  assumes  on  the  addition  of  potash.  The  so  called  carthartin,  in 
doses  of  two  and  a  half  to  three  drachms,  caused  only  nausea  and  dis- 
agreeable eructation,  without  operating  upon  the  bowels. 

These  experiments  tend  to  show  that  the  individual  constituents  ex- 
tracted by  spirit  of  wine  from  the  senna  leaves,  as  well  as  their  aggregate, 
do  not  purge.  The  authors,  however,  doubt  the  statement  of  Heerlein, 
that  spirit  of  wine  only  extracts  from  the  leaves  macerated  in  it  inert  sub- 
stances, and  none  of  the  active  principle.  The  final  result  to  which  they 
are  led  by  their  examinations  is,  that  odor,  taste,  relation  to  chemical 
agents,  and  medicinal  powers  of  senna  depend  chiefly  on  the  co-operation  of 
the  extractive  matter'  and  the  resin,  and  only  in  a  subordinate  degree  on 
the  pectin,  the  pectates,  and  the  other  salts  of  the  leaves.  No  share  in  the 
activity  can  be  ascribed  to  the  volatile  oil,  as  no  appreciable  quantity  of  it 
can  be  procured.  {Pharmaceut.  Cen.  Blatt.  and  Tlie  Druggist. 


Selected  Articles^  Abstracts^  dbc.  373 


THE  ACTION  AND  USES  OF  DIGITALINE. 

MM.  Homolle  and  Quevenne  have  stated,  as  the  result  of  their  ex- 
perience, that  in  doses  of  one  seventy-fifth  of  a  grain,  given  three  times  a 
day,  this  substance  acts  as  a  diuretic  in  general  dropsy,  and  with  great 
speed  and  efficacy  in  reducing  the  effusion;  and  that  it  is  not  rendered 
more  certain  by  any  material  increase  of  the  dose.  They  further  found 
that,  in  about  double  this  dose,  and  sometimes  in  the  same  dose,  it  re- 
duces greatly  the  frequency  of  the  heart's  action ;  and  that  the  dose  can  not 
reach  the  one-twelfth  of  a  grain  without  producing  nausea  and  symptoms 
of  incipient  poisoning.  Dr.  Christison,  in  the  Monthly  Journal  of  Medical 
Science  Jan.,  1855,  gives  us  the  result  of  his  experience  of  its  use.  He 
believes  it  to  be  an  energetic  diuretic  and  sedative.  His  first  two  trials  of 
it  were  made  in  cases  of  extensive  renal  anasarca.  In  one  case,  diuresis 
commenced  towards  the  close  of  the  second  day,  and  in  the  other  a  day 
later ;  in  both  the  flow  was  profuse,  and  the  oedema  entirely  disappeared. 
He  commends  strongly  the  use  of  such  diuretics  as  digitalis,  squill,  and  bi- 
tartrate  of  potash,  in  renal  dropsy.  He  has  not  found  them,  except  in  one 
instance,  increase  the  albumen  in  the  urine ;  and  believes  they  have  been 
shunned  on  grounds  purely  theoretical  and  baseless.  It  is  the  same  with 
digitaline.  In  the  first  of  the  two  patients,  the  albumen  quickly  and  great- 
ly diminished ;  in  both  it  disappeared  at  last,  but  in  one,  after  some  days, 
reappeared,  but  in  diminished  proportion.  In  one  instance,  great  depres- 
sion of  the  heart's  action  was  brought  on,  instead  of  a  flow  of  urine.  He 
thinks  it  very  likely  that  diuretic  and  sedative  actions  do  not  concur.  He 
gives  it  in  the  doses  recommended  by  Homolle  and  Quevenne. 

{^Association  Med.  Journal. 

TREATMENT  OF  VARICOSE  VEINS  BY  BLISTERING. 

According  to  the  Lancet  for  July,  palliative  treatment  is  usually 
resorted  to  at  St.  Mary's  Hospital,  in  cases  of  varicose  veins.  The 
radical  treatment  usually  preferred  consists 

"  In  the  application  of  pins  or  needles  beneath  the  vein,  laying  apiece 
of  bougie  over  it,  and  then  applying  the  twisted  suture  around  the  pin  and 
over  the  bougie.  Failure  by  this  method  is  comparatively  rare.  Latterly, 
Mr.  Ure  has  treated  several  cases  of  varix  successfully  by  repeated  blister- 
ing over  the  veins,  the  result  being  consolidation  and  consequent  oblitera- 
tion. A  radical  cure  is,  therefore,  effected  as  completely  as  when  the 
needles  have  been  employed." 


IODIDE  OF  SODIUM. 

From  the  same  authority  we  learn  that  Dr,  Alexander  Ure,  re- 
commends the  substitution  of  Iodide  of  Sodium  for  the  Iodide  of  Po- 
tassium.      He  asserts   that   "Iodide  of  sodium  is  a  blander  salt,  more 


3V4  The  Peninsular  and  Independent.  • 

assimilable,  and  better  borne  by  the  stomach  than  iodide  of  potassium, 
and  much  less  prone  to  produce  iodic  disturbance,"  while,  as  a  the- 
rapeutic agent,  it  is  as  eflBcient  as  the  iodide  of  potassium.  Uose  : 
Four  to  six  grains,  twice  or  thriced  daily,  dissolved  in  plenty  of  liquid. 


WHOOPING  COUGH. 

"We  notice  in  the  Semi -Monthly  Xeics,  that  a  letter  from  Har- 
vey A.  Hall,  Surgeon  Accoucheur  to  the  Royal  Pimlico  Dispensary, 
states  that  the  writer  has  seen  marked  and  speedy  benefit  from  the 
application  of  one  or  more  blisters,  from  the  size  of  a  crown  piece 
and  upwards,  according  to  the  age  of  the  child,  to  the  back  of  the 
neck,  as  high  up  as  possible  in  the  hollow  between  the  insertion  of 
the  extensor  muscles,  and  encroaching  a  little  upon  the  scalp.  The 
blister  should  be  removed  after  four  or  five  hours  and  a  warm  lin- 
seed meal  poultice  applied.  The  effect  of  this  mode  of  treatment  is 
to  lessen  the  convulsive  character  of  the  cough  within  twenty -four 
hours,  sometimes  to  suppress  its  spasmodic  character  entirely.  The 
more  convulsive  the  cough,  the  more  marked  the  effect  of  the  blis- 
ter; but  in  bad  cases  it  is  necessary  to  repeat  the  blister  when  the 
first  has   healed. 

Mr.  Hall  says 

"  He  has  now  treated  a  considerable  number  of  cases  on  this  plan,  and 
in  only  one  instance  has  the  blister  failed  to  produce  a  decided  benefit;  but 
in  this  case,  on  a  second  blister  having  been  applied,  the  mother  reported 
at  her  next  visit  that  the  child  had  been  very  much  better  ever  since." 

His   constitutional   treatment   is   simple. 


CONDY'S  FLUID  IN  ULCERATED  SURFACEP. 

This  fluid,  "  which  is  prepared  by  dissolving  half  drachm  of  per- 
manganate of  potash  in  a  pint  of  water,"  has  been  applied  in  the 
hospitals,   as  stated  by  the  reporter   of   the   Lancet,   with  advantage 

"  In  cases  of  burns,  large  ulcers,  and  suppurating  surfaces  arising  from 
any  cause,  especially  where  the  secretions  are  not  only  copious,  but  at  the 
same  time  offensive.  This  fluid  prevents  any  foetor  arising  from  suppura- 
tion. It  was  employed  in  cases  of  cancer  of  the  breast,  from  which  there 
had  been  a  very  foul  discharge ;  also,  with  apparent  benefit,  in  obstinate  uU 
cers  of  the  legs." 


STOMATITIS  MATERNI. 

Dr.   David   Prince,   of    Jacksonville,  Illinois,   writes  to   the  editor 
of  the    Chicago  Medical  Journal,   July,    1859,    that 

"Nursing  sore  mouth  is  endemic  in  and  around  Jacksonville;  that  the 
treatment  in  this  region  has  come  to  be  a  settled  and  sure  thing.     It  is  very 


Selected  Articles^  Abstracts^  c&c,  *  375 

rarely  the  case  that  a  nursing  mother  is  required  to  wean  her  child  on  ac- 
count of  this  aflfection,  unless  it  has  become  obstinate  by  neglect,  and  the 
general  health  reduced  by  its  irritation  and  the  attendant  inability  to  take 
nourishment. 

"  The  favorite  remedy  is  iodide  of  iron.  The  liquor  ferri  iodide  of  the 
U.  S.  D.  is  combined  with  an  equal  quantity  of  compound  Syrup  of  Sarsa- 
parilla,  for  the  more  agreeable  taste,  and  of  this  a  common  sized  tea-spoon- 
ful is  directed  to  be  taken  three  times  a  day.  In  nine  cases  out  of  ten  this 
cures,  whether  before  or  after  delivery."  *******  "  Q^jie 
next  remedy  in  favor  is  the  chlorate  of  potash.  A  saturated  solution  is 
used  both  as  a  local  application  and  an  internal  remedy.  A  tablespoonful 
of  the  solution  may  be  held  in  the  mouth  for  a  few  seconds  and  then  swal- 
lowed, or  if  only  a  local  application  is  intended,  it  can  be  thrown  out  of  the 
mouth.  This  may  be  done  from  three  to  twelve  times  a  day.  The  two 
remedies  may  be  used  singly  or  in  combination." 


PURITY  OF  OPIUM. 

When  physicians  prescribe  opium  or  its  preparations,  can  they 
foretell  with  certainty  the  effects  of  the  medicine?  In  other  words, 
is  it  possible  to  estimate  with  precision  the  purity  and  strength  of 
opium?  An  important  and  highly  practical  question,  which  a  Paris 
ian  chemist,  Mr.  Bekthe,  inquires  into  and  answers  in  the  negative 
in   various   Memoirs   presented   to  the   Academy   of    Medicine. 

In  order  that  the  estimation  referred  to  should  be  practicable,  the 
merchants  should  be  in  a  position  to  supply  invariably  samples  of 
uniform  strength.  Now  nothing  can  possibly  be  more  variable  than 
the  composition  of  this  substance,  and  in  order  to  prove  this  asser- 
tion, Mr.  Berthe  describes  a  series  of  researches  instituted  by  him- 
self on  the  subject. 

IGO  cakes  of  Smyrna  opium  were  weighed  and  found  equivalent 
to  35  kilogrammes  (92  lbs.).  From  each  cake  5  grammes  (80  grs.) 
were  abstracted,  and  the  160  fragments  were  manipulated  into  one 
homogeneous  mass  of  the  weight  of  800  grammes  (about  2  lbs.). 
This  mass,  representing  exactly  the  mean  composition  of  the  160  cakes, 
was   analysed  and   yielded   8  1-4   grammes   per   cent,   of  pure  morphia. 

On  the  other  hand,  twelve  pieces  of  opium  were  taken  at  ran- 
dom among  160  cakes,  and  were  separately  examined.  These  opiums 
designated  by   numbers   were   found   to   contain: 


Opium 

No 

1, 

6       per  cent. 

of 

morphia. 

u 

2, 

7-10 

(( 

3, 

9-05         " 

u 

4, 

6-10         " 

(( 

5, 

9-15         " 

(( 

6, 

5-15         " 

(( 

T, 

8-25 

(( 

8, 

6-50         " 

(( 

9, 

6-25 

(( 

10, 

9-50         " 

(( 

11, 

8-75 

i( 

12, 

9-25         " 

376  Tlui  Peninsular  and  Independent, 

Thus,  an  opium  of  excellent  quality,  yielding  on  an  average  8  1-4 
per  cent,  of  morphia,  is  constituted  by  the  kneading  together  of  cakes 
of  course,  destined  to  be  sold  as  they  were,  for  the  most  part  sepa- 
rately, and  varying  from  each  other  as  nmch  as  45  per  cent,  with  re- 
gard to  their  alkaloid  contents. 

From  this  fact,  Mr.  Bektiie  concludas  that  in  medical  practice 
opium  should  Ijc  replaced  by  its  alkaloids,  and  among  which  he  prefers 
codeia. 

It  is,  however,  but  fair  to  add  tliat  the  estimation  of  the  strength 
of  opium  does  not  appear  to  all  chemists  so  impossible  a  task  as  repre- 
sented by  Mr.  Bektiie.  Thus,  since  this  gentleman's  communications, 
the  Academy  has  received  a  letter  from  Mr.  Aubergeii,  of  Clermont- 
Ferrand,  who  states  that,  having  made  inquiries  into  the  production  of 
opium  into  the  Levant,  he  can  ])rocure  without  difficulty  opium  war- 
ranted to  contain  10  per  cent,  of  morphine.  The  only  condition  re- 
quisite for  the  purpose  of  obtaining  samples  of  equal  strength,  is  when 
French  opium  is  deficient,  to  procure  the  drug  in  the  Levant  before  it 
has  undergone  adulteration.  Mr.  Auheiuher,  founding  himself  upon 
his  information,  and  upon  sixteen  years  experience  of  the  business, 
undertakes  to  furnish  the  trade  with  opium  warranted  to  contain  10 
per  cent,   of  morphia,   and  always  of   unvarying   strength. 

[Champa iiniere' 8  Journal^  from  The  DruggUt. 


HYDROPnONE. 

At  a  late  meeting  of  the  Academy  of  Medicine,  Paris,  a  report  was 
made  on  the  use  of  the  stethoscope,  in  which  the  advantages  of  the  various 
instruments  were  discussed.  Among  others  were  mentioned  those  in- 
vented by  our  distinguished  fellow  -  citizen,  Dr.  Cammaxx,  and  by  Dr. 
Makph,  of  Cincinnati.  A  new  medium,  called  by  the  inventor  (Dr.  Scott 
Alison,  of  the  Consumptive  Hospital,  London)  a  Uydrophone,  was  also 
mentioned.  This  is  a  small,  thin  india-rubber  ball,  filled  with  water, 
which  is  placed  on  the  part  to  be  auscultated ;  the  ear  is  then  directly 
applied  over  the  ball,  or  it  is  covered  by  the  inferior  outlet  of  a  stetho- 
scope. By  means  of  this,  normal  and  abnormal  sounds  are  transmitted  to 
the  ear  with  greater  distinctness. 


NEW  METHOD  OF  RELIEVING  RETENTION  OF  URINE. 

Mr.  Langston  Parker,  Surgeon  to  the  Royal  Hospital,  Birmingham, 
proposes  a  new  method  of  relieving  retention  of  urine,  when  it  is  not  pos- 
sible to  pass  the  catheter  in  the  ordinary  manner.  To  the  end  of  a  small 
flexible  bougie  is  accurately  fitted  a  piece  of  potassa  fusa,  pointed,  and  the 
flexible  material  moulded  around  it,  leaving  only  the  point  exposed ;  the 
instrument  is  then  passed  rapidly  down  to  the  point  of  obstruction,  where 


Selected  Articles^  Abstracts^  dbc.  377 

pressure  is  kept  up  for  a  few  moments,  after  which  the  obstruction  will 
give  way,  the  instrument  pass  and  the  patient  be  relieved.  It  will  be  well 
to  direct  the  patient  to  make  an  effort  to  pass  water  while  the  surgeon 
withdraws  the  bougie. 


SCURVY  OF  THE   GUMS  TREATED  BY  XIT.   ARGENT. 

Dr.  Faris,  of  Marlborough,  Tennesse  in  a  communication  to  the 
editors  of  the   Nashville  Journal  of  Medicine  and  Surgery,   states: 

"  In  the  course  of  last  year  I  have  cured  upwards  of  one  hundred  cases 
of  scurvy  by  a  solution  of  nitras  argenti.  Canterizing  the  gums  once  or 
twice  effectually  cures.  I  have  never  heard  or  read  of  this  practice ;  it 
originated  with  myself.  The  analogical  mode  of  reasoning  is  the  only  true 
mode,  and  this  satisfied  me  that  if  other  sore  surfaces  could  be  cured  by 
the  nitrate,  the  gums  could." 

A   rational  conclusion ;    as   the   remedy,  has  been  used  in  the  west 

for  years,   not  perhaps   as   a  specific,    but    as  an  adjuvant   in   cases  of 

scorbutic  gums. 


NEWS  ITEMS. 


The  so-called  Persian,  but  properly  termed  Caucasian  insect-powder, 
has  long  been  known  to  the  Trans-Caucasian  populations,  under  the  name 
of  "Guirila."  In  that  paradise  of  vermin  it  is  an  article  of  a  very  con- 
siderable commerce,  and  is  not  only  carried  inland  through  Russia  in  large 
quantities,  but  is  also  exported  to  Germany  and  France.  A  large  depot 
exists  at  Vienna.  It  is  a  coarsely  ground  powder  of  a  green  color,  and 
penetrating  odor,  formed  of  the  flowers  of  the  'pyrethum  carneum,  and 
roscinn,  which  grow  in  the  Trans-Caucasus  at  a  height  of  5000  or  6000  feet. 
This  powder  possesses  the  peculiarity  of  rapidly  stupifjang  the  insects, 
which  soon  afterwards  die.  Strown  about  the  room  or  the  bed,  it  proves 
a  poison  to  fleas,  lice,  flies,  &c.  In  the  military  hospitals  in  hot  countries 
it  is  an  invaluable  preventive  of  the  formation  of  maggots  in  wounds,  and 
the  more  so  inasmuch  as  its  use  is  attended  with  no  disadvantage,  unless 
employed  in  large  quantities  in  closed  bed-rooms,  when  it  may  give  rise  to 
confusion  in  the  head,  such  as  is  produced  by  flowers  or  new  hay.  It  has 
been  long  used  as  a  means  of  preserving  insects  ;  and  can  not  be  strongly 
recommended  to  those  who  have  the  care  of  herbarian  and  other  natural 
history  collections,  liable  to  the  depredations  of  insects.  Unfortunately  the 
demand  for  the  powder  has  been  so  great  of  late  as  to  lead  to  its  adultera- 
tion by  the  addition  of  the  stalks  and  leaves  of  the  plants  to  the  flowers, 
and  to  the  mixing  of  the  new  with  stale  powder.  As  a  general  rule,  the 
powder  purchasable  in  Germany  is  very  different  from  the  Asiatic  in  color, 
smell,  and  efficiency.  —  Buchner^s  Report. 

In  Japan,  the  physicians  have  no  system  of  medicine,  and  are  guided 
only  by  their  experience.  Many  use  shells  and  exorcisms;  and  most  of 
them  become  rich.  Many  plants  are  held  in  great  medicinal  esteem,  and 
some  roots,  chief  among  these  the  ginseng,  are  brought  to  Japan  by  the 
Chinese  and  Dutch.     Among  the  medicines  which  are  prescribed,  the  acids 


378  The  Peninsular  and  Independent. 

and  salts  predominate.  When  they  are  well,  the  Japanese  drink  water  only 
when  it  is  hot ;  when  they  are  sick,  they  are  ordered  to  drink  as  much  cold 
water  as  they  like,  and  they  drink  a  great  deal.  A  common,  and  one  of 
the  most  terrible  diseases  in  Japan,  is  the  Senki,  a  kind  of  colic,  which  is 
usually  treated  with  bloodletting  in  the  lower  part  of  the  body  by  means 
of  a  needle.  Great  stress  is  laid  on  the  making  of  those  needles.  They 
must  be  of  gold  or  silver,  without  alloy,  and  nnist  have  a  high  polish  and  a 
very  fine  point.  Nobody  is  allowed  to  make  them  without  a  patent  from 
the  Emperor.  This  manner  of  bloodletting  is  also  used,  by  those  who  can 
afford  it,  in  cholera. 

The  poorer  classes  use  a  bitter  powder,  a  principal  ingredient  of  which 
is  the  costus,  a  plant  brought  by  the  Dutch  from  Surat.  The  discoverer  of 
this  powder  became  so  rich  by  its  sale  that  his  heirs  have  built  three  tem- 
ples in  Yeddo,  to  express  their  gratitude  to  God  for  it.  Opposite  these 
temples  are  three  shops,  where  they  prepare  and  sell  the  powder. 

Yeddo  has  lately  lost  150,000  people  by  cholera. 

There  are  17  licensed  physicians  in  Valparaiso.  Of  these  5  are  English- 
men; 2,  Frenchmen;  2,  German;  1,  North  American;  3,  Chilians;  1 
Spaniard;  and  two  others  whose  nationality  I  am  ignorant  of  The  oldest 
of  these  is  Dr.  Cox,  whose  diploma  dates  from  1813. 

Foreign  physicians  coming  here,  have  to  render  an  examination  before 
the  Medical  Board  in  the  Capital.  This  examination  is  conducted  in 
Spanish  exclusively.  AVithout  passing  it,  no  one  can  practice  in  any  part 
of  the  Republic,  where  any  licensed  physician  resides  without  his  consent; 
although,  in  towns  where  there  is  no  doctor,  a  new  comer  unexamined, 
may  practice  unhindered,  provided  he  show  proof  that  he  has  been  admit- 
ted somewhere  else. 

Law  is  the  most  popular  of  all  professions.  The  foolish  old  Roman 
idea  exerts  an  influence  against  young  men  entering  the  medical  profes- 
sion, as  if  it  were  not  full  caste. 

There  are  ten  druggists.  No  man  can  be  a  druggist  and  practicing 
physician  at  the  same  time.  No  man  can  own  more  than  one  drug  shop. 
Of  the  ten,  five  are  Chilians,  and  five  are  Germans. 

There  is  now  going  up  in  Twenty  -  third  street,  near  Sixth  avenue, 
New  York,  a  splendid  edifice  for  the  "  College  of  Veterinary  Surgeons," 
which  is  to  cost  about  !^-iO,000. 


Iprmat^utital  i^prtmnU. 


New  Chalybeatcs. 

A  dispute  has  recently  arisen  in  Boston,  between  two  prominent 
Pharmaceutists,  concerning  the  relative  merits  of  a  new  chalybeate 
syrup,  which  is  made  by  each,  and  sold  under  the  title  of  "  Un- 
changeable Solution  of  Protoxide  of  Iron,"  but  which,  as  made  by 
Mr.  Cakxey  differs  in  appearance  from  that  made  by  Mr.  Nickols.  A 
friend  of  the  latter  gentleman  having  called  in  question,  in  the  pages 
of  the  Boston  Medical  and  Surgical  Journal,  the  honor  and  integ- 
rity of  the  former,  he  (Mr.  Carney)  has  published  analyses  of  both 
preparations,  from  which  it  appears  that  both  are  solutions  of  proto- 
carbonate  of  iron  in  acetic  or  citric  acid,  rendered  syrupy  by  means 
of   sugar. 

There  is  no  novelty  in  these  preparations,  and  we  can  not  see 
their  therapeutical  value  to  be  as  great  as  that  would  be  arising 
from  the  use  of  the  proto  -  carbonate  of  iron  itself,  in  the  usual  form 
of  Vallet's  mass,  or  pills.  It  is  true  that  Vallet's  mass  is  incon- 
venient, but  Danne^y  has  recently  proposed  its  solution,  by  a  simple 
and  ready  means — that  is,  in  simple  syrup;  it  being  found  that  when 
in  a  nascent  state  it  dissolves  slowly  and  unchanged  in  this  ve- 
hicle. 

We  do  not  know  of  any  chalybeate  less  objectionable,  and  more 
prompt  and  more  efficient,  than  the  proto  -  carbonate ;  and  when  this 
is  dissolved,  it  certainly  forms  an  acceptable,  as  well  as  convenient, 
form   of   medicament. 

In  the  last  Volume  of  our  Journal,  we  printed  the  process  of 
Danne^y   for  preparing  this  syrup ;     and  now   here  again   insert  it : 

Dannegy''s  Syrup  Proto  -  Oardonate  of  Iron. 
Take  of  purified  protosulphate  of  iron,  two  ounces ;  distilled  water, 
sixteen  ounces  ;  white  sugar,  two  ounces ;  dissolve  with  ebullition,  and  fil- 
ter. Secondly,  take  of  crystallized  carbonate  of  soda,  two  and  a  half 
ounces;  distilled  water,  sixteen  ounces;  white  sugar,  two  ounces;  dissolve 
with  ebullition,  and  filter.  When  the  two  solutions  have  cooled,  mix  them 
in  a  glass  vessel  and  shake  for  a  moment ;  a  precipitate  is  formed,  which  is 
at  first  white,  but  soon  becomes  a  greenish  -  gray  color,  preserving  this 
shade.    Allow  this  precipitate  to  collect  during  twenty-four  hours ;   decant. 


380  The  Peninsular  and  Independent. 

Afterwards  take  a  solution  of  sugar  in  the  following  proportions:  white 
sugar,  two  and  a  half  ounces;  distilled  water,  ten  ounces ;  dissolve  with 
ebullition  and  filter.  Add  the  precipitate  to  this  saccharine  fluid  when  cold  ; 
set  it  aside  to  rest ;  decant.  Repeat  this  process  once  more,  in  order  to  re- 
move the  sulphate  of  soda  resulting  from  the  double  decomposition.  This 
washing  ought  to  be  accomplished  as  quickly  as  possible  to  prevent  the  un- 
necessary solution  of  the  ferrugineous  precipitate.  Subsequently,  agitate 
this  precipitate  from  time  to  time  in  a  fresh  portion  of  saccharine  solution 
(water,  ten  ounces ;  sugar,  two  and  a  half  ounces).  Tt  will  dissolve  in  the 
course  of  some  days.  Lastl}^,  take  of  white  sugar  thirty -eight  and  a  half 
ounces ;  distilled  water,  nineteen  ounces  ;  add  the  saccharine  ferruginous 
solution,  and  boil  to  specific  gravity  1'2G2,  at  the  temperature  of  ebullition; 
flavor  with  tincture  of  lemon  or  orange.  The  product  will  be  sixty  -four 
ounces  of  almost  colorless  and  perfectly  clear  syrup  of  proto-carbonatc  of 
iron,  containing  9*90  per  cent,  of  oxide  of  iron. 

Though  this  is  not  as  strong  a  solution  of  iron  as  are  those  under 
the  title  of  "  Unchangeable  Solution  of  Protoxide  of  Iron,"  yet,  we 
doubt  not,  it  would  prove,  judging  from  its  constituents,  far  more 
valuable  in  use.  In  the  rage  for  novel  remedies,  the  tried  value  of 
some  old  one,  is  oftentimes  only  masked  or  covered  up  by  some 
far-fetched  addition,  which  injures  rather  than  enhances  its  real  value. 
For  this  reason,  we  should  think  that  the  addition  of  acids  to  pro- 
tocarbonate  of  iron,  in  order  to  form  a  solution,  is  far  more  objec- 
tionable than  to  dissolve  the  same  in  simple  syrup.  We  believe  acids 
to  be  considered  objectionable  in  tonics  and  alteratives  —  at  least  more 
so  than  is  syrup  ;  and  we  conclude  that  the  unchangeable  Boston  so- 
lutions must  be  acid  —  at  least  containing  free  acid,  masked  only  by 
the  syrup;  that  is,  if  the  citric  and  acetic  acid  act  as  solvents 
only  ;  if  they  do  not,  but  are  neutralized  {i.  e.  decomposed)  by  the 
proto-carbonate  of  iron,  how  can  they  be  called  solutions  of  protoxide 
of  iron?  F.  S. 


E.  8.  Wayne  on  Catawba  Brandy. 

Mr.  Wayne,  in  a  notice  (for  the  7'he  Druggist)  of  Mr.  Zimmer- 
man's remarks  on  Catawba  Brandy,  which  we  alluded  to  editorially  in 
our  last  No.,  says: 

I  have  seen  and  examined  many  specimens  of  this  marc  brandy, 
and,  as  a  general  thing,  unless  very  much  reduced  with  proof  spirit, 
the  amount  of  fusel  oil  that  it  contained,  or  held  in  solution,  was  so 
great  that  upon  the  addition  of  water  to  it,  a  milky  mixture  was  the 
result ;  the  addition  of  the  water  reducing  the  solvent  property  of  the 
alcoholic  solvent,  and  causing  the  oil  to  separate. 

The  process  mentioned  by  Mr.  Zimmerman  is  that  used  gener- 
ally by  those  who  manufacture  Catawba  brandy  in  the  vicinity  of 
Cincinnati,  which,  after  it  passes  from  the  hands  of  the  manufacturer 
(unless  he  has  previously  made  the  addition),  to  those  of  the  liquor 
dealer,  undergoes  the  dilution  of  whisky  at  their  hands ;  without  which 
the  spirit  is  so  rank  and  nauseous  with  grape  fusel  oil,  that  it  is  not 
saleable  unless  thus  reduced. 


Pharmaceutical  Department.  381 

Brandy,  as  I  understand  it,  should  be  a  spirit  distilled  from  wine; 
and  such  is  the  spirit  intended  to  be  when  brandy  is  to  be  used,  either 
pharmaceutically  or  medicinally,  and  is  quite  another  spirit  as  far  as  its 
flavor  properties,  etc.,  are  concerned,  from  that  of  grape  marc  brandy, 
and  contains  but  little,  if  any,  of  grape  fusel  oil.  Mr.  Zimmerman 
seems  to  think  that  the  flavor  or  boquet  of  wine  depends  upon  this  oil, 
but  in  this  I  think  he  is  in  error.  Every  kind  of  wine  has  a  distinctive 
flavor  or  boquet,  which  characterizes  the  brandy  made  from  it,  and 
which  is  not  a  fusel  or  grape  oil,  but  a  peculiar  acid  and  alkaline 
principle,  whose  compound  produces  the  boquet,  and  is  not  an  amyle 
or  ethyle  compound.  To  this  point,  as  confirmation,  I  would  refer, 
both  him  and  the  reader,  to  Winkler's  experiments  upon  the  boquet  of 
wines,  which  fully  substantiates   my  position. 

Respecting  French  brandies,  I  have  no  doubt  that  most  of  the  low 
priced,  rank  and  high  flavored  brandies,  are  made  after  the  method  de- 
scibed  by  Mr.  Zimmerman,  which,  like  the  Catawba  marc  brandy,  to 
make  them  saleable,  must  be  reduced  by  the  addition  of  pure  spirits, 
and  are  known  by  the  trade  as  mixing  brandies,  and  are  no  more  fit 
for  medical  and  other  uses  than  the  other. 

In  France,  there  is  made  from  the  grape,  three  spirituous  liquors ; 
the  first,  Eau  de  Vie  (brandy),  distilled  from  wine;  second  Eau  de  Vie 
de  Marc  (marc  brandy),  distilled  from  the  grape  marc ;  and  third,  Eau 
de  lie  ( lee  brandy),  distilled  from  wine  lees ;  each  of  which  has  a  very 
different  trade  value,  and  are  not  indiscriminately  sold  as  Eau  de  Vie 
(brandy). 

True  Catawba  brandy,  made  from  wine,  is  a  rarity  even  in  Cin- 
cinnati, and  made  more  as  a  curiosity  than  for  sale.  The  wine  is  too 
high  priced,  and  in  too  great  demand,  to  distill  it,  unless  it  has  accident- 
ally soured.  As  it  would  require  about  five  gallons  of  wine  to  make 
one  of  proof  brandy,  which  allowing  a  low  value  for  the  wine  ($1.25 
per  gallon),  would  cost  $G.25  per  gallon, together  with  the  cost  of  man- 
ufacturing, would  much  exceed  the  value  of  good  French  brandy.  The 
sour  wine  mentioned  does  not  make  a  good  brandy ;  contains  too  much 
acetic   ether. 

Besides  the  grape  marc  Catawba  brandy  there  is  to  be  found  in 
our  market  what  is  called  Catawba  brandy,  which  has  never  had  the 
slightest  acquaintance  with  the  grape ;  merely  whisky  flavored  and  colored, 
and  not  even  an  attempt  made  to  imitate  the  flavor  of  the  other,  quantities 
of  which  have  been  bottled,  labeled,  and  shipped  East,  and  been  analy- 
sed by  chemists  both  in  New  York  and  Boston,  who  have  given  their 
certificates,  indorsing  the  same  as  pure  brandy,  obtained  from  Catawba 
wines,  etc.,  etc. ;  fully  illustrating  Mr.  Edwin  Parrish's  remarks  upon 
use  of  silver  in  analysis. 

In  conclusion,  I  would  say,  that  from  reasons  above  given  respect- 
ing the  medicinal  and  other  uses  of  Catawba  marc  brandy  as  made 
by  Mr.  Zimmerman,  I  can  not  indorse  them ;  which,  had  it  been  possible 
for  me  to  have  done,  being  a  home  product,  would  have  given  me 
much   gratification. 


Arnica  Montana. 

The  therapeutical  properties  of  the  Leopard''s  lane  is  made  the 
subject  of  an  article  in  the  College  Journal  by  Dr.  T.  C.  Miller,  and 
we  abstract  as  follows  the  observations  he  has  made  with  it  in  his 
own  practice.     He   says: 


382  The  Peninsular  and  Independent. 

I  have  been  accustomed  to  use  it  for  twenty-eight  years.  In  ner- 
vous fevers  characterized  by  torpor,  this  remedy  is  very  valuable  to 
rouse  the  sinking  energy  of  the  nerves,  particularly  the  nerves  of  the 
abdominal  viscera,  while  at  the  same  time  it  increases  the  contractile 
power  of  the  muscular  fibres,  and  especially  the  fibres  of  the  un- 
striated  muscles  of  the  walls  of  tubes  and  ducts.  It  is  a  very  valu- 
able remedy  in  enteric  fever,  and  where  there  is  colliquative  hemor- 
rhages, passive  sweatings,  and  exanthemata  of  the  abdomen.  It  will  not 
take  the  place  of  valerian,  quinia,  camphor,  or  the  acids,  for  its  action 
on  the  system  is  unlike  that  of  either  and  all  of  these.  These  four 
great  remedies  have  each  its  own  distinctive  influence,  and  each  is  a 
valuable  aid  to  the  others,    when  needed. 

In  inflammations  combined  with  torpidity,  as  in  typhoid  pneu- 
monia, in  inflammation  of  the  brain  and  its  coverings,  in  gangrene, 
and  other  similar  affections,  it  requires  oftentimes,  camphor,  quinia,  and 
perhaps  opium,   to   be   given  in   conjunction  with  it. 

In  obstinate  maltreated  intermittents,  with  torpidity  of  the  ab- 
dominal viscera,  and  engorgement  and  enlargement  of  the  spleen  and 
liver,  and  perhaps  abdominal  dropsy,  and  in  the  so-called  typhoid  cholera, 
arnica  is  great  value.  My  brother,  Lewis  E.  Miller,  uses  it  in  con- 
junction  with   ether  in  those  cases. 

In  old,  atonic  gout  and  rheumatism,  especially  locally  applied,  it 
always  is  of  value.  In  dysentery,  where  the  disease  is  complicated 
with  torpidity  of  the  bowels,  or  constipation,  exhaustion,  or  colliqua- 
tive dysentery,  it  is  peculiarly  indicated.  In  these  cases  I  consider 
the  root   preferable  to   the  flowers. 

In  passive  haemorrhage,  of  a  scorbutic  character;  in  discharges 
from  the  respiratory  or  the  reproductive  organs ;  in  bloody  or  serous 
extravasations  caused  by  contusions  and  hurts,  it  is  the  main  remedy 
I   depend  upon.     It  is  also  very  valuable  in  atonic   dropsies. 

The  external  use  of  the  flowers,  in  tincture  or  infusion,  is  the  best 
agent  I  have  tried  in  acute  hydrocephalus. 

In  paralysis,  particularly  where  the  paralysis  has  been  caused  by 
mechanical  influence  upon  the  brain  or  spinal  marrow,  but  the  nerve 
structure  remains  intact  —  not  by  congestion  or  softening  of  the  nerve 
structure  —  and  in  the  commencement  of  amaurosis,  it  has  always  proved 
of  utility.  TheilMann,  in  treating  amaurosis,  made  use  of  an  infusion 
of  three  drachms  of  the  flowers  to  eight  ounces  of  water,  and  gave  a 
large  spoonful  at  a  dose,  once  in  three  hours. 

In  enlargment,  torpidity,  or  engorgement  of  any  of  the  abdominal 
viscera;  and  also  in  suppression  of  the  menstrual,  lochial,  or  hemor- 
rhoidal discharges  in  consequence  of  torpidity,  its  use  is  of  great  value. 
LEiDBEck  speaks  very  favorably  of  it  in  varicose  veins  of  pregnant 
women.     I  have  derived  great  benefit  from  it  in  such  cases. 


Alcoholic  Extract  of  Mezereum. 

By  treating  with  alcohol  the  fresh  bark  of  Daphne  mezereum,  a 
dark  green  extract  is  obtained,  of  a  burning  acrid,  bitter,  and  at 
the  same  time  sweetish,  taste.  Water  extracts  from  it  a  brown  red 
fluid,  consisting  mainly  of  sugar,  daphnin,  malate  of  potassa,  salts  of 
lime,  and  magnesia,  but  still  retaining  some  acrid  taste.  By  dissolv- 
ing   the    residual    green  resinous  matter  in   some  alcohol,   so  that   it 


Pharmaceutical  Department.  383 

becomes  of  the  consistence  of  honey,  by  evaporation  in  the  air,  a 
strong  preparation  is  formed,  possessing  the  rubefacient  property  in  a 
high  degree,  and  which  may  be  used  as  a  salve  or  spread  upon  silk 
or   other  material. 

By  treating  such  an  alcoholic  resinous  solution  with  an  alcoholic 
solution  of  potassa,  a  milky  green  fluid  is  formed  upon  the  addition 
of  water,  and  on  adding  to  this  dilute  hydrochloric  acid,  light  green 
flocculi  precipitate,  perfectly  soluble  in  alcohol  when  washed,  and  pos- 
sessing the  same  acrimony.  This  shows  that  the  resinous  matter  par- 
ticularly possesses  the  rubefacient  property,  and  that  it  is  not  de- 
stroyed   by  the    process   of    saponification. 

[Wittstein's    Vierteljahresschrift,  from  The  Druggist. 


Syrup  of  Coffee  for  Whooping  Cough. 

When  whooping  cough  has  resisted  the  agents  most  ordinarily 
used,  the  following  syrup,  which  is  the  formula  given  by  M.  Dela- 
HAYE,  slightly  modified,  will  be  used  with  full  success.  We  have  ex- 
perimented very  often,  says  Dr.  Cotjrbassier,  in  the  localities  where 
whooping  cough  appears  each  year  with  an  epidemic  character,  and 
it  has  rarely  failed  us.       Here  is  the  mode   of   its  preparation: 

Take  eight  ounces  of  Mocha  or  Martinique  cofiee,  slightly  brown- 
ed, in  powder ;  treat  by  displacement  with  boiling  water,  so  as  to 
obtain  sixteen   ounces   of   infusion. 

Dissolve  in  this  liquid,  alcoholic  extract  of  belladonna,  alcoholic 
extract  of  ipecac,  of  each  31  1-4 ;  alcoholic  extract  of  cinchona  gr. 
xxxvj  ;   add  sugar    3  xvj.      Digest  on  a   water  bath,    and  filter. 

The  dose  for  children  of  three  or  four  years  is  a  tablespoonful 
repeated  three  times  a  day.  Under  this  age,  the  dose  should  be 
reduced  one  half.  [Eevue  de   Therajoeutique,  from  The  Druggist. 


Aromatic  Spirits  of  Ammonia. 

In  the  discussions  attending  the  coming  revision  of  the  British 
Pharmacopoeia,  a  formula  for  Spiritus  Ammonia}  Aromatieus,  is  pro- 
posed, which  promises  to  do  away  with  the  tedious  necessity  of  dis- 
tilling ammonia  with  aromatics,  and  at  the  same  time  make  a 
preparation  which  will  both  remain  clear  and  possess  a  fine  aromatic 
flavor.     The  following  is  the  formula: 

15.     Rectified  Spirits         .         .         .         .  Oj.   |  xiv. 

Sesquicarbonate  of  Ammonia  (powd.)  |  ss. 

Solution  of  Ammonia  (sp.  g.  880)       .  |  ij. 

Oil  Lemon         .....  |  iij. 

Oil  Nutmeg       .         .         .         .         .  |  j. 

Oil  Lavender  (or  Rosemary)      .         .  min.  xx. 
"Water,  q.  s.  to  make  Oij. 


384  The  Peninsular  and  Independent, 

Liniment  of  Ammonia. 

A  writer  in  the  London  Pharmaceutical  Journal  suggests  that 
almond  oil  be  used  to  substitute  olive  oil  in  the  preparation  of  vo- 
latile liniment,  as  it  never  becomes  thick  or  ropy,  thus  preventing  its 
being  poured  from  the  bottle. 


Wine  of  Iron. 

The  same  writer  thinks  that,  in  order  to  prepare  this  wine  of 
uniform  strength,  that  the  ammonia- tartrate,  or,  better  yet,  the  am- 
monia -  citrate  of  iron  should  be  used,  rather  than  trust  to  the  vari- 
able acidity  of  wine. 


Carbonate  of  Ammonia  In  Measles 

Dr.  S.  N.  PiEKCE,  of  Cedar  Falls,  Iowa,  in  a  communication  to  the 
Boston  Medical  and  Surgical  Journal,  says  he  has  used  Carbonate  of 
Ammonia  Avith  complete  success  in  Measles.     He  states : 

For  about  two  months  past,  this  disease  has  prevailed  quite  extensively 
in  this  vicinity,  and  in  a  very  severe  form.  In  nearly  every  case  that  I 
have  been  called  upon  to  attend,  I  have  prescribed  the  carbonate  of  am- 
monia, and  in  every  case  where  this  has  been  given,  the  disease  has  come 
to  a  speedy  and  favorable  termination.  The  medicine  should  always  be 
given  early  in  the  disease,  before  the  eruption  appears ;  or  if  not,  immedi- 
ately upon  its  making  its  appearance. 

My  usual  prescription  is :  R.  Ammonite  carb.,  3  i. ;  aquae  camph., 
3  iss.  M.  Dose,  a  teaspoonful  three  times  a  day,  varying  the  dose  accord- 
ing to  the  age  of  the  patient  and  other  circumstances. 


THE 


PENINSULAR  md  INDEPENDENT 


MEDICAL  JOURML. 


Vol.  II.  DETROIT,  OCTOBER,  1859.  No.  7. 


Original  C0mmuinrEti0ns  ul^  ^xnshtUuL 


ART.    XXVI.— Critical  Jfotice:    "The  Vegetable  Parasites  of  the 

Human  Skin,"  by  Jabez  Hogg.* 


By  V.     Translated  by  0.  D.  Palmer,  Zelienople,  Pa. 

The    first   researches   on   Vegetable   Parasites,    in    general, 
are  due  to  Bassi,  of  Milan.     He  discovered,  some  twenty 
years  since,  the  vegetable  character  of  a  disease  that  pro- 
duced great  ravages  among  the  silkworms.     About  the  same 
time,  ScHONLEiN  discovered  vegetables  of  the  class  Crypto- 
(jamia,  order   Fungi;   the   appearance  and  development  of 
which  accompanied  certain  diseases  of  the  skin.     Since  that 
time,   the   observations   of  Schonlein   have   been   repeated 
and  extended  by  a  great  number  of  authors,  such  as  Messrs. 
Remak,  Gkuby,   Langenbeck,   Robin,   Hughs,   Bennett, 
KucHENMEiSTER,  Bazin,  Jenner,  Gall,  and  many  others. 
Do  the  cryptogamic  productions  of  the  skin  play  the  part 
of   determining   cause,    or   are   they   not   merely   accidental 

*  From  Gazette  Rebdomadaire  de  Medicine  et  de  Ghirurgie,  July,  1859. 
Vol.  II.  — Z. 


83 G  The  Peninsular  and  Index^endent. 

epi  -  phenomena  of  the  affections  denominated  parasitic? 
This  is  the  question  pro2)ounded  by  Jabez  Hogg,  and  which 
he  seeks  to  investigate.  Each  side  of  the  question  has  grave 
authority  to  sustain  it.  Dr.  Bennett  maintains  that  these 
vegetable  formations  are  secondary,  and  are  only  found  on 
animals  previously  diseased.  Drs.  Kobin,  Gall,  Jenner, 
Bazin,  and  others,  on  the  other  side,  affirm  that  the  parasite 
is  the  sole  cause  of  the  disease.  Dr.  Jabez  Hogg  inclines  to 
the  opinion  of  Bennett  ;  and  here  follows  an  ej)itome  of 
the   arguments  on  which  he  is  supported  : 

1st.  The  vegetables  of  the  order  Fungus  invariably  derive 
their  nutritive  elements  from  matter,  the  vitality  of  which 
is  diminished,  and  in  the  way  of  being  decomposed,  or  already 
partly  decomposed. 

2d.  These  vegetables  have  nothing  characteristic,  for 
they  have  been  observed  in  almost  every  species  of  chronic 
disease  of  the  skin.  Thus,  in  twenty  cases  of  Le^jrosy  and 
Psoriasis,  evident  traces  of  vegetables  were  found  in  ten. 
The  same  production  was  noticed,  in  two  out  of  three  cases 
of  Licliin,  four  times  out  of  six  cases  of  Eczema,  in  one 
case  of  IctJiyosis,  and  in  one  of  Spilus.  None  of  these 
cases  passed  for  being  caused  by  fungi,  accoTding  to  Jabez 
Hogg. 

3d.  Other  observers  have  not  been  able  to  find  fungi 
in  the  diseases  that  have  been  attributed  to  their  develop, 
ment;  and  Dr.  Hogg  cites  in  support  of  this  allegation- 
and  as  competent  authority,  Malherle,  Cazenane,  and 
Wilson. 

Among  the  diseases  passed  in  review  by  Dr.  Hogg,  Favies 
is  found  in  the  first  rank ;  but  the  singularity  of  the  matter 
is,  that  in  a  goodly  number  of  cutaneous  affections,  he  has 
encountered  not  one  single  case  of  this  disease;  which,  it 
is  true,  is  very  rare  in  England. 

The  preceding  considerations  induce  the  author  to  con- 
clude that  there  does  not  exist  parasites   characteristic   of 


Vegetahle  Parasites  of  the  Human  Skin,  387 

such  and  such  diseases,  and  constituting  their  determining 
cause.  He  adds  to  the  proofs  he  has  given,  that  the  inocu- 
lation tried  by  Eemak  and  others,  repeatedly,  on  sound 
individuals,  always  failed,  and  that  cutaneous  diseases  are 
rarely,  if  they  are  ever,  cured  by  the  destruction  of  the 
parasites ;  whilst  they  may  be  remedied  bf  the  suitable 
administration  of  alteratives  and  tonics,  such  as  are  suscep- 
tible of  correcting  the  dycrasia  of  the  blood,  the  true  source 
of  the  disease. 

The  memoir  of  Dr.  Hogg,  of  which  we  have  given  but 
a  very  concise  summary,  is  quite  extended.  It  has  required 
verv  considerable  research,  and  therefore  deserves  to  be  held 
in  consideration.  Notwithstanding,  it  is  very  easy  to  be 
convinced,  in  reading  it,  that  the  author  is  not  perfectly 
posted  in  the  science  appertaining  to  this  subject.  Many 
of  the  arguments  employed  by  him  are  valueless. 

It  were  necessary,  in  order  that  we  should  comprehend 
the  results  at  which  he  arrives,  by  an  examination  of  many 
cutaneous  affections,  that  he  should  have  specified  well, 
Lichen,  Eczema,  etc.,  instead  of  assuming,  as  Dr.  Bazin  has 
done,  that  certain  varieties  of  these  eruptions,  ought  to 
enter  into  the  group  of  parasitic  affections. 

No  one  will  dispute  but  there  may  be  conditions  of  the 
soil  that  favor  the  development  of  the  cryptoganaia.  With- 
out this,  it  would  be  very  difficult  to  explain  why  the 
Acarion  Schoneinu,  or  Fungus  of  the  favus,  vegetates,  in 
preference,  on  the  hairy  scalp  of  infants ;  why  the  Tricho- 
phyton tonsurans  should  occupy,  by  predilection,  the  same 
seat  in  children,  and  the  parts  of  the  face  covered  by  the 
beard  in  man.  {Blentagra).  But  we  must  not  attribute  to 
these  conditions  of  the  soil  more  importance  than  they 
deserve,  whilst  they  exert  only  a  predisposing  influence. 

Dr.  Hogg  still  invokes,  in  favor  of  his  opinion,  facts 
that  can  lend  him  no  aid.  He  cites  the  experiments  of 
Kemak,  and  says   the   inoculations   tried   by  him  did   not 


388  The  Peninsular  and  Independent. 

succeed.  Now,  the  inoculation,  or  rather  transplantation, 
practiced  by  Kemak  on  himself,  did  succeed  perfectly. 
Bazin,  moreover,  has  been  successful  not  only  in  inoculating 
the  favus,  but  also  the  Trichophyton  tonsurans. 

Finally,  Dr.  Hogg  contends  that  the  destruction  of  the 
parasite  but  rarely  cures  the  cutaneous  affections  called 
parasitic,  if  indeed  it  ever  cures  them.  And,  further,  ac- 
cording to  him,  these  affections  may  be  cured,  by  a  system 
of  medication,  directed  solely  against  the  dycrasia  that  causes 
the  disease. 

In  order  to  express  as  exactly  as  possible  the  truth 
on  these  two  points,  we  must  take  the  counterpart  of  Dr. 
Hogg's  propositions.  The  beautiful  experiments  of  Dr. 
Bazin  have  established  irrefutably  —  and  this  is  one  of  the 
greatest  progresses  in  pathology  in  modern  times  —  that 
the  radical  destruction  of  parasites,  such  as  is  made  by 
epilation,  is  the  sole  efficacious  means  of  treating  parasitic 
affections  having  a  vegetable  cause. 

Of  all  the  arguments  of  Dr.  Hogg,  there  remains  only  one 
sole  assertion  —  i.  e.  That  fungi  have  been  found  in  many 
diseases,  not  hitherto  ascribed  to  cryptogamic  productions 
as  a  cause.  We  have  already  made  reservations  in  regard 
to  certain  facts.  As  to  others,  what  do  they  prove?  We 
should  not,  in  any  manner,  be  surprised  if  there  should 
be  found  spores,  after  an  assiduous  search,  in  the  products 
of  various  eruptions.  But  how  can  any  comparison  be 
established  between  these  cases  and  those  where  the  spores, 
either  alone,  or  accompanied  by  sporidies  and  by  mycelium, 
are  in  considerable  quantit}',  and  have  penetrated  to  the 
midst  of  all  the  elements  they  enter.  It  is  enough  to  exam- 
incj  by  the  aid  of  a  microscope,  a  small  portion  of  a  cell 
in  Favus,  a  hair  torn  from  a  part  affected  with  Mentagra, 
a  parcel  of  the  scales  in  Pityriasis  versicolor,  to  be  con- 
vinced of  the  importance  exerted  by  the  Gryptogamia  in  these 


Yegetahle  Parasites  of  the  Human  /Skin.  389 

aiFections — importance  demonstrated  in  a  manner  altogether 
peremptory,  by  the  effects  of  the  parasiticide  treatment. 

This  new  war,  very  benign  to  be  sure,  against  the  con- 
quests of  the  microscope,  in  the  field  of  cutaneous  pathology, 
will  have  no  better  success  than  the  others.  Whatever 
may  be  said  to  the  contrary,  the  microscope,  in  all  these 
affections,  has  rendered  an  immense  service.  It  has  thrown 
light  upon  these  affections,  previously  so  little  understood. 
It  has  led  Dr.  Bazin  to  establish  a  rational  and  methodical 
treatment  for  them,  and  to  substitute  for  the  secret  remedies 
vaunted  by  the  successors  of  the  Mahans,  a  more  simple 
and  efficacious  medication.  The  argument  appearing  most 
in  fashion  at  present,  consists  in  saying  that  the  parasitic 
diseases  were  cured  before  these  new  researches  were  made. 
We  will  say  nothing  of  the  ItcJi,  but  as  regards  the  cutaneous 
affections  produced  by  the  cryptogamia,  they  were  not  cured 
certainly  but  in  a  very  small  minority  of  cases.  This  is 
]3roved  by  the  physicians  sending  their  patients  to  the 
brothers  Mahan,  in  despair  of  healing  them  by  their  own 
means ;  proclaiming  thereby  their  proper  inability.  I  speak 
here  of  the  Plica  only.  The  Mentagra  may  rightfully  pass, 
in  certain  cases,  as  altogether  incurable ;  and  the  Itch  itself, 
although  the  method  of  general  friction  had  been  employed, 
we  were  so  little  instructed  in  its  effects  previous  to  the 
investigations  of  Dr.  Bazin,  that  we  daily  resorted  to  some 
new  mode  of  medication,  either  externally  or  internally. 
Now,  it  is  the  microscope,  that  has  brought  us  to  understand 
the  utility  of  general  frictions ;  and  since  that  time  this 
method  is  nearly  the  only  one  put  in  requisition.  It  is  to  the 
microscope  that  we  are  indebted  for  the  disembarrassment 
of  that  incessant  and  deplorable  hatching- out ,  still-born 
therapeutic  means  of  cure.  This  most  precious  instrument 
has  taught  us  why  the  epilation  and  the  parasiticide  lotions, 
general  frictions,  and  parasite  -  destroying  unctions,  heal  the 
cutaneous  eruptions  caused  by  parasites. 


390  The  Peninsular  and  Independent. 

If  we  call  medicine  an  Art,  it  is  a  Science  also.  To  know 
how  to  cure  a  disease  is  evidently  the  supreme  aim  of  the 
Art.  To  know  the  wherefore  of  the  curing  of  this  disease 
is  almost  the  last  words  of  Science. 


ART.  XXVII.— Carbonic  Acid  Gas  as  a  local  Anaesthetic  Agent, 

By  H.  0.  Hitchcock,  M.  D. 


The  following  cases  were  treated  in  Bellevue  Hospital.  I 
am  induced  to  report  them,  hoping  that  more  experiments 
may  be  instituted,  and  more  facts  brought  forward,  bearing 
upon  this  subject. 

Case  I. — Margaret  M.  was  suffering  from  an  ulcer,  granu- 
lar, red,  and  tender  to  the  touch,  upon  and  within  the  cervix 
uteri.  During  the  course  of  treatment  she  frequently  suf- 
fered from   severe   ^?i\n.  in  the  back  and  down. the   thighs. 

Various  remedies  were  tried,  topical  as  well  as  general — • 
opiate,  and  other  sedative  supjDOsitories — but  with  no,  or 
but  temporary,' relief  to  the  pain.  As  a  last  resort,  and  as  an 
experiment,  carbonic  acid  gas  was  applied  to  the  vagina 
and  neck  of  the  uterus.  It  was  administered  with  rather 
imperfect  apparatus,  but  with  such  complete  relief  to  jDain 
as  to  induce  us  to  resort  to  its  use  again.  Within  five 
or  ten  minutes  from  the  commencement  of  its  apjDlication, 
the  patient  assured  us  that  she  began  to  experience  relief. 
The  gas  was  applied  for  fifteen  or  twenty  minutes  with 
almost  complete  relief  of  all  her  pain  ;  and  she  had  no  more 
pain  of  consequence  for  four  or  ^yq  days. 

This  treatment  was  resorted  to  in  this  case  four  or  ^yq 
times,  and  in  every  instance  with  the  best  result. 

On  one  occasion,  I  examined  the  ulcer  before  the  appli- 
cation, and  found  it  red  and  granular,  like  a  ripe  strawberry^ 
and  very   sensitive.      After   the   application,    it   was   much 


Hitchcock  on  Carbonic  Acid  Gas.  391 

smoother,   and  the  ulcer  and   the  whole  mucous  membrane 
were  of  a  paler  color  than  before. 

This  patient  repeatedly  assured  me  that,  after  the  appli- 
cation of  the  gas,  she  was  almost  entirely  free  from  pain 
for  a  full  week.  At  any  rate  she  did  not  complain ;  which 
is  pretty  good  evidence  that  her  testimony  of  its  effects 
was  true. 

Case  II. — A  woman,  aged  twenty,  married  but  without 
children,  was  suffering  from  acute  suppression  from  exposure 
to  cold  and  wet  on  the  second  day  of  menstruation.  Pain 
in  back,  loins,  and  abdomen,  were  intense ;  pulse  120,  sharp 
and  quick.  She  sometimes  had  paroxysms  of  pain  very 
severe,  in  one  of  which  she  seemed  near  dying.  Soon  after 
her  admission,  carbonic  acid  gas  was  applied  to  the  vagina 
and  cervix,  with  speedy  and  complete  relief  to  her  pain,  which 
continued  for  two  or  three  days.  The  gas  was  applied  in 
this  case  two  or  three  times  —  always  with  the  same  result. 
The  patient,  under  accompanying  treatment,  soon  recovered, 
and  was  discharged. 

Case  III. — A  young  woman,  aged  nineteen,  married,  was 
suffering  almost  precisely  as  the  last  case,  and  from  the  same 
cause.  When  admitted,  she  complained  of  very  great  pain, 
and  extreme  tenderness  extending  over  the  whole  abdomen — 
the  slightest  pressure  causing  intense  pain.  The  vagina  was 
hot  and  dry ;  the  cervix  uteri  hard,  swollen,  immovable,  and 
very  tender  to  the  touch.  The  tongue  was  heavily  coated, 
bowels  had  been  constipated  for  a  week,  and  the  abdomen 
was  considerably  tympanitic.  She  had  repeatedly  had  green 
vomiting  before  coming  to  the  Hospital.  Decubitus  was  at 
first  dorsal,  with  legs  drawn  up  —  afterwards  lateral.  Face 
red  and  anxious  ;  skin  hot  and  dry  ;  pulse  130,  sharp,  quick, 
and  small. 

Twenty -five  leeches  were  applied  to  the  hypo-gastrium, 
and  carbonic  acid  gas  to  the  vagina  and  cervix  uteri. 

The  gas  was  applied  about   four   o'clock  p.  m.     In  ten 


392  The  Peninsular  and  Independent, 

minutes  after  the  patient  said  she  began  to  experience  relief. 
The  application  was  continued  thirty  minutes,  when  there 
was  complete  relief  of  pain  in  the  womb  and  thighs.  This 
relief  continued  all  night,  and  the  patient  slept  much  more 
than  she  had  done  before. 

There  was  some  relief  of  the  tenderness  of  the  abdomen, 
though  not  so  much  as  we  had  hoped  for. 

The  next  day,  and  for  three  or  four  days  after,  the  gas 
was  applied]  with  the  same  entire  relief  of  pain ;  and  the 
patient  soon  left  the  Hospital,  well. 

For  the  purpose  of  local  anassthesia,  carbonic  acid  may 
be  generated  from  common  chalk  and  hydrochloric  acid,  in 
an  ordinary  inhaling  apjoaratus.  If  the  application  is  to 
be  made  to  the  vagina  and  uterus,  a  simple  rubber  tube  will 
connect  the  apparatus  with  the  speculum,  and  the  acid 
being  added  gradually,  through  the  oj)en  tube  in  the  top 
of  the  apparatus,  the  gas  can  be  made  as  rapidly  and 
abundantly  as  desirable.  If  it  is  wished  to  apply  it  to  a 
painful  blistered  surface,  or  to  an  irritable  or  painful  ulcer, 
the  gas  can  be  carried  under  a  piece  of  oiled  silk,  or  of 
gutta-percha  tissue. 

Kalamazoo,  September  2d,  1859. 


ART.  XXVIII.— A  Setting  Right— Not  a  Criticism. 

By  J.  A.  Brown,  M.  D. 


It  would  seem,  from  an  article  possessing  at  least  one 
merit,  viz.  that  of  being  wordy,  in  the  July  No.  of  the 
Peninsular  and  Independent,  entitled  ^' A  Criticism 
Criticised,''  that  our  plain,  common -sense  criticism,  in  a 
former  No.  of  the  same  Journal,  of  "^  Case  of  Obstruc- 
tion (not  intussusception)  of  the  Boivels,  relieved  hy  Copious 
Injections,  after  the  Failure  of  other  Means,"  had  very  much 


A  letting  Right — Not  a  Criticism.  393 

disturbed  the  equilibrium^  if^  indeed,  lie  ever  bad  any,  of 
the  author  ;  and  we  somewhat  fear  the  approach  of  eclamp- 
sia (commonly  called  fits),  as,  which  is  very  evident,  said 
criticism,  in  his  estimation,  as  in  the  estimation  of  the  intel- 
ligent readers  of  the  Journal^  seemed  to  take  a  rational 
view  of  the  case  as  unmistakably  indicated  by  the  symptoms 
specified ;  and  pointed  out  an  equally  rational,  and  almost 
the  only,  if  not  only,  authorized  treatment,  thereby  exposing 
his  perhaps  only  professional  blunder.  The  article  in  ques- 
tion, had  he  the  requisite  docility  —  imitating,  instead  of 
spurning  our  example — and  "incubated''  a  little  longer  upon 
our  criticism,  —  at  least,  long  enough  to  have  re-read  his 
own  in  connection  with  it,  which  might  have  prevented  much 
of  his  either  unintentional  (and  we  are  disposed  to  be 
charitable),  or  malicious  misrepresentation,  —  it  is  possible 
he  might  have  brought  forth  something  worthy  the  attention 
of  a  sensible  critic,  but,  as  it  is,  would  be  passed  over  in 
silence,  were  it  not  for  these  misrepresentations.  Hence,  in 
justice  to  ourselves,  and  in  defense  of  the  truth,  it  may  not 
be  improper,  though  reluctantly,  to  make  a  few  plain, 
matter-of-fact  statements,  which,  we  trust,  we  shall  not 
be  called  upon  to  repeat. 

We  exceedingly  regret  that  a  man  of  such  calibre,  and 
of  such  wide -world  reputation  as  a  physician  and  author, 
as  he  would  have  us  think  his  references  would  seem  to 
indicate,  and  to  which  he  boastingly,  and  evidently  with 
no  small  amount  of  self-complacency,  invites  our  attention, 
should  be  so  easily  thrown  off  his  balance,  especially  to  such 
an  extent  as  to  indulge  in  the  low  ridicule,  possibly  natural 
to  him  before  taking  on  himself  professional  honors,  and 
literally  to  empty  himself,  as  if  by  the  action  of  a  violent 
emetic,  of  so  many  undignified  and  unbecoming  appellations 
with  which  his  puerile  production  seems  only  to  abound,  by 
the  criticism  of  an  unpretending  Western  Doctor. 

Now,  let  us  inquire  what  this  boasting  reference  to  files 


394  The  Peninsular  and  Independent. 

of  BanJcm's  Abstract,  Braithioaite's  Retrospect ,  The  British 
and  Foreign  Medico -Ohirurgical  Review y  &c.,  in  which  he 
would  have  us  think  his  name  figures  conspicuously,  has 
to  do  with  the  subject  of  his  criticism  ?  And  whether  it 
does  or  not,  is  he  vain  enough  to  suppose  that  it  would  be 
any  argument  in  favor  of  or  against  the  correctness  of  his 
conclusion,  or  practice,  in  the  case  under  consideration  ? 
If  it  has  no  relation'  to  this  subject,  what  then  does  it 
import  ?  Well,  really,  we  are  too  modest  to  express  an 
opinion.  But  if  it  be  a  fact  that  our  exasperated  and 
aggrieved  friend,  as  we  fear  the  inference  will  be  almost 
irresistible,  is  laboring  under  the  very  common,  but  by  no 
means,  dangerous  malady,  technically  denominated  hyper- 
trophy of  the  bony  expansion  of  the  superior  extremity 
of  the  spinal  column,  why,  we  are  not  to  blame  for  it,  any 
more  than  we  are  for  his  numerous  blunders,  and  would  beg 
to  be  excused  from  prescribing  for  him,  as  there  is  some 
reason  to  fear  that  it  has  already  become  chronic,  and  not 
likely  to  yield  readily  to  the  ordinary  means  any  more  than 
did  the  disease  in  question.  By  the  by,  a  medical  friend  of 
mine,  from  Chicago,  who  is  taking  one  or  all  of  the  above 
named  periodicals,  in  conversation  with  us  the  other  day, 
wished  that  the  Doctor  would  have  the  kindness  to  specify 
the  particular  No.  or  Nos.  in  which  those  articles,  thought 
by  the  editors  of  those  works  to  be  so  wise  and  sensible, 
may  be  found,  as  they  have  entirely  eluded  his  observation. 
To  us  it  is  not  at  all  strange  that  Dr.  G.,  after  searching 
carefully  our  "  five  pages,"  about  which  he  makes  so  much 
ado,  as  if  the  very  length  troubled  him,  should  have  dis- 
covered no  new  idea  (not  being  accustomed  to  communicate 
any),  since  nearly,  or  quite  half  of  those  '^  Jive  pages''  con- 
sist in  quotations  from  his  own  pen.  And  as  to  the  self- 
conceit,  so  apparent  to  him,  we  have  nothing  to  say,  except 
that,  in  our  article,  we  were  both  modest  and  reserved, 
making  no  pretensions  to  a  knowledge  of  the  case,  or  ability 


A  jSettmg  Right — JVot  a  Criticism.  395 

to  prescribe,  except  from  his  own  commuDication  ;  and  we 
are  obliged  to  confess,  even  at  this  late  hour,  after  another 
"incubation  upon  it/"'  of  some  two  months  more,  and  with 
all  his  profusion  of  words  in  his  last  display  (for  we  can 
not  call  it  a  criticism),  that,  as  yet,  we  have  had  no  occa- 
sion to  alter  our  opinion,  his  learned,  though  we  appre- 
hend, too  late  counsel,  to  the  contrary  notwithstanding, 
from  whose  superior  wisdom  and  experience,  he  not  only 
acknowledges  no  benefit,  but  does  not  seem  to  have  profited 
any  more  than,  if  as  much  as,  he  did  from  our  ^'  five  pages f 
not  having  mentioned  a  single  suggestion  from  his  sagacious 
lips,  or  even  the  fact  of  counsel  at  all. 

The   following   is   an   illustration  of  Dr.    G's   ingenuity 
in  an  attempt  at  justification  of  himself  in  a  palpable  error : 

"Now,  for  the  information  of  our  amicMe  friend,  we  would  say,  that 
we  made  that  report  as  short  as  was  consistent  with  a  well  understanding 
of  the  case,  *  *  *  our  object  being  simply  to  add  another  case  of 
intussusception,  rectified  by  mechanical  means  from  below,  with  the 
intent  of  urging  an  earlier  resort  to  such  means,"  &c. 

From  which,  without  being  put  to  the  necessity  of  seeing  the 
case,  we  infer  that,  with  this,  it  is  to  be  expected  we  have,  or 
may  have,  a  good  understanding  of  the  case  ;  and  it  is  upon 
this  data,  or  such  an  understanding,  that  what  we  have  said, 
or  may  hereafter  say,  is  based,  having  nothing  to  do  with  any 
new  diagnosis,  new  symptoms,  or  new  treatment ;  and  cer- 
tainly he  ought  not  to  complain  that  our  understanding, 
from  this  data,  happened  to  be  more  rational  than  his  own, 
and  our  views  of  the  case  more  consistent,  as  well  as  more 
in  harmony  with  the  teachings  of  standard  authorities.  And, 
as  to  his  pretended  object  in  writing,  viz.  'Ho  add  another 
case  of  intussusception  with  the  intent  of  urging  an  earlier 
resort  to  mechanical  pressure  from  below,''  what  are  we  to 
believe,  since  the  article  criticised  was  profoundly  silent  as 
to  all  these,  except  the  first,  which  was  there  given  a  different 
name  ? 


396  The  Peninsular  and  Independent. 

Now,  the  term  -intussusception  did  not  aj)pear  in  the 
original,  and  we  have  reason  to  believe,  was  not  thought 
of  until  after  the  criticism — some  fifteen  months  after  the 
death  of  the  patient ;  and  then,  as  already  intimated,  only 
as  a  miserable  invention,  or  difficultly  hatched-up  fabrication, 
intended  only  to  deceive  or  mislead,  and  to  serve  as  a  loop- 
hole through  which  to  creep  and  get  out  of  his  dilemma, 
or  as  a  pretext  or  justification  of  himself  in  the  use  of  the 
^^  copious  enema"  resorted  to,  with  the  entire  omission  of 
appropriate  cathartics.  Hence  our  criticism  has  just  about 
as  much  relation  to  intussusception,  or  invagination  of  the 
intestine  and  its  treatment,  as  it  has  to  gonorrhoea  in  the 
guinea  pig,  and  the  sanction  or  condemnation  of  the  use 
of  the  syringe  in  its  treatment.  We  do  n't  know  so  well  how 
it  is  in  the  East,  but  here  in  the  West,  it  would  be  thought 
a  strange  thing  for  a  man  of  sound  mind,  in  answering  a 
criticism  of  an  article  descriptive  of  a  certain  case,  with  the 
treatment  adopted,  to  make  out  an  entirely  new  and  different 
diagnosis,  with  a  corresponding  change  in,  or  alike  new 
symptoms,  and  yet,  our  brother  -  critical,  fifteen  months  after 
the  fatal  termination  of  the  case,  and  several  after  giving 
us  his  description  of  it,  says  he  believes  after  all  (though 
without  evidence,  as  is  clear  by  the  following:  —  '^We  could 
not  diagnosticate  intussusception  even,  for  we  lacked  the 
evidence  ;  but  we  did  diagnosticate  inflammation  of  that 
limited  portion  of  the  intestine  called  the  c^cum,  and  pre- 
dicted [^diagnosticated  is  the  word']  obstruction'')  that  he 
had  a  case  of  intussusception  to  deal  with";  adding  that 
"the  bowels  were  soft  and  painless";  while  in  his  case  of 
"obstruction"  "they  were  painful  and  tympanitic,"  the 
pulse  was  weak,  soft,  and  120  per  minute,  but,  as  first  stated, 
only  "quick."  Now,  if  such  licenses  as  these  are  granted 
to  authors,  we  have  it  yet  to  learn  ;  and,  once  established, 
all  criticism  would  be  at  an  end,  or  at  least  vain  and  profit- 
less.    With  what  show  of  good  intentions   and   purity   of 


A  Setting  Bight — Not  a  Criticism.  397 

motives  does  this  quibbling  and  deception  come,  from 
one  who  has  previously  made  the  charge  (falsely,  however, 
as  we  shall  hereafter  show),  and   condemned   the   practice ! 

Now,  for  the  relief  of  Dr.  G.,  we  will  here  state  that 
we  are  not  sure  that  any  one  else  has  taken  the  same  view  of 
the  case  that  we  have,  though  we  are  apprehensive  that  it 
is  his  fearfulness  that  they  have  that  has  thrown  him  into 
such  a  panic.  Indeed,  we  hope,  for  his  sake,  that  if  our 
conclusions  are  incorrect,  others  will  take  a  different  and 
more  favorable  view  of  the  case,  and  be  able  to  assign  the 
best  of  reasons  for  their  opinions.  It  is  the  information  we 
are  after,  and  not  the  justification  of  ourself  in  an  error. 

If  our  inferences  are  wrong,  from  the  premises  given, 
or  symptoms  described,  we  would  like  to  be  informed,  but 
have  it  yet  to  learn,  even  with  all  the  additional  light  of  his 
last  voluminous  article,  in  giving  us  a  new  diagnosis,  new 
symptoms,  new  treatment,  &c.,  and  who,  we  think,  if  it 
were  not  too  late,  would  like  to  make  out  a  new  prognosis 
also. 

In  our  criticism,  we  aimed  to  be  courteous  and  gentle- 
manly, fairly  stating  the  case  upon  the  only  data  given  us 
(which  he  does  not  deny,  yet  with  no  just  reason  insinu- 
ates we  were  guilty  of  dishonesty),  but  of  course  taking  a 
different  view  of  it  from  what  he  did,  which  we  supposed 
was  perfectly  admissible  and  a  violation  of  no  professional 
principle,  while  he,  as  if  unrestrained  by  any  rule  of  ethics, 
deals  in  little  else  but  ridicule,  which  is  seldom  resorted  to 
except  when  argument  fails,  and  seemingly  has  but  one  ob- 
ject in  view,  viz,  that  of  enhancing  our  insignifiance  and 
the  exaltati(5n'>  of  himself.  His  mode  of  allusion  to  us,  al- 
though highly  exceptionable  to  a  correct  taste,  and  which 
is  as  little  heeded  as  the  idle  wind  that  sweeps  over  our 
vast  prairies,  is  neither  overlooked  or  misunderstood,  ■■ —  the 
plain  English  of  it  being  that  we  are  just  the  opposite  of 
what   these    expressions   imply,  viz.    unlearned,    untalented, 


398  The  Peninsular  and  Tndex>endent. 

&c.,  and  but  a  pigmy  ;  as  if  nothing  good  or  great  could 
come  out  of  Kankakee,  or  indeed  any  other  place  west  of 
Frewsburg,  N.  Y.  We  make  no  hesitation  in  saying,  that 
all  this  will  be  taken  for  its  real  value^  or  no  more  than 
it  is  worth,  and  we  do  not  choose  to  degrade  ourselves  to 
the  same  level,  as  we  might  easily  do  if  weak  enough,  by 
resorting  to  similar  irony.  Although  unnatural  and  a  little 
out  of  the  ordinary  course  of  things,  yet  any  one  might 
readily  have  inferred  his  proclivity  to  this  highly  censur- 
able indiscretion  and  senseless  manoeuvering,  from  the  prece- 
dent he  has  given  us  in  his   fancied  case  of  "Obstruction." 

Now,  as  we  have  already  said,  what  we  stated  in  our 
article  was  upon  a  case  supj)Osed  to  be,  and  described  only 
as,  ordinary  obstruction  ;  and  what  we  there  said,  we  now 
reaffirm  with  emphasis,  viz.  tliai  in  a  case  ivhere  an  evac- 
uation of  the  bowels  was  tliouglit  to  he  almost  the  only 
desideratum,  solid  opiuon  tuas  used  for  three  or  four  days 
together,  ivith  little  or  nothing  else;  and  indeed  nothing 
else  in  anything  like  sufficient  qualities  to  produce  cathar- 
sis; which  language  Dr.  G.  quotes,  and  then  immediately, 
in  endeavoring  to  falsify  it,  says :  '^  On  the  second  day, 
(not  on  the  fourth),  we  said,  the  treatment  was  continued, 
the  opium  in  diminished,  the  calomel  in  increased  doses.'' 
(Did  not  we  so  quote  him,  and  can  it  have  any  different 
signification  rej^ieated  here  ?).  And,  ^'from  aught  that  is 
stated,  and  for  aught  that  Dr.  Brown  knows,  calomel 
might  (though  we  aver  it  was  not)  have  been  used  in  tea- 
spoonful  doses  so  early  as  the  second  day  ;  yet  our  fair, 
honorable,  and  learned  critic  avers  —  uj^on  what  authority 
we  know  not  —  that  for  four  days  we  used  nothing  else  but 
solid  opium  ! "  AVhat  quibbling  !  !  Are  we  to  look  u2}on 
this  as  malicious  falsehood  ?  or  are  we  to  infer  his  want 
of  a  knowledge  of,  and  ability  to  understand,  the  English 
language  ? 

If  indeed  the  Doctor  was  misrepresented,  as  he  seems  to 


A  Setting  Right  —  Not  a  Criticism.  399 

tliiiik,  and  upon  which  impression  alone  he  justifies  his  last 
effort,  we  disavow  his  having  any  reason  for  blaming  us, 
as  we  had  both  the  fairness  and  manliness  to  state  the 
case  and  treatment  in  his  own  words.  Has  he  become  dis- 
satisfied with  his  first  representation  of  it,  which  renders 
the  treatment  adopted  inapplicable,  as  is  plainly  indicated 
by  his  attempt  at  improvement,  let  him  have  the  honesty 
and  frankness  to  say  so,  and  we  will  let  him  off.  We 
furthermore  state  (not  so  much,  however,  for  his  discomfort, 
as  for  his  information,  as  was  clearly  expressed  in  our 
other),  that  the  above  treatment  luent  on,  with  little  or  no 
cJiange  (except  an  entire  omission  of  all  treatment  through  , 
the  night),  up  to  the  seventh  day  even,  with  the  exception 
of  an  increase  of  the  calomel  to  ^yq  grain  doses  (not 
ten,  nor  designed  as  a  cathartic  either) — notwithstanding, 
he  gravely  says  : 

"As  a  dernier  resort^  with  death  staring  us  in  the  face,  we  gave  the 
cathartic  powers  of  calomel  a  full,  and  even  rash,  trial.  If  we  rightly 
remember  (we  have  sent  the  Peninsular  and  Independent  for  1858,  away, 
&c.),  ten  grains  were  given  every  three  or  four  hours,  for  two  days." 

Then  upon  this  misstatement,  and  evidently  as  if  de- 
serving of  great  credit  for  such  heroism,  comes  the  fol- 
lowing : 

"What  more  would  our  friend  require  of  us?  In  our  judgment, 
this  would  have  been  imprudent  and  uncalled-for  at  first,  but  was 
justifiable  at  the  time  such  treatment  was  brought  in  requisition,  Gur 
20111/ side ing  [physicing  is  the  correct  orthography]  advocate  should  re- 
member that  even  this  [Jiuge  dose^  — five  grains  of  calomel^  and  no  more^ 
with  opium  to  counteract  its  laxative  infiuence],  aided  by  purgative  ene- 
mata,  failed  entirely  to  produce  alvine  evacuations  until  the  intussus- 
ception  icas  removed  l)y  mechanical  meansy 

Now,  we  really  hope  the  Doctor  will  get  back  his 
absent  Journal  before  he  writes  again,  and  if  a  gentle- 
man, we  shall  expect  him  to  make  the  amende  hono- 
rable.   Indeed,   it  is   deeply   to    be    regretted   that   it   was 


400  The  Peninsular  and  Independent. 

not  before  him  at  his  last  writing,  as  it  would  have  saved 
him  a  ^''lieap''  of  words.  At  least,  a  careful  examination 
of  it,  we  think,  in  connection  with  the  criticism,  would 
have  curtailed  the  length  of  his  article  materially,  if  it 
had  not  obviated  the  necessity  for  it  altogether.  Our  read- 
ers, of  course,  will  see  which  of  us  is  in  the  error  ;  and 
should  our  friend,  on  examination,  aided  by  his  learned 
counsel  or  otherwise,  find  that  any  larger  doses  than  we 
first  stated  were  given,  he  will  have  the  privilege  of  com- 
municating the  information  at  a  subsequent  writing.  But 
supposing  he  had  given  30  gr.,  and  stated  it ;  would  it 
have  been  more  than  "a  full  test  of  the  cathartic  powers 
of  calomel "  ?  or  even  double  that  amount  ?  would  much 
less  than  this  have  justified  his  plainly  indicated  claim  to 
heroic  practice  ?  !  And  even  this  would  not  have  met  our 
views,  with  this  object  only,  as  we  can  readily  conceive  of 
many  other  cathartics  much  more  reliable  and,  in  other  re- 
spects, less  objectionable. 

In  allusion  to  Dr.  G's  ^^ remarks"  upon  the  report  of 
Dr.  Dubois,  he  says  : 

"AVe  then  disavowed  all  intent  to  criticise,  —  making  Dr.  Dubois's 
[Dubois'  is  correct]  article  a  text  for  a  few  remarks  of  our  own,  —  never 
dreaming  that  every  medical  article  must  suggest  a  new  remedy." 

No,  but  it  is  customary  for  authors  and  ^^  learned  crit- 
ics" to  speak  only  in  commendation  of  an  article  that  is 
already  complete  ;  and  where  it  is  otherwise,  as  evidently 
was  supposed  in  this  case,  and  langu'age  like  the  following 
used,  — 

"Rheumatism  is  a  disease  of  such  frequent  occurrence,  so  distress- 
ing in  its  symptoms,  so  protracted  in  its  course,  and  so  often  fatal  in 
its  consequences,  that  any  practical  remarks  in  regard  to  its  treatment 
can  not  be  deemed  ill  -  timed,  or  out  of  place.  And  in  rheumatism,  as  in 
all  other  diseases,  for  their  successful  treatment,  a  goodly  share  of  com- 
mon sense,  and  a  thorough  and  appreciative  knowledge  of  the  princi- 
ples of  medicine  are  more  indispensible  to  the  practitioner  than  the  best 
set  formula  that  was  ever  devised," 


A  Setting  Right — Not  a  Criticism  401 

we  hold  that  something  new  is  expected  —  some  additional 
light  to  he  thrown  upon  the  subject,  instead  of  a  mere  re- 
petition of  the  same  thing ;  and  when  this  is  not  done, 
there  is  always  a  disappointment,  as  in  the  present  instance. 
Hence,  the  manufacture  of  sermons  so  much  inferior  to  their 
text  we  still  condemn. 

Doubtless,  we  ma^  be  permitted  here  to  inquire,  With 
what  grace  does  a  quotation  from  Dr.  Watson,  condemn- 
ing cathartics  in  peritonitis,  and  to  show  that  our  friend 
was  right,  come  from  an  individual  who,  in  attempting  to 
criticise  the  report  of  Dr.  Dubois,  criticised  only  a  quota- 
tion from  the  same  distinguished  author  ?  And  as  the  other 
quotation  from  Druitt,  the  object  of  which  is  to  make  us 
appear  diminutive  in  comparison  with  himself — the  great  lu- 
minary of  Frewsburg,  N.  Y.  —  we  will  only  say,  that  Druitt 
is  only  another  author,  fallible,  and  liable  to  error,  incon- 
sistency, &c.,  like  Watson,  and  entitled  to  no  more  re- 
spect, farther  than  what  he  inculcates  commends  itself  to 
an  enlightened  reason.  Hence  we  shall  be  influenced  by 
this  suggestion  of  his  as  we  are  by  all  others,  viz.  in  pro- 
portion to  its  importance  ;  which,  in  our  ojDinion,  does  not 
happen  to  be  among  the  most  valuable  of  this  excellent 
author's  teachings.  However,  if  Dr.  Gr.  chooses  to  be  to  the 
trouble  of  "  examining  loell  the  bend  of  the  thigh  in  every 
case  of  sadden  and  violent  vomiting  and  colic  he  meets 
with,"  certainly  we  have  not  the  slightest  objection  ;  but,  as 
we  have  already  reminded  him,  that  in  doing  so  he  will 
necessarily  violate  the  very  principles  or  rules  that  led  him 
to  find  fault  with  Watson  for  stating,  that,  in  Kheumatism, 
or  throughout  all  this  febrile  disturbance,  there  is  no  coma, 
no  marked  trouble  of  the  stomach  or  of  the  bowels,  no 
vomiting^  no  diarrhoea,  &c."  The  truth  is,  however,  that 
Watson  passes  no  such  condemnation  upon  the  appropriate 
use  of  cathartics  in  ordinary  peritonitis,  and  the  language 
referred  to  from  his  pen  has  direct  reference  only  to  a  case 

Vol.  II.  — 2A. 


402  The  Peninsular  and  Independent. 

of  peritonitis  caused  by  actual  perforation  (wound)  of  the 
intestine  by  an  accident,  as  will  hereafter  be  shown,  and 
which,  of  course,  Dr.  Gr.,  who  inveighs  so  vehemently  against 
unfairness,  dishonesty,  &c.,  knew  when  he  selected  it.  What 
beardless  student  of  medicine,  even,  don't  know  that,  for 
union  to  take  place  in  these  most  serious  of  accidents,  the 
bowels  must  be  kept  still,  or,  in  other  words,  put  in  splints 
by  a  powerful  opiate,  and  that  to  disturb  them  by  cathar- 
tics would  be  perilous.?  !  But  his  was  a  case  of  '^obstruc- 
tion^'' and  not  peritonitis,  making  an  evacuation  indispens- 
able. 

To  what  Dr.  G.  ingeniously  denominates  our  "first 
flourish''  (an  appellation  for  a  simple  question  we  should 
never  have  thought  of),  we  would  say,  that,  with  the  symp- 
toms before  the  reader,  upon  which  alone  the  opinion  is 
predicated,  and  which,  in  quoting,  as  he  saw  it  would  be 
fatal  to  any  other  conclusion,  he  does  us  the  injustice  to 
leave  out,  we  are  willing  to  risk  the  decision,  and  will  not 
complain  if  it  be  against  us.  But,  for  the  edification  of  our 
friend,  as  well  as  for  amusement,  we  will  change  the  aspect 
of  our  "  flourish "  a  little,  and  inquire  again  :  What  as- 
tute, practical  physician,  with  a  keen  discrimination,  look- 
ing at  the  symptoms  as  described,  viz. :  '^  Severe  pain  in  the 
bowels  and  tenderness  on  pressure,  vomiting,  quick  pulse, 
furred  tongue,  countenance  haggard  and  indicative  of  great 
distress,  obstinate  constipation  and  prostration,"  would  hardly 
have  thought  of  obstruction,  much  less  hernia,  and  still 
less  intussusception  ;  or  even  anything  else  but  inflam- 
ation  with  constipation,  indicating  a  brisk,  but  by  no  means 
drastic,  cathartic  ?  However,  to  leave  no  doubt  upon  the 
mind  of  any  one  as  to  the  indentity  of  these  symptoms 
with  those  of  peritonitis,  we  quote  from  Dr.  Wood,  under 
this  head  : 

"Nausea  and    vomiting,    thirst,    constipation,    and    scanty   or    sup- 
pressed urine,  are  very  frequent  symptoms.     The  vomiting  is  som  etimes 


A  Setting  Bight — Not  a  Criticism.  403 

exceedingly  distressing.  The  constipation  is  obstinate  in  those  cases  in 
which  the  muscular  coat  of  the  bowels  becomes  involved  in  the  inflam- 
mation. .  .  .  The  face  is  pale,  contracted,  and  marked  by  an  expression 
of  deep  distress  and  anxiety  characteristic  of  the  disease.  .  .  .  The  pulse 
is  usually  very  frequent,  &c." 

But^  to  our  surprise.  Dr.  Gr.,  who  professes  such  famil- 
iarity with  authorS;  maintains  that,  ^^had  the  case  been 
one  of  peritonitis,  as  we  supposed/'  a  cathartic  would  have 
been  inapplicable,  and  makes  the  following  quotation  from 
Watson  in  reference  to  a  case  not  distinguished  from  ordi- 
nary "peritonitis,  first  cured  by  opium,  and  afterwards 
killed  by  a  cathartic"  : 

"This  example  puts  in  a  very  strong  light  the  good  effects  of  opium, 
and  the  dangerous  effects  of  purgatives." 

Now,  in  ordinary  peritonitis,  Watson  says  nothing 
against  the  use  of  purgatives  only  as  antiphogistics,  and  by 
no  means  condemns  the  usual  practice  of  opening  the  bow- 
els in  the  beginning,  and  keeping  them  reasonably  open 
through  tout  the  disease;  and,  as  before  asserted,  the  above 
'quotation  is  applicable  only  to  a  rupture  of  the  bowels, 
which  will  be  seen  by  the  following  from  the  same  author : 

"The  well  known  symptoms  of  perforation  had  existed  for  two  days; 
the  patient  was  apparently  sinking,  his  countenance  was  collapsed,  anxi- 
■Qus,  and  expressive  of  dreadful  suffering;  the  extremeties  were  cold,  and 
the  pulse  hardly  perceptible." 

Now,  let  a  case  of  peritonitis  once  be  made  out,  and 
there  can  be  but  little  chance  for  dispute  as  to  the  appro- 
priate treatment,  which  is  settled  by  authorities ;  and  as 
it  had  been  more  than  intimated  that  our  recently  express- 
•ed  views  were  at  variance  with  these,  and  to  prevent  fur- 
ther quibbling,  it  may  not  be  amiss  for  us  to  furnish  Dr. 
G.  with  one  example  from  Watson's  own  practice  —  his 
favorite  author  —  and  which  we  trust  will  be  sufficient  to 
show  how  he  stands  in  relation   to  this  mater.     He  says : 


404  The  Peninsular  and  Independent. 

"Sept.   17th  he"  (patient  with  peritonitis)  "entered  the  hospital.     I 
directed  immediate  venesection.    ...    He  appeared  to  be  in  great  agony 
In  this  state  the  apothecary  gave  him  twelve  grains  of  calomel  and  five 
of  opium  in  one  dose.  .  .  .  Next  morning  his  countenance  had  lost  in  a 
great  degree  its  expression  of  anxiety,  &c.  ...  No  stool. 

"Capiat  pilulae  saponis  cum  opio  gr.  v.  8va.  quaq.  hora. 
"On  the  20th  the  bowels  were  freely  open;  the  dejections  were  dark  and 
watery;  the  abdomen  was  less  tender.  .  .  .  The  bowels  being  every  day 
mo'oed^  &c.  ...  he  at  length  got  quite  well." 

In  corroboration  of  this  treatment  we  might  quote  from 
nearly  every  author  upon  practice,  but  it  is  not  necessary, 
and  we  will   only  introduce  a  few  lines   from    Dr.   Wood  : 

"In  ordinary  peritonitis,  prompt  and  copious  bleeding  is  the  most 
important  remedy.  .  .  .  Neither  should  paleness  of  the  face,  and  absence 
of  febrile  heat  upon  the  surface,  deter  from  venesection,  when  the  evi- 
dences of  inflammation  are  unequivocal  and  the  patient  is  seen  early  in 
the  attack.  .  .  .  After  the  first  bleeding,  from  five  to  fifteen  grains  of 
calomel  should  be  given,  followed  in  six  or  eight  hours  by  castor  oil, 
or  sulphate  of  magnesia,  or  infusion  of  senna  with  salts,  whichever  may 
be  most  easily  retained  upon  the  stomach,  so  as  to  produce  a  tliorougJi 
e'oaGuation  of  the  bowels." 

Again,  immediately  on  quoting  what  is  called  our  "  sec- 
ond flourish,"  he  exclaims  : 

"  Guided  ty  such  reason  as  is  vouchsafed  to  us,  toe  have  registered 
our  opinion   Above"  (in  Heaven   we  suppose    is    meantj. 

And  then  goes  on: 

"Our  critic  finds  fault  with  us  for  giving  opium  at  first,  instead 
of  bleeding,  and  giving  an  efficient  and  reliable  cathartic." 

This  we  positively  deny.  We  found  no  fault  with  the 
use  of  opium  only  as  a  means  to  a  specific  end,  viz.  evac- 
uation of  the  bowels.  On  the  contrary,  we  sanctioned  its 
use,  as  the  following  from  our  article  will  show  :  which 
;(viz.  calomel  and  opium,)  "were  by  no  means  inappropri- 
ate, had  they  been  given  with  direct  reference  of  the  in- 
flammation instead  of  supposed  obstruction;"  and  also,  we 


A  Setting  Right — Not  a  Criticism.  405 

might  add^  as  a  means  of  quieting  an  irritable  stomach  or 
easing  pain,  are  highly  commendable.  Certainly  there  can 
be  no  further  dispute  on  this  item  of  the  affair.  But  this 
is  only  one  example  of  his  misrepresentation.  Indeed  we 
can  not  rid  ourselves  of  the  conviction,  that,  even  in  connec- 
tion with  the  opium,  the  bowels  would  readily  have  respond- 
ed to  the  influence  of  a  brisk,  reliable  purgative,  as  it  seems 
to  us  he  had  no  other  obstruction  than  the  constipation 
consequent  upon  the  condition  to  which  all  the  symptoms 
seemed  conclusively  to  point.  As  before  intimated,  we  have 
reason  to  think  that,  had  he  examined  our  article  more 
carefully,  he  would  have  been  saved  the  trouble  at  least  of 
penning  the  following : 

"  To  the  no  small  discomfiture  of  Dr.  Brown,  we  would  say  that  the 
patient  experienced  none  of  the  peculiar  effects  of  opium." 

Now  if  it  will  be  any  relief  to  Dr.  Gr.,  we  will  here 
state,  that  we  did  not  think  the  symptoms  were  those  of 
narcotic  poisoning  by  any  means. 

Again  it  is  said : 

"  Dr.  Brown  charges  us  with  neglecting  the  use  of  efficient  cathartics. 
When  every  means  failed  to  procure  relief,  and  death  was  imminent,  though 
we  were  firm  in  the  faith  that  we  had  a  case  of  intussusception  to  deal 
with,  ....  we  were  bound  to  hope  at  least  that  our  diagnosis  might  be 
wrong." 

Well  we  did  think — and  have  not  altered  our  opinion 
yet — and  also  said,  that  it  seemed  to  us,  if  a  proper  pur- 
gative had  been  given  early,  it  would  have  been  in  place. 
But  what  are  his  every  means  which  "failed  to  procure 
relief  in  the  direction  of  evacuation  of  the  bowels  (this 
being  the  acknowledged  desideratum),  which^  in  our  opinion, 
ought  to  have  been  resorted  to  before  "  death  was  immi- 
nent^" but  calomel  in  four  grain  doses,  to  the  fourth  day, 
and  increased  only  one  grain  above  this  to  the  seventh, 
with  opium,  except  a  little  castor  oil  ?     Now,  is  he  willing 


406  The  Peninsular  and  Independent. 

to  have  this  called  exhausting  every  means  of  procuring 
catharsis  ?  If  so,  we  have  no  objection.  Also,  what  kind 
of  "faith"  must  that  have  been,  that  led  him  so  firmly  to 
believe  "he  had  a  case  of  intussusception  to  deal  with," 
and  yet  failing  to  give  us  the  diagnosis  he  so  clearly  made 
out  (or  rather  now  makes  out),  and  that  too  with  the  ex- 
pressed object  in  view  in  reporting  the  case,  viz.:  ^Ho  add 
another  of  this  kind  to  the  list  relieved  by  r)iechanical 
means!'     Was  not  this  an  oversight !  I 

Now  as  to  the  incongruity  which  Dr.  G.'s  "  obtuse  per- 
ceptions fail  to  discover "  in  the  idea  of  "  death  from  an 
inability  to  rally  from  the  extreme  prostration"  caused  by 
obstruction,  and  at  the  same  time  "peritoneal  inflamma- 
tion being  the  cause  of  death,"  we  will  only  say,  that  a 
man's  perceptions,  especially  those  of  a  medical  man,  cer- 
tainly must  be  very  "obtuse"  indeed  not  to  be  able  to 
make  such  a  discovery. 

We  are  also  told  by  the  Doctor  that  he  was  favored 
with  decidedly  the  best  counsel  in  Westekn  New  York. 
Well,  perhaps  he  was,  after  the  appearance  of  our  criticism, 
to  assist  him  in  making  out  his  recent  diagnosis,  which 
doubtless  he  takes  upon  said  counsers  ipse  dixit,  as  he 
admits  the  evidence  of  it  to  him  was  wanting.  Isn't  it 
a  little  singular,  however,  that  an  expert  physician  like  the 
one  in  question  should  have  committed  such  an  oversight 
as  not  to  have  honored  his  counsel  with  at  least  as  much 
as  a  mere  mention  of  the  fact  in  his  report  ?  !  Wonder 
where  said  counsel  was,  that  he  rendered  him  no  assistance 
when  in  the  bed-room  with  the  patient — the  "door  closed 
against  spectators"  —  with  pump  in  hand  to  do  execution, 
in  the  midst  of  the  "  heart-rending  shrieks  and  groans  "  of 
the  dying  sufferer — the  husband  and  friends  without' — 
but  soon  "rushing  in,  evidently  looking  upon  him  as  a 
personification  of  brutality"  !  ! 

Asking  pardon  for  so  lengthy  a  trespass  upon  the  pages 


A  Setting  Right — Not  a  Criticism,  407 

of  your  excellent  Journal^  we  now  take  our  leave  of  Dr,  0.  C. 
Gibbs  (though,  as  an  offset,  we  might  say  of  Dr.  Ckiticism 
Ckiticised,  the  famous  Feewsburg  pump-operatoe,  and 
shrewd  Diagnosticatoe  of  Intussusception  fourteen 
months  after  death,  but  we  do  not  choose  to)  for  the  pres- 
ent, and  we  think  forever,  unless  he  can  ^ incubate"  long 
enough  upon  the  subject  matter  of  his  discourse  hereafter  to 
develope  something  more  worthy  of  our  attention,  "kindly 
reminding  him"  that,  in  our  opinion,  the  "old  addage"  with 
which,  he  closes  his  article,  evidently  for  our  own  improve- 
ment, viz.  ^^Be  sure  you  are  right,  and  then  go  ahead, ^* 
would  have  been  peculiarly  applicable  to  him  in  the  treatment 
of  his  case  of  '^obstruction,''  and  which  he  would:  have  done 
well  to  have  brushed  himself  up  on  previous  to  the  appear- 
ance of  our  criticism.  We  confess  our  error  in  the  first  in- 
stance in  noticing  his  displays  in  the  Journal,  which  indeed 
we  should  not  have  done  could  we  have  become  convinced 
that  they  had  no  relation  to  the  lives  of  our  fellows ;  and  we 
now  pledge  ourselves  to  be  guilty  of  the  like  sin  no  more, 
unless  justice  to  ourselves  and  duty  to  humanity  demand  it. 

J.  A.  Brown,  M.  D. 

Kankakee  City,  111. 


408 


The  Feninsuiar  and  Index>endent. 


AKT.  nil. -Meteorological  Register  for  Month  of  August,  1859. 

By  L.  S.  Horton,  House  Physician  to  U.  S.  Marine  Hospital. 

Altitude  of  Barometer  above  the  level  of  the  sea,  597  feet.     Latitude,  42^24' N  •  and 
Longitude.  82<=58' W.  of  Greenwich.  '  '     ^ 


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•■♦  ^  -♦- 


A  PRACTICAL  TREATISE  ON  ENTERIC  FEVER;  its  Diagnosis  and 
Treatment:  Being  an  analysis  of  One  Hundred  and  Thirty  Con- 
secutive Cases,  derived  from  Private  Practice,  and  embracing  a 
Partial  History  of  the  Disease  in  Virginia.  By  James  Reeves,  M.  D. 
Philadelphia:     J.  B.  Lippincott  &  Co.     1859. 

The  little  volume^  the  title  of  wliicli  is  given  above,  is 
decidedly  practical  in  its  nature,  and  as  sucli,  it  will 
be  appreciated  by  practical  men.  It  is  tbe  work  of 
a  country  physician,  whose  experience  has  been  gathered 
from  a  class  of  patients  far  different  from  those  who  usually 
find  admission  into  the  wards  of  a  hospital.  While  the  rich 
and  the  poor  have  alike  furnished  him  cases,  and  while 
luxuries,  comforts,  and  deprivation,  have,  in  different  in- 
stances, attended  upon  and  influenced  the  progress  and  ter- 
mination of  the  disease,  still,  as  a  general  rule,  pure  air, 
and  uncontaminated  constitutions,  have,  in  all  probability, 
been  distinguishing  peculiarities  in  his  practice.  For  these 
reasons,  the  experience  of  our  author,  while  valuable  to  all, 
will  prove  especially  serviceable  to  country  practitioners. 

The  author,  too,  deserves  much  praise  in  setting  a 
worthy  example  in  keeping  full  and  accurate  notes  of  all 
his  cases,  and  in  reducing  them  to  an  available  form. 

On  the  subject  of  treatment  the  author  is  full,  and  as 
explicit  as  the  nature  of  the  disease  will  permit.  Fully  re- 
cognizing the  recuperative  powers  of  nature,  he  still  avoids 
the  extreme  into  which  such  recognition  sometimes  leads; 
and  recommends  a  course  of  treatment  which  generally  cor- 


410  The  Peninsular  and  Independent. 

responds  with  the  views  which  we  have  derived  from  our 
own  experience.  G. 


THE  ACTION  OF  MEDICINES  IN  THE  SYSTEM;  or,  "On  the  mode 
in  which  Therapeutic  Agents  introduced  into  the  Stomach  produce 
their  Pecuhar  Effects  on  the  Animal  Economy."  Being  a  Prize 
Essay  to  which  the  Medical  Society  of  London  awarded  the  Fother- 
gillian  Gold  Medal  for  MDCCCLII.  By  Frederick  William  Head- 
land, M.  D.,  B.  A.,  F.  S.  S.,  Licentiate  of  the  Royal  College  of  Phy- 
sicians, etc.  etc.  Third  Edition,  Revised  and  Enlarged.  Philadelphia : 
Lindsay  &  Blakiston.     1859. 

A   NEW  and   handsome  edition  of   a  well  known  and  valu- 
able work. 


iHt0rial  i^prtm^itt. 


Medical  Controyersy. 

When  the  Consolidated  Journal  was  offered  to  the  patrons 
of  the  Peninsular  Journal  and  the  Medical  Independent, 
it  was  stated  that  the  design  was  to  make  it  ^Hhe  organ 
of  the  whole  Profession  within  the  range  of  its  circulation 
— to  furnish  a  medium  for  the  dissemination  of  professional 
knowledge^  and  the  interchange  of  professional  opinions.'' 

Within  the  scope  of  the  latter  clause  of  the  above  quo- 
tation are  to  be  included  such  criticisms  upon  opinion  and 
practice,  as  contributors,  from  time  to  time,  see  fit  to  propose 
and  offer.  It  is,  however,  but  right  and  proper  that  harsh 
expressions  and  personalities  should  find  no  place  in  such 
criticisms.  It  is  very  easy  to  criticise  severely ,  without  being 
'personal ;  it  is  also  very  easy  to  be  personal,  and  at  the 
same  time  dignified  and  gentlemanly.  Personalities  may 
even  become  necessary  in  the  course  of  a  controversy ;  but 
they  should  not,  when  such  is  the  case,  sink  below  the  level 
of  the  true  gentleman.  They  should  also  be  pertinent  to 
the  point  in  dispute  ;  otherwise  they  are  unworthy  the  high- 
toned  controversialist. 

It  was  with  a  conviction  of  the  truthfulness  of  these 
sentiments  that,  in  the  salutatory,  from  which  we  have 
already  quoted,  the  following  language  was  held : 

*'  On  the  subject  of  controversies  and  personalities,  from  the  peculiar 
circumstances  under  which  this  Journal  has  commenced,  and  as  a  guide 
to  our  future  contributors  and  correspondents,  it  seems  proper  that  we 


412  The  Peninsular  and  Independent. 

should  be   somewhat   more   explicit,    and,    once  for  all,  that  our    course 

should  be  definitely  stated,  and  distinctly  defined All 

improper  personalities  shall  be  excluded,  and,  also,  all  subjects  specially 
tending  to  the  production  of  personalities,  or  the  endangering  of  feelings 
inconsistent  with  the  proper  peace  and  harmony  of  the  Profession." 

Improper  personalities^  however,  sometimes  gradually 
creep  into  controversial  articles,  without  seeming  at  first 
sufficiently  objectionable  to  render  their  exclusion  necessary. 
In  this  way,  pleasantries  beget  sharper  expressions,  which, 
in  turn,  call  forth  sneers  or  sarcasms,  until  a  highly  objec- 
tionable article  is  the  result.  In  this  way  we  account,  and 
also  apologise,  for  an  article  in  the  original  department  of 
this  No.  We  trust  our  controversialists  will,  hereafter,  re- 
frain from  indulging  in  the  least  personalities.  The  point 
at  issue  is  the  propriety  of  a  given  course  of  practice.  The 
pages  of  the  Peninsular  and  Independent  are  free  to 
our  disputants  for  the  discussion  of  that  point ;  but  we  beg 
them  to  confine  themselves  to  the  real  issue ;  so  shall  science 
and  politeness  at  once  be  served.  G. 


thttt^  $xixthB,  ^^Btxuti^,  &t. 


• » • 


PIROGOFPS  OSTEOPLASTIC  PROLONGATION  OF  THE  BONES  OP  THE  LEG, 
WITH  EXARTICULATION    IN  THE  TIBIO-TARSAL  ARTICULATION. 


By  Gustav  C.  E.  Weber,  M.  D., 
Professor   of  Surgery  in  the   Cleveland  Medical  College,  etc,  etc. 


{Continued  from  September  No.) 

Case  I.  —  On  the  2d  day  of  October,  1857,  I  was  called  upon  by  my 
friend.  Dr.  Roeder,  to  see  a  little  boy  of  eight  years,  whose  right 
foot  had  been  very  badly  smashed,  a  few  hours  previous,  by  the  wheel 
of  a  railroad  car.  The  bones  of  the  metatarsus  and  tarsus,  together 
with  the  surrounding  integuments,  to  within  one  quarter  of  an  inch 
of  a  line  drawn  in  front  of  the  ankle  joint,  from  one  to  the  other  mal- 
leolus, were  literally  crushed  to  a  jelly.  Thus  the  question  as  to  a 
primary  amputation  was  very  easily  settled,  and  the  removal  of  the 
foot  in  the  tibo-tarsal  articulation  agreed  upon.  The  tuberosity  of  the 
OS  calcis  was  uninjured,  and  consequently  Pirogopf's  operation  was  pro- 
posed. A  few  hours  after  the  infliction  of  the  injury,  the  boy  having 
suflSciently  recovered  from  the  shock,  the  operation  was  performed  with 
neatness  and  celerity  by  Dr.  Roeder,  with  my  assistance.  We  followed 
Pirogoff's  original  plan  of  dividing  the  calcaneus  vertically,  modifying 
it,  however,  so  far  that  we  removed  with  the  malleoli  the  articular 
surface,  together  with  a  thin  section  of  the  tibia  and  jBbula,  also  in  a 
vertical  direction.  This  vertical  division  I  recommended  instead  of  the 
oblique  division  of  the  bony  structures  in  question,  because  it  seemed  to 
me  that  after  coaptation  disarrangement  of  the  osseous  flaps  would  more 
easily  occur  when  the  line  of  union  of  the  flaps  formed  an  obtuse 
angle  with  the  line  of  action  of  the  muscles  of  the  calf  of  the  leg. 
Possible  spasmodic  contractions  during  reaction  seemed  to  me  capable  of 
pulling  the  remaining  portion  of  the  heel  upwards  and  backwards  along 
the  oblique  line  of  division  of  tibia  and  fibula.  We  experienced  no 
trouble  in  bringing  the  posterior  flaps  forward,  and  adapting  the  os- 
seous surfaces.  Thr^e  arteries  were  tied,  four  strong  sutures  passed, 
a  few  adhesive  strips  applied,  and  the  stump  adjusted  by  means  of 
a  roller  to  a  concave  splint,  the  lower  end  of  which  was   moulded  so 


414  The  Peninsular  and  Independent. 

as  firmly  to  surround  the  stump,  leaving  only  the  most  anterior  part 
of  it  uncovered.  This  particular  splint  appeared  to  me  essential  to 
secure  the  entire  rest  of  the  wound,  and  avoid  the  tearing  through 
of  the  sutures  if  the  muscular  contraction  should  be  great.  The  re- 
action after  the  operation  was  very  slight.  The  whole  wound  seemed 
to  heal  by  fiist  intention,  when  on  the  fourth  day,  without  a  known 
cause,  tolerably  profuse  hemorrhage  occured,  which,  however,  was  ar- 
rested by  the  use  of  additional  compression  more  firmly  applied. 
When,  twenty-four  hours  after  this  accident,  the  compresses  were 
removed,  we  found  the  lips  of  the  wound  in  the  soft  parts  separa- 
ted by  coagula  and  suppurating.  For  about  two  weeks  suppuration 
was  extensive.  It  diminished  gradually;  and  six  weeks  from  the  day 
of  the  operation  the  little  patient  came  walking  into  the  Amphithe- 
atre of  the  College  building  to  present  himself  before  the  class.  The 
stump  was  perfectly  sound;  the  union  between  the  bones  perfectly 
firm;  and  the  shortening  of  the  extremity  only  ^  of  an  inch,  accu- 
rately  measured. 

Case  IT. — A  German  laborer,  aged  fifty-eight,  a  lover  of  the  narco- 
tic effects  of  alcoholic  liquors,  was  admitted,  on  the  10th  of  October,  into 
the  hospital  wards  of  the  City  Infirmary  with  gangrena  of  both  feet.    The 
extremities   were  both  tumefied,  bright  red  and  yor^  painful   to  within 
four   inches   beyond  malleoli.     There  was  complete  mortification  of  the 
right  foot  up   the  tarso-metarsal  articulation.     The  toes  of  the   left  foot 
were  attacked  with  superficial   gangrena,  and   covered   with  dark -color- 
ed   bullae.      The    general    condition   of    the   patient   appeared   tolerably 
good    for    so  much    local    inflammatory    action ;  there   was    only  slight 
febrile   disturbance.     Ordered  locally   extensive   scarifications,    glycerine 
and   cotton,  internally  light  antiphlogistics.     During  the  first  few   days 
after    his    admittance,    the    gangrenous    process    slowly  extended.      The 
swelling   and  other    symptoms  of     inflammation,    however,    diminished. 
Symptoms   of  delirium  tremens  supervened,  which   lapsed   into  those  of 
a  typhoid  condition.     Continued  local  treatment  with  glycerine  and  cot- 
ton.    Applied   linen   soaked    in   a   strong   solution   of    chlorate   of  lime 
over  the  sloughs.    General  treatment:  opium,  cinchona,  and  acids.  About 
ten    days   from   the   time  I   first    saw   the   patient,   the   line  of   demar- 
cation, and  the   process  of  separation  commenced  on  the  right  foot,   a 
little   above   the  line  of  amputation  of  Chopart.     On   the  left*  foot  the 
destruction   of  tissues  remained  superficial  and  limited   to  points  some- 
what beyond  the  toes.     The  general   condition  of   the   patient  improv- 
ed gradually,  so  that   on  the   fifteenth  day  after  the   exposure  to  the 
cold   causing    the   mischief,    amputation   at   the  ankle  joint  became  in- 
dicated.    I  selected  PiRogoff's  operation.     In  the  presence  of  the   class 
and  several  of    my  colleagues,    the  patient  was  placed   on   the   operat- 
ing table  under  the  influence   of  ether  and   the   original  plan  of  Piro- 
GOFF  followed   out. 


Selected  Articles^  Abstracts^  (he.  415 

In   trying  to  bring  about  the  coaptation  of  the  flaps,  I   met  with 
obstacles.     The  contractions  of  the  muscles  of  the  calf  of  the  leg  were 
so  powerful  that,  even  by  forcible  and  continued  extension  and  counter- 
extension,    it    was   impossible   to  bring    the   posterior   superior  margin 
of  cut  surface   of  the   calcaneus  to   a  level  with  the   posterior   and  in- 
ferior margin   of  tibia  and  fibula.     I  therefore  was  obliged  to  take  an- 
other slice   from  tibia  and   fibula.     (In  a  vertical   direction  to  the  axis 
of  the   bones,   for   the  same  reason  which   I  gave  in   the  description  of 
the   Case  No.  I).    When  this  piece  of  the  bones,  about  one-fifth  of  an 
inch    in    thickness,   was    removed,   the    coaptation   required   still   some 
force.     However,  I  succeeded  in  inserting  the  posterior  superior  margin 
of  the  cut  surface   of  the  os   calcis   upon   the  posterior  inferior  one  of 
tibia  and  fibula;  and,  using  the  latter  as  a  fulcrum,  and  the  calcaneus 
as    a  short  lever,   I   easily  described  with   it  the  part  of  a  circle  ne- 
cessary  to    bring    the  flaps   into    apposition.     A    few  sutures    then   se- 
cured the   equilibrium   of  both  forces   acting   upon   the  fulctum.      For 
better  security,   the    splint,   before   described,    was   applied.     The   case 
progressed  fovorably  without  much  local  and  general  reaction ;  part  of 
the   wound    healed    by   first    intention,    part    by   granulations,    so    that 
within   eighteen  days  after  the  operation,  the  stump   seemed  sound  and 
well.      Upon  closer  examination,   I  found  the  calcaneus  still  moveable. 
On  the  twentieth  day  two  painful  abscesses  formed,  one  situated  upon 
the   anterior  aspect  of  the  stump,  and  one   internally,  near   the   inser- 
tion  of  the  tendo  Achillis.     When   these  abscesses  healed  again  after 
a   few   days,    several  new   ones  appeared   in   succession  in  the  cicatrix, 
one  of   which    remained    discharging  for   five   weeks.      On    the    sixty- 
eighth  day,  the  stump   was  perfectly  firm  and  healed,   although    still 
tender,  so  that  yet  for  two  months  the  patient  was  unable  to  bear   his 
weight  upon   it.     The  shortening  was  one   inch;  and   now  with  only  a 
round  thick  soled  boot,  firmly  laced  to  the  lower  extremity,  the  patient 
can   walk  without  much  of  a   limp. 

The  superficial  sloughs  of  the  left  foot  became  detached  in  the 
course  of  the  treatment  of  the  stump ;  and  the  deficiency,  upon  the 
application  of  simple  ointment,  was  soon  restored  by  granulation  and 
cicatrization. 

Case  III.  —  Mr.  A.,  from  Ontonagon,  Lake  Superior,  came  in  the  early 
part  of  April,  1858,  to  our  city,  and  placed  himself  under  my  care 
with  caries  of  the  metatarsal  and  tarsal  bones,  caused  by  injuries  in- 
flicted with  an  axe,  some  eight  months  previous.  His  general  condi- 
tion had  suifered  to  such  an  extent,  and  the  disease  of  the  bones 
was  so  extensive,  that  amputation  was  at  once  decided  and  agreed 
upon.  The  whole  foot  was  swollen  to  an  unsightly  shape ;  the  in- 
teguments around  the  ankle  were  thickened  and  hardened ;  and  the 
movability  of  the  joint  lessened.  Fistulous  openings  were  leading  down 
to  the  carious  bone  everywhere,   on  the  dorsum  and  the  planta  pedis. 


416  The  Peninsular  and  Independent, 

With  a  sound  I  could  push  through  and  into  almost  all  the  bones 
of  the  tarsus  in  every  direction.  AVhen  introducing  the  sound  through 
an  opening  over  about  the  junction  of  the  astragalus  with  the  scaphoid, 
I  could  traverse  backwards  and  slightly  downwards  softened  bony  struc- 
ture until  I  reached  resistant  bone.  I  concluded  that  the  bone  of  the 
heel  was  still  sound,  and  Pikogoff's  operation  practicable;  consequently 
this  operation  was  performed  lege  autliorls.  When  sawing  through  the 
OS  calcis  just  behind  the  sustentaculum  tali,  I  found  my  anticipation 
as  to  its  condition  verified.  The  malleoli,  however,  appeared  spongy, 
and  the  articulating  surface  soft.  I  therefore  removed  with  them  a  piece 
of  the  lower  portion  of  tibia  and  fibula,  about  a  quarter  of  an  inch  thick. 
The  contractions  of  the  gastrocnemii  and  soleus  were  not  very  power- 
ful, but  still  the  coaptation  of  the  flaps  impossible.  I  then  removed 
a  wedge-shaped  piece  from  the  remaining  portion  of  the  calcaneus, 
after  Siiuii's  proposition,  yet  to  no  purpose.  I  divided  carefully  the 
insertion  of  the  tendo  Achillis.  This  seemed  to  loosen  the  tension 
occasioned  by  an  attempt  to  bring  the  posterior  flap  forward  some- 
what, but  not  sufficient  to  achieve  the  object.  Besides,  when  I  brought 
the  flap  forward  as  much  as  possible,  its  circulation  seemed  at  once 
entirely  interrupted.  I  was  then  convinced  that  the  extremely  thick- 
ened and  hardened  condition  of  the  integuments  was  the  obstacle 
hindering  the  adaptation,  and  that  only  the  removal  of  the  bony  con- 
tents of  the  posterior  flap  would  finish  this  operation  to  the  benefit 
of  the  patient.  After  a  tedious  dissection,  the  calcaneus  was_  taken 
awaj^,  the  arteries  were  secured,  and  the  flaps  united  by  sutures  and 
adhesive   straps. 

Notwithstanding  severe  hemorrhage  on  the  fourth  day,  and  ex- 
cessive suppuration  for  nearly  two  months,  the  patient  obtained,  at 
the  end  of  three  months,  a  sound  and  useful  stump,  to  which  he 
adjusted  an   artifical   foot,    perfect  for   locomotion  and  symmetry. 

Case  IY.  — A  Swiss  laborer,  aet.  51,  came  on  the  20th  of  Decem- 
ber last,  with  frozen  feet,  into  the  Hospital  ward  of  the  City  Infirmary. 
His  left  foot  was  gangrenous  up  to  the  tarso-metatarsal  articulation, 
the  line  of  demarcation  distinctly  visible  at  that  point  all  round  the 
foot.  The  right  foot  and  leg  were  extremely  red  and  tumefied,  with 
mortification  extending  up  to  the  line  of  Chopart,  and  apparently 
spreading. 

Poverty,  privation,  bad  air  and  bad  liquor  had  influenced  the 
patient's  constitution  in  such  manner  before  the  accident,  that  the 
symptomatic  irritation  soon  after  presented  the  irritative  character.  With 
a  dry,  brown  tongue,  weak,  wiry  pulse,  quick  respiration,  and  an  ap- 
pearance of  heaviness  and  drowsiness,  he  was  brought  to  the  Hospital. 
Suitable  local  and  internal  applications  were  made,  which  decreased 
his  constitutional  irritation  materially.  Then  the  inflammatory  process 
of  the  right  leg  also   gradually  subsided,    and  the  line   of  demarcation 


Selected  Articles^  Abstracts^  dbc.  417 

formed  anteriorly  to  within  one-quarter  of  an  inch  of  the  right  ankle 
joint,  and  on  the  planta  pedis,  along  the  line  of  junction  of  the  cal- 
caneus with   the   scaphoid. 

Ten  days  after  the  admission  of  the  patient,  I  considered  his  ge- 
neral condition  such  as  to  warrant  the  removal  of  the  spoiled  tissues* 
I  consequently  determined  to  amputate,  first,  the  left  foot,  and  after- 
wards, when  the  reaction  from  this  attack  had,  to  a  certain  degree, 
subsided,  the  other.  The  simultaneous  amputation  seemed  to  me  not 
advisable,  on  account  of  the  double  shock  such  proceeding  must  ne- 
cessarily communicate  to  his   already  shattered  system. 

I  performed  Chopart's  amputation,  obtaining  sufficient  covering 
for  the  bony  surfaces,  by  making  the  anterior  flap  a  little  larger  than 
common,  and  the  posterior  a  little    smaller. 

In  about  eight  days  the  stump  was  doing  so  well,  the  man  had 
so  finely  overcome  the  consequences  of  the  operation,  that  the  second 
amputation  became  indicated.  The  process  of  separation  had  at  some 
points  cut  nearly  through  the  whole  thickness  of  soft  parts,  the  gan- 
grenous mass  from  the  living  tissues.  The  integuments  of  the  ankle 
joint  and  its   vicinity   appeared  perfectly   sound. 

Pirogoff's  operation  was  thus  practicable,  and  neatly  performed 
by  my  assistant.  Dr.  H.  K.  Spoonek,  after  the  same  plan  as  in  case 
No.  I.  The  coaptation  of  the  flaps  M'as  perfect,  and  comparatively  easy. 
This  second  operation  exercised  apparently  very  little  influence  upon 
the  patient's  condition,  which  remained,  with  the  exception  of  a  little 
increase  of  his  symptomatic  fever,  about  the  same.  He  progressed  fa- 
vorably until  the  fourth  night,  when  all  at  once  severe  hemorrhage 
occurred.  The  loss  of  blood  was  considerable  before  the  nurse  became 
aware  of  it,  and  procured  the  assistance  of  the  house  surgeon.  This 
gentleman  applied  a  strong  compress  over  the  stump,  adjusted  it  with 
a  roller,  and  placing  his  fingers  over  the  femoral  artery,  awaited  my 
arrival. 

When  I  came,  I  found  the  patient  very  anaemic,  with  a  hardly 
perceptible  pulse.  He  tossed  about  and  screamed  for  pains  in  his  limb. 
The  bleeding  had  for  some  time  ceased,  and  fearing  that  the'  bandages 
caused  the  restlessness  of  the  man,  I  removed  them.  This  was  not 
yet  quite  done  when  the  blood  commenced  again  to  flow.  Compres 
sion  of  the  posterior  tibial  arrested  it  instanter.  This  fact  would  have 
led  me  to  the  ligation  of  that  vessel,  if  the  patient's  condition  at 
that  time  had  not  forbid  all  surgical  interference,  or  the  use  of  chlo- 
roform. Examining  the  stump  carefully,  I  found  the  bony  surfaces 
separated  from  each  other  by  coagula,  at  least  three-fourths  of  an  inch. 
The  adhesive  strips  having  been  well  applied,  kept  the  lips  of  the 
wound  of  the  soft  parts,  at  a  point  where  the  strips  lay,  in  close  prox- 
imitj^,  but  pulled  the  anterior  flap  or  anterior  integuments  of  tibia  and 
fibula  downwards  over   their   sharp   edge.     In  the  spaces  between  the 

Vol.  II. -2B. 


418  The  Peninsular  and  Independent. 

adhesive  plaster,  the  wound  was  driven  apart  by  coagula.  AYhen  the 
compression  of  the  artery  M'as  discontinued,  blood  trickled  tolerably  fast 
out  of  the  inner  angle  of  the  wound.  Having  satisfied  myself  that  the 
hemorrhage  could  be  controlled  by  pressure,  I  applied  a  small,  thick 
compress,  about  two  inches  above  the  stump,  over  the  before  named 
artery,  secured  it  by  a  roller,  enveloped  the  stump  with  another,  and 
adjusted  the  splint.  This  bandage  answered  the  purpose  admirably 
well,  and  remained  in  situ  for  about  fifteen  hours.  During  the  last 
three  of  these,  the  patient  complained  bitterly  about  excruciating  pains 
in  the  extremity,  which,  together  with  his  stronger  pulse,  hot  skin,  and 
restless  behavior,  indicated  a  general  re-action.  Upon  removal  of  the 
bandages,  the  stump  and  leg  presented  a  sorry  appearance.  The  pos- 
terior flap  had  entirely  lost  its  position,  being  drawn  backwards  and 
upwards,  at  the  same  time  swollen  to  an  unsightly  lump,  the  space 
between  the  flaps  filled  with  decomposing  coagula,  and  the  anterior  flap 
turned  downwards ;  the  whole  leg  was  tumefied,  red,  and  painful ;  the 
integuments  over  the  edge  of  tibia  and  fibula,  as  well  as  at  other  points 
on  the  limb  up  the  knee,  were  bluish  discolored.  Whether  this  state  of 
things  was  owing  to  the  bandages,  too  tightly  applied,  or  to  excessive 
re-action  in  tissues  whose  vitality  had  been  greatly  lowered  by  a  former 
inflammatory  process,  and  by  the  excessive  loss  of  blood,  and  generally 
depraved  system  of  the  man,  is  hard  to  tell.  I  am  inclined  to  believe 
the  latter  to  have  been  the  cause,  from  the  fact,  that  extensive  sloughs 
afterwards  formed  where  the  bandage  could  not  have  exercised  any  un- 
due pressure,  and  that  no  sloughs  formed  where  the  pressure  was  un- 
doubtedly the  greatest,  as,  for  instance  under  the  compress  over  the 
artery.  Then  a  real  tight  bandage  might  have  secured  the  splint  in 
such  a  way  that  the  posterior  flap  could  not  have  been  retracted.  This 
may  be  as  it  will.  At  the  time  the  bandage  was  applied  we  had  to  ar- 
rest bleeding,  and  had  no  other  avenue  for  that  object  open  to  us,  the 
patient  being,  as  remarked  before,  in  a  very  critical  condition.  From 
the  appearance  of  the  whole  limb,  I  was  satisfied  that  our  prospects  for 
union  of  the  flaps  were  rather  dubious,  even  if  the  patient  should  sur- 
vive such  alarming  symptoms.  I  left,  therefore',  the  stump  to  its  fate, 
and  looked  alone  to  the  inflammatory  process  and  constitutional  disturb- 
ance. 

For  two  weeks  the  patient  was  at  the  point  of  death,  but  gradually 
the  inflammatory  process  diminished,  and  M'ith  it  improved  slowly  his 
general  condition.  The  sloughs  separated,  granulations  sprang  up,  cover- 
ing the  cut  surfaces  of  the  bones  and  the  loss  of  substance  in  the  soft 
tissues.  In  about  twenty-eight  days,  the  patient  was  ready  for  a  third 
amputation,  becoming  imperative  on  account  of  the  impossibility  to  re- 
place the  flap,  whose  vitality  during  the  whole  siege  was  not  in  the  least 
enrocached  upon,  or  to  bring  it  into  any  kind  of  shape  for  cicatrization. 

The   left   stump,  during   the   height   of  trouble  with  the  right  one, 
seemed  to  suffer  some,  but  healed,  ultimately,  nicely. 


Selected  Articles,  Abstracts,  c&c.  419 

The  third  amputation  was  performed  below  the  knee;  and  also  of 
this  operation,  the  patient,  in  a  comparatively  short  time,  got  up  with- 
out further  trouble. 


»  o  t 


The  Employment  of  Water  in  Auscultation.  * 


By  S.  Scott  Alison,  M.  D., 
Assistant  Physician  to  the  Hospital  for  Consumption. 


The  Hydrophone.  —  If  M^e  desire  to  employ  water  as  an  agent  in 
auscultation  and  in  aid  of  hearing  -  tubes,  diflaculties  at  once  present 
themselves.  To  apply  water  to  the  chest  is  easy  enough;  but  it  is 
not  so  easy  to  retain  it  there  in  a  suitable  manner.  The  application 
of  water  may  be  unpleasant  to  the  patient,  and,  by  wetting  his 
clothes,  may  give  rise  to  much  annoyance  and  inconvenience.  The 
idea  occurred  to  me  that  if  I  could  confine  water  in  some  material 
that  would  not  interfere  with  its  sound  -  intensifying  power,  a  material 
advantage  would  be  gained,  and  we  should  have  a  convenient  mode 
of  reinforcing  hearing -tubes.  In  a  former  paper  it  was  stated  that  a 
thin  membrane  oifers  no  sensible  impediment  in  the  way  of  water 
intensifying  sound,  although  thick  and  non  -  elastic  or  non  -  vibrating 
bodies  did;  and,  taking  advantage  of  this  fact,  I  made  a  waterproof 
bag  of  india-rubber  to  contain  water.  The  india-rubber  membrane  is 
so  thin  as  to  offer  little  or  no  resistance  to  the  undulations  of  water. 
The  bag  is  about  the  size  of  a  large  watch,  and  is  sufficient  to  re- 
ceive the  extremity  of  an  ordinary  flexible  stethoscope,  or  to  form 
a  medium  of  connexion  between  the  external  ear  and  a  solid  sounding 
body,  such  as  the  human  chest.  The  thickness  of  the  bag  is  not 
above  the  third  of  an  inch.  Nothing  is  gained  by  greater  thickness, 
and  the  advantages  of  sound  having  to  travel  only  a  short  way,  and 
also  of  only  a  very  little  weight  pressing  upon  the  sounding  body, 
are  secured.  The  sonorous  pulses,  so  to  speak,  are  readily  taken  up 
from  the  solid  body  or  the  chest,  and  are  conveyed  through  the 
water  and  membrane  on  either  side,  and,  reach  the  edge  of  the  .aper- 
ture of  the  hearing -tube  and  the  contained  air,  whether  the  instru- 
ment be  the  flexible  stethoscope,  the  human  ear,  or  any  other  hear- 
ing-tube. This  instrument  possesses  valuable  advantages,  and  I  have 
therefore  ventured  to  give  it  a  name,  that  of  the  Hydrophone.  It 
fits  admirably  and  exactly  upon  the  part  of  the  chest  to  which  it 
is  applied,  however  uneven  and  irregular,  whether  this  be  a  project- 
ing rib  or  a  deeply  -  sunk  intercostal  space,  a  broad  level  surface  or 
a  narrow  depression,  the  clavicle  or  spine  of  the  scapula.  By  its 
other    side,    the    hydrophone   fits    as    exactly   to   the  aperture  of   the 

*  From  the  London  Pharmaceutical  Journal. 


420  The  Peninsular  and  Independent. 

hearing-tube  or  to  the  exterior  of  the  human  ear.  Every  part  of  the 
solid  body  covered  by  the  hydrophone  contribtes  its  quota  of  sound. 
The  fitting  of  the  instrument  to  the  hearing -tube  prevents  the  escape 
of  sound  from  the  contained  air  to  the  external  atmosphere,  and  by 
this  means  resonance  of  the  contained  air,  and  of  the  containing 
tube,  is  greatly  promoted,  with  the  result  of  a  greatly  augmented 
sound.  The  edge  of  the  hearing -tube  sits  so  easily,  and  with  so  little 
resistance  from  the  water -bag,  or  hydrophone,  that  the  vibrations 
which  are  communicated  to  it  are  readily  reciprocated,  and  find  none 
or  little  of  that  resistance  so  fatal  to  its  vibrations  when  pressed 
upon  a  solid   body."^ 

The  hydrophone  may  be  employed  either  in  aid  of  the  stetho- 
scope, or  as  a  distinct  acoustic  instrument  by  itself.  In  the  case  of 
wooden  stethoscopes  which  arc  solid,  applied  to  the  distal  aperture,  it 
is  injurious  by  damping  sound ;  in  the  case  of  the  hollow  wooden 
stethoscope  it  is  of  no  material  value,  for  water  is  an  indifferent 
conductor  of  sound  from  a  solid  body  to  another  solid  body,  and  it 
may  be  stated  that  the  hollow  wooden  stethoscope  is  more  a  solid  than 
in  air  instrument.  What  it  gains  as  an  air  instrument  from  the 
water,  is  lost  as  a  solid  instrument.  In  fact,  more  may  be  lost  in 
the  one   way  than  is   gained  in  the   other. 

It  is  in  the  case  of  the  flexible  stethoscope  that  the  hydrophone 
forms  a  material  aid  in  auscultation  by  hearing -tubes.  The  flexible 
stethoscope  is  here  meant  to  signify  all  stethoscopes  into  whose  con- 
struction flexible  tubes  enter,  either  forming  the  whole  tube  part  of 
the  instrument,  as  in  the  ordinary  flexible  stethoscope,  or  part  only, 
as  in  Camman's  double  stethoscope,  or  my  own  differential  stethos- 
cope. These  instruments  are  essentially  air  instruments,  and  I  am 
glad  to  say  that  Cam3[an  designated  his  instrument  such  when  he 
first  made  it  known;  for  this  corresponds  with  my  own  investiga- 
tions. In  the  case  of  all  these  instruments  the  intensification  of  sound 
by  the  hydrophone  is  so  material,  that  I  have  no  hesitation  in  say- 
ing that  without  its  employment  their  resources  are  by  no  means 
fully  ^made  available.  To  have  the  full  benefit  of  any  one  of  these 
instruments,  the  hydrophone  is  essential.  Kespiratory  sounds,  healthy 
and  morbid,  which  are  audible  with  the  simple  flexible  stethoscope, 
are  made  more  audible  when  the  hydrophone  is  placed  under  it. 
Rhonchi  and  moist  crepitation  are  strikingly  augmented.  Yocal  reso- 
nance,  solid  and   cavernous,   dry  and  moist,  are   in   a  marked  manner 

*  A  fact  whicli  I  have  very  lately  ascertained  appears  to  me  Avell  worthy  of  being 
here  recorded.  It  hears  directly  upon  the  importance  of  perfect  freedom  of  the  cup  of 
flexible  stethoscopes.  A  cup  held  rather  firmly  upon  a  piece  of  wood  upon  which  a 
tuning-fork  is  placed  gives  a  fainter  auditory  sensation  than  when  held  loose,  but  the 
auditory  sensation  is  further  and  very  materially  reduced,  if,  instead  of  being  held  firm, 
the  cup  be  glued  to  the  piece  of  wood.  Here  we  have  perfect  continuity,  but  reduced 
sound.    The  explanation  is  found  in  the  reduced  vibration. 


Selected  Articles^  Abstracts^  Sc.  421 

amiDlified.  Pectoriloquy,  accompanied  with  much  vibration  of  the  chest, 
is  increased  in  a  very  striking  manner.  Murmurs  of  the  heart,  usu- 
ally heard  in  a  mitigated  form  only  by  flexible  stethoscopes  —  at  least 
in  my  experience  —  are  conveyed  to  the  ear  so  as  to  produce  a  very 
distinct  and  defined  sensation.  To  sum  up,  it  appears  to  me  that 
flexible  stethoscopes,  however  ingeniously  constructed  with  twisted 
wire  and  other  contrivances,  are,  compared  with  the  simple  wooden 
stethoscope,  essentially  deficient  as  sound  -  conveying  instruments,  some 
few  sounds  excepted;  but  that  the  hydrophone  greatly  counteracts 
this  deficiency,  and  brings  them  up  much  more  to  the  rank  of  L^en- 
NEc's  stethoscope.  But  the  inquiry  may  be  made, — What  good,  pur- 
pose can  the  hydrophone  subserve  under  such  circumstances,  if  it 
can  only  bring  a  second-rate  instrument  nearly  up  to  the  position 
of  another  ?  The  answer  is  this,  —  There  are  situations  and  occasions 
which  require  the  flexible  instruments,  as  is  well  known,  and  it  is 
certainly  important  to  render  them,  defective  though  they  are,  as  use- 
ful acoustic  instruments  as  is  possible.  It  may  be  possible  to  place  the 
cup  of  a  flexible  tube  with  a  hydrophone  under  it,  where  it  would  be 
difficult  or  impossible  to  employ  a  wooden  stethoscope.  In  auscultating 
the  sounds  of  the  gravid  uterus,  or  of  the  foetus  in  process  of  birth,  a 
flexible  stethoscope  with  a  hydrophone  might  possibly  afford  evidence 
that  would  under  certain  circumstances  be  very  important. 

Pulsating  tumors  of  the  chest,  too  tender  to  admit  of  the  pres* 
sure  of  the  wooden  stethoscope,  or  even  of  the  naked  cup  of  the  flexible 
stethoscope,  or  upon  which  it  might  be  dangerous  or  harzardous  to 
exercise  pressure,  are  well  auscultated  by  means  of  the  flexible  stetho- 
scope, provided  either  with  a  flat  ear  -  piece  or  a  tubular  ear  -  piece  to 
enter  the  meatus,  having  the  hydrophone  placed  under  it  and  upon  the 
morbid  part.  The  hydrophone  takes  up  sound  from  every  part ;  how- 
ever uneven  it  may  be,  it  forms  a  soft  water  cushion,  and  it  serves,  at 
the  same  time,  greatly  to  reinforce  sound  procured  without  it.  In 
practice,  I  have  on  many  occasions,  with  the  aid  of  the  hydrophone, 
distinctly  heard  murmurs  of  the  heart,  of  the  existence  of  which  I  had 
been  in  doubt  when  simply  employing  the  flexible  stethoscope. 

I  have  observed  that  when  the  flexible  stethoscope  is  employed 
with  the  clothes  of  the  patient  intervening,  as  is  unavoidable  under 
some  circumstances,  as,  for  instance,  w^hen  time  does  not  admit  of  un- 
dressing, or  when  the  patient  would  suffer  by  exposure  to  cold,  the 
impression  made  upon  the  ear  by  lung  and  heart  sounds  is  greatly  en- 
feebled, and  is  very  unsatisfactory.  This  evil  attendant  upon  the  em- 
ployment of  the  flexible  stethoscope,  including  Oamman's  double  stetho- 
scope, and.  my  own  differential  stethoscope,  is  obviated,  I  may  say  alto- 
gether, by  placing  the  hydrophone  under  the  stethoscope.  The  rein- 
forcement of  the  sounds  is  so  great  as  to  be  quite  surprising,  as  well 
as  very  useful.     An  examination  that  would  be  worthless  is,  by  the  use 


422  The  Peninsular  and  Independent. 

of  the  hydrophone,  rendered  satisfactory.  This  result  is  obtained  partly 
by  a  gentle  yet  efficient  pressure  exerted  upon  the  clothes,  compressing 
them  into  less  density  by  excluding  layers  of  air.  But  a  great  portion 
of  the  result  is  due  to  a  more  complete  closure  of  the  aperture  of  the 
instrument,  attained  by  a  surface  of  water  covered  by  thin  membrane, 
than  can  be  secured  by  one  of  porous  and  comparatively  uneven 
cloth,  &c. 

In  the  examination  of  children,  the  employment  of  the  hydrophone, 
together  with  the  double  or  the  differential  stethoscope,  is  most  satis- 
factory, and  is  well  deserving  of  notice  here.  I  believe  it  to  be  a  very 
great  improvement  upon  the  use  of  the  wooden  stethoscope,  and  well 
worthy  of  the  adoption  of  the  profession  in  dealing  with  children.  The 
intensity  of  sound  procured  is  nearly  the  same  as  in  the  case  of  wooden 
instruments.  The  cup  of  the  stethoscope  fits  perfectly  upon  the  water, 
which  it  can  seldom  do  upon  the  sharply  -  curved  chest  of  infants,  and 
thus  much  economizing  of  sound  is  secured.  For  the  same  reasons  no 
irregular  pressure  is  endured.  The  child  suffers  no  pain,  and  is  spared 
one  great  source  of  restlessness  and  vociferation.  Lastly,  the  employ- 
ment of  the  hydrophone  and  a  flexible  stethoscope  causes  no  alarm,  as 
in  the  case  of  the  wooden  instrument,  and  is  very  generally  the  source 
of  much  interest  and  even  amusement  to  the  child,  who  consequently 
remains  in  a  state  of  quietude  very  favorable  for  the  examination  of 
the  auscultator.  I  constantly  examine  children  with  the  utmost  ease 
and  deliberation  in  this  way,  whom  I  should  otherwise  have  to  send 
away  after  fruitless  efforts  at  auscultation. 

The  same  method  of  examination,  viz.  by  the  hydrophone  and  the 
flexible  stethoscope,  including  Camman's  double  stethoscope  and  my  dif- 
ferential stethoscope,  is  very  valuable  in  the  case  of  wasted  patients. 
The  employment  of  the  wooden  stethoscope  with  such  persons  is  fre- 
quently very  painful,  and  is  positively  cruel.  Moreover,  as  the  aperture 
fits  very  badly,  it  is  highly  unfavorable  for  the  propagation  of  sound 
to  the  ear.  Now,  the  water-pad,  or  hydrophone,  sinks  into  the  hollowed 
intercostal  spaces,  and  comes  into  complete  contact  with  the  entire  cir- 
cumference of  the  mouth  of  the  stethoscope,  at  once  collecting  more 
sound,  preventing  its  escape,  and  obviating  the  occurrence  of  painful 
pressure. 

Upon  blistered  surfaces  and  parts  tender  either  from  internal  disease 
or  from  external  applications,  this  mode  of  auscultation  is  much  su- 
perior to  that  by  the  wooden  stethoscope.  When  an  examination  by 
the  latter  instrument  is  positively  refused,  one  by  the  method  under 
consideration  is  at  once  permitted,  as  being  altogether  painless.  Many 
patients,  particularly  females  with  tender  and  wasted  chests,  have  ex- 
pressed to  me  their  satisfaction  with,  and  surprise  at,  this  painless 
mode   of  examination. 

A  very  slight  augmentation  of  sound,  in  the  case  of  some  sounds, 


Selected  Articles^  Abstracts^  <S;c.  423 

is  procured  by  placing  the  hydrophone  on  the  proximal  or  aural  ex- 
tremity of  the  ordinary  wooden  stethoscope,  but  it  is  scarcely  avail- 
able  in  practice. 

The  bag  of  water,  or  hydrophone,  as  I  have  ventured  to  call  it, 
is  of  service,  not  only  in  the  case  of  artificial  hearing-tubes,  but  in 
that  of  the  natural  hearing-tube,  viz.  the  ear.  Applied  to  the  naked 
chest  it  forms  a  stethoscope  not  materially  inferior  to  the  best  wooden 
stethoscope,  length  excepted.  When  the  part  auscultated  is  very  un- 
even or  much  curved,  by  fitting  well,  it  excels  the  wooden  instru- 
ment in  an  acoustic  point  of  view.  By  fitting  well,  also,  upon  the 
external  ear  of  the  auscultator,  and  by  closiiig  thoroughly  the  meatus 
externus,  great  acoustic  advantages  are  obtained.  The  sonorous  undu- 
lations are  freely  conveyed  to  every  part  of  the  external  ear,  the  air 
in  the  meatus  comes  in  immediate  contact  with  the  instrument  with- 
out the  possibility  of  any  sonorous  undulations  escaping.  The  sonorous 
undulations  of  the  walls  of  the  tube  and  those  of  the  enclosed  air 
re-act  upon  each  other.  The  water  again  reciprocates  as  a  sounding- 
board,  and  the  general  resonance  is  greatly  promoted  by  the  thorough 
closure  of  the  tube.  The  closure  of  the  meatus  is  greatly  more  com- 
plete in  the  case  of  the  water  -  bag  than  can  be  procured  by  any 
ordinary  wooden  disc.  The  complete  closing  of  the  ear,  it  may  be 
remarked,  is  useful  chiefly  by  promoting  resonance,  and  not,  as  has 
been  erroneously  taught  by  some  eminent  stethoscopists,  by  excluding 
other  sounds. 

The  hydrophone  forms  a  great  aid  to  the  external  ear  when  the 
patient  is  to  be  examined,  with  his  clothes  still  upon  him.  As  a 
general  rule,  good  stethoscopists  strip  their  patients  for  examination, 
but  it  may  be  sometimes  desirable  to  examine  through  their  clothes, 
as  in  probably  trivial  cases,  when  there  is  little  time,  when  the  pa- 
tient suffers  from  cold,  or  when  the  examination  is  only  a  supple- 
mentary one,  or  a  rough  observation  will  suffice.  In  such  an  exam- 
ination the  hydrophone  proves  of  great  value;  a  sound  which  is  very 
indistinct  to  the  ear  placed  upon  the  clothes,  becomes  full  and  distinct 
when  the  hydrophone  is  employed.  Voice  sounds,  heart  sounds,  and 
rhonchi,  are  greatly  improved.  Employed  in  this  manner,  I  am  in- 
clined to  think  the  hydrophone  is  equal,  if  not  superior  to  the  wooden 
stethoscope. 

The  water  instrument  has  this  material  advantage,  that  it  is  very 
readily  moved  from  one  place  to  another  —  i.  e,  from  one  part  of 
the  chest  to  another.  For  example,  in  examining  the  back,  the  whole 
of  the  surface  may  be,  as  it  were,  run  over  without  once  lifting 
the  head,  the  hydrophone  being  shifted  with  the  ear  upon  it  from 
place  to  place. 

In  respect  of  delicacy,  the  hydrophone  is  not  without  some  value, 
for,   in  the  case   of  females,   the  interposition  of  this  instrument  meets 


424  The  Peninsular  and  Independent. 

the  objection  to  the  immediate  contact  of  the  ear  of  the  auscultator 
with  the  chest  of  the  patient.  "When  the  apphcation  of  the  hydro- 
phone gives  annoyance  from  its  coldness,  this  evil  may  be  readily 
obviated  by  placir.g  the  instrument  in  warm  water,  or  by  otherwise 
warming  it.  Minor  advantages  of  this  instrument  are  its  portability 
and  cleanliness. 

Other  liquids,  besides  water,  tend  to  intensify  sound  proceeding 
from  solid  bodies,  and  conveyed  to  the  ear  by  means  of  hearing  tubes, 
but  none  experimented  upon  have  given  practically  better  results. 
Mercury  gives  an  increase,  and  the  character  of  the  sound  is  heavy 
and  forcible.  Thick  glutinous  fluids,  such  as  treacle  and  marmalade, 
and  thick  oils,  give  less  increase  than  water;  and  much  of  the  fine 
liquid  vibrating  character  of  the  sound,  when  passed  through  water, 
is  lost. 

Some  solid  bodies  serve  likewise  to  give  a  stronger  auditory  im- 
pression when  placed  upon  other  solid  bodies,  when  hearing  tubes 
are  employed.  Layers  of  paper,  such  as  a  pamphlet,  layers  of  gutta 
percha  membrane,  and  thin  slices  of  India-rubber,  lard,  and  butter, 
give  an  increase;  but  it  is  much  less  than  is  obtained  from  water. 
In  the  case  of  these  solid  bodies  the  augmentation  is  due  to  two 
circumstances :  1st,  the  exact  fitting  of  the  instrument  upon  them ; 
2d,  the  greater  amount  of  its  vibration  in  their  case  than  in  that 
of  more  solid  and  resisting  bodies.  Dr.  Sieson  has  long  employed  a 
stethoscope  closed  with  a  thin  plate  of  wood,  with  the  effect  of 
rendering  valvular  sounds   more  distinct. 

That  I  may  not  appear  intentionally  to  ignore  anything  that  has 
been  done  by  a  professional  brother,  I  deem  it  right  to  say,  that  a 
water  stethoscope  was  invented  some  ^''ears  ago;  the  name  of  the 
inventor  I  have  been  unable  to  discover.  I  have  endeavored  to  find 
some  printed  details  of  this  instrument,  but  have  failed.  Dr.  Hamil- 
ton Roe  and  Dr.  Markham  have  informed  me  that  they  have  seen 
an  instrument  so  called.  It  is  said  to  be  a  solid  tube  filled  with 
water,  but  I  can  not  conceive  it  could  afford  any  advantage.  If  water 
be  made  to  fill  the  ordinary  wooden  stethoscopic  tube,  I  am  con- 
vinced the  addition  can  only  serve  to  spoil  the  instrument,  for  this 
reason  —  that  water  in  the  interior  will  interfere  with  the  full  vibra- 
tions of  the  wood.  It  is  as  an  adjunct  to  hearing-tubes,  or  employed 
as  the  hydrophone,  as  previously  described,  that  water  can  prove  of 
service  in   ordinary  auscultation. 

Before  concluding  this  communication,  I  may  be  permitted  to 
refer  to  a  point  which,  though  not  bearing  immediately  upon  the 
employment  of  water  in  auscultation,  yet  has  suggested  itself  to  se- 
veral professional  friends  —  viz. :  the  apparent  contradiction  offered  to 
the  sound-propagating  properties  of  water,  by  the  absence  or  deficiency 
of  respiration  and  voice  sounds  in  some  examples  of  liquid  in  the 
chest,  and  of  heart  sounds  in  examples  of  effusion  in  the  pericardium 


\ 


Selected  Articles,  Abstracts,  dc,  425 

I  would  briefly  remark,  that  though,  water  is  a  good  conductor 
of  sound,  second  only  to  wood  and  other  solid  bodies,  and  better  in 
the  case  of  air-tubes  as  above  described,  it  is  yet  in  many  cases  op- 
posed to  the  2^'>^ocluctioii  of  sound,  and  effectually  prevents  those  move- 
ments upon  which  sound  depends.  A  lung  pressed  upon  by  water 
till  it  becomes  impervious  to  air  is  not  likely  to  be  the  seat  of  res- 
piration sounds,  and  if  they  are  not  produced  inside,  they  can  not 
be  heard  outside.     Ex  nihilo  nihil  Jit. 

Besides  this,  the  circumstances  under  which  the  liquid  is  situated 
in  respect  of  the  stethoscope  or  hearing -tube  are  different.  The  liquid 
in  the  chest  is  separated  from  the  hearing -tube  by  the  whole  thick- 
ness of  the  walls  of  the  cavity;  while  in  the  case  of  the  hydrophone 
and  of  water  employed  in  my  experiments,  the  liquid  is  brought  in 
immediate,  or  almost  immediate,  contact  with  the  aperture  of  the 
stethoscope,  a  condition  which,  as  was  stated  in  a  former  communi- 
cation, is  essential  to  the  procuring  an  augmentation  of  sound  from 
solid  bodies  by   the   intervention   of  water. 

Park  Street,  Grosvenor  Square. 


ABSTRACTS  AND  SELECTIONS  for  the  PENINSULAR  AND  INDEPENDENT. 


By  M.  A.  Patterson,  M.  D.,  Tecumseh. 

ON   THE   TREATMENT   OF  ULCERATIONS  AND  OTHER  DISEASED  CONDI- 
TIONS OF  THE  OS  AND  CERVIX  UTERL 

By  way  of  introduction  to  an  article  from  the  p*en  of  Dr.  McRuer 
on  the  Uterine  Speculum,  published  in  the  August  No.  of  this 
Journal  we  had  occasion  to  allude  to  the  indiscriminate  employment 
of  this  instrument,  in  consequence,  perhaps,  of  the  general  circulation 
of  Dr.  James  Henry  Bennet's  book,  and  the  hasty  adoption  of  his 
boldly  asserted  theories. 

From  a  monthly  examination  of  the  periodical  medical  literature 
of  our  country,  it  is  gratifying  to  learn  that  the  dogmatisms  of  this 
European  Specialist  have  been  subjected  to  the  rigid  scrutiny  of  some 
of  our  most  practical  and  talented  physicians,  and  that  this  scrutiny 
is  rapidly  stripping  his  book  of  much  that  is  mischievous  in  its  pages. 
An  overweening  fondness  for  distinction  in  the  field  of  medical  spe- 
cialism, has  the  effect  of  ignoring  the  part  that  the  general  system 
plays  in  the  production  and  prolongation  of  disease,  and  leads  us  to 
expect  too  much   from  local,    and  too  little  from   general  treatment. 

We  have  seen  this  exemplified  in  the  cruel  local  treatment  of  that 
almost  mythical  affection  called  "spinal  irritation" — also  in  diseases 
of  the  eyes;  and  the  same  is  unquestionably  true  of  much  of  the 
modern  treatment  for  morbid  conditions   of  the  uterus;    as  these  mal- 


426  The,  Peninsular  and  Independent. 

adies  are  not  unfrequently  merely  symptomatic  of  some  constitutional 
disturbance,  remote  from  the  supposed  cause,  which  the  speculum  can 
not  detect,  nor  the  caustics  remedy.  The  following  remarks  on  this 
important  .subject  are   entitled   to   consideration : 

When  we  examine  all  that  has  been  written  on  this  subject  during 
the  last  ten  years,  and  find,  on  the  one  hand,  authors  of  unquestionable 
authority  contending  that  disease  of  the  os  and  cervix  uteri  is  of  extreme 
frequency,  and  that  to  it  may  be  referred  almost  all  the  morbid  sensations 
and  conditions  which  occur  in  the  female  from  puberty  upwards,  while,  on 
the  other  hand,  writers  of  equal  weight  and  eminence  insist  that  disease  of 
the  neck  of  the  womb  is  of  comparatively  rare  occurrence,  and  when  present, 
that  it  is  an  affection  attended,  most  commonly,  with  no  other  than  local 
symptoms,  and  these  of  no  decided  prominence,  while  the  general  system  is 
implicated  only  when  the  morbid  condition  of  the  uterus  is  very  extensive, 
has  been  of  long  duration,  or  is  of  a  malignant  character  —  we  can  only 
reconcile  this  striking  discrepancy — this  direct  opposition  of  opinion,  upon 
the  supposition  that  the  same  terms  are  made  use  of  by  the  supporters  of 
the  two  positions  in  very  different  senses.  In  no  other  manner  can  the 
remarkable  discordance  in  their  respective  statements  be  accounted  for, 
consistent  with  the  supposition  that  they  both  deal  in  facts,  based  on  ob- 
serva,tions  in  the  truth  of  which  they  honestly  believe.  For  it  is  to  be 
recollected  that  they  both  predicate  their  opinions  upon  the  results  of 
actual  observations  made  by  them  by  means  of  the  metroscope. 

Notwithstanding,  however,  the  different  and  dissimilar  views  enter- 
tained by  recent  writers  in  respect  to  the  frequency  and  importance  of 
ulceration  of  the  os  and  cervix  uteri,  Dr.  McRuek  believes  that  a  calm  and 
unprejudiced  observer  may  still  be  able  to  glean,  from  the  conflicting 
testimony  advanced,  some  important  pathological  hints,  and  valuable 
therapeutical  indications.  Thus,  from  Dr.  Benket's  admissions,  he  con- 
siders we  are  warranted  in  inferring  the  two  following  important  facts  in 
op2^osition  to  his-  theory:  namely^  the  trivial  character  of  his  so-called 
ulcerations ;  and  their  dependence  upon  constitutional  and  other  mala- 
dies. 

That  simple  ulceration  of  the  uterus  can  not  be  so  formidable  a  malady 
as  it  is  maintained  to  be  by  certain  writers,  i3r.  McR.  infers  from  the  fol- 
lowing facts :  — 

"In  cases  of  procidentia,  it  is  not  uncommon  to  see  the  os  and  cervix 
honey-combed,  as  it  were,  with  deep,  ragged  ulcerations,  and  it  may  be 
remarked  here  that  all  authorities  who  have  written  on  this  displacement 
admit  that  when  the  parts  are  returned  to,  and  kept  in,  their  natural 
position,  and  the  patients  observe  a  recumbent  posture,  with  the  occasional 
use  of  mild  astringent  washes,  these  really  true  local  ulcers  usually  become 
soon  cicatrized,  and  regain  a  perfectly  healthful  condition,  without  resort- 
ing either  to  the  speculum  or  to  the  caustic." 

From  the  facts  and  considerations  adduced  in  the  essay  before  us.  Dr. 
McR.  believes  the  conclusion  to  be  almost  irresistible  that  an  affection 
which  exists  under  every  variety  of  symptom,  some  contradictory  to  such 
as  usually  attend  upon  ulceration  in  other  parts,  and  even  in  the  same 
parts,  and  at  times  giving  rise  to  no  symptoms  whatever,  must  be  rather 
a  concomitant  of  various  primary  affections  than  a  disease  J9e7'  se^  and  that 
it  does  not  constitute  a  morbid  centre  from  which  irritations  radiate  to 
disturb  and  affect  distant  organs. 

Dr.  McR.  believes  that  from  constitutional  disturbance,  the  secretions 
of  the  mucous  membrane  of  the  uterus,  and  especially  from  the  glandular 


Selected  Articles.  Abstracts^  <&c.  427 


J,       ^J-l/Ot//    t,t,V!/0, 


portion  of  the  neck,  become  vitiated  in  character,  and  by  their  corrosive 
properties,  irritate  the  surfaces  with  which  they  come  in  contact,  produ- 
cing those  excoriations  which  are  oftentimes  attendant  upon  similar  affec- 
tions in  other  parts  of  the  body :  on  the  cheek  from  epiphora ;  on  the  nares 
and  upper  lip  from  coryza ;  on  the  glans  penis  from  blennorrhagia ;  and 
on  the  rectum  of  children  from  mucous  diarrhoea. 

"In  regard  to  the  therapeutics  laid  down  by  both  parties  in  this  con- 
troversy, as  the  most  judicious  in  cases  of  chronic  leucorrhoea,  attended  or 
not  attended  by  local  lesions  of  the  cervix,  there  is,"  Dr.  McK.  remarks, 
"no  great  difference  of  opinion,  except  so  far  as  a  resort  to-  destructive 
cauterization  is  concerned,  and  the  necessary  and  repeated  introduction  of 
the  speculum  ;  for  it  is  agreed  by  all  parties  that  absolute  rest  of  the  parts 
concerned  is  essential  to  their  return  to  a  normal  state;  consequently,  all 
mechanical  irritations  arising  from  sexual  congress,  or  sudden,  violent,  or 
prolonged  movements  of  the  body,  ought  to  be  avoided.  It  is  neglect  of 
this  single  requirement  that,  more  than  anything  else,  has  prevented 
recoveries  in  the  early  stages  of  leucorrhoea,  before  any  local  abrasion 
whatever  had  manifested  itself.  Cleanliness  of  the  vaginal  passage,  main- 
tained by  emollient  and  cooling  washes,  giving  to  them  an  astringency 
when  the  profuseness  or  liquid  character  of  the  discharges  seems  to  require 
it,  is  another  of  the  means  which  are  recognized  by  the  experience  of  all 
practitioners  as  requisite  in  the  successful  treatment  of  these  affections. 
Attention  to  the  general  health  is  another  important  sine  qua  non  in  the 
treatment  of  lesions  of  the  os  and  cervix  uteri,  or  even  of  the  vaginal  pas- 
sage. All  causes  tending  to  divert  or  confine  the  circulation  to  the  pelvic 
viscera  ought  to  be  avoided  and  removed,  such  as  long  continued  standing 
or  sitting,  as  such  positions  favor  gravitative  congestions  in  the  parts  con- 
cerned ;  and  consequently  the  vessels  ought  to  be  often  relieved,  by 
occasionally  adopting  a  horizontal  position  for  a  short  time  during  the 
day.  Constipation,  or  the  lodgment  of  hardened  foeces  in  the  rectum, 
prominently  comes  within  this  category ;  but  the  measures  used  to  remove 
this  cause  of  congestion  ought  not  to  be  such  as  to  leave  behind  their 
operation  an  irritability  equally  as  far  removed  from  health  as  the  con- 
gestion which  they  are  designed  to  relieve.  All  drastic  purgatives,  there- 
fore, especially  those  containing  aloes,  should  be  prohibited,  and  the  neces- 
sary soluble  condition  of  the  bowels  secured  by  attention  to  diet,  the 
occasional  use  of  tepid  water  injections  or  the  mildest  laxatives,  and  the 
strength  sustained  by  a  judicious  selection  of  tonics,  and  as  generous  a 
diet  as  the  patient  can  assimilate." 

"A  persistence  for  two  or  three  months  in  a  treatment  embracing  the 
principles  just  adverted  to,  choosing  such  particular  remedies  to  fulfil  the 
required  indications  as  each  individual  case  may  seem  to  demand,  modi- 
fying the  persistence  or  activity  of  the  treatment  conformably  with  the 
constitutional  idiosyncrasies  of  the  patient,  all  of  which  can  not  be  pre- 
cisely defined,  but  must  be  left  to  the  judgment  and  discrimination  of 
the  attending  physician,  will,  in  most  cases,  remove  the  malady.  But 
should  the  symptoms  attendant  upon  chronic  leucorrhoea  persist,  in  despite 
of  the  treatment  thus  laid  down,  then  a  resort  to  stronger  local  applica- 
tions may  be  proper,  from  the  supposition  that  local  abrasions  may  com- 
plicate the'  case.  Injections  per  vaginam  of  solutions  of  sulph.  zinc,  or 
decoctions  of  oak  or  Peruvian  bark,  daily  used  after  the  tepid  water 
washings,  or  a  solution  of  nit.  argent,  of  the  strength  of  gr.  vj  to  xij.  to 
Ij.  of  distilled  water,  may  be  advantageously  substituted  once  a  week, 
it  being  not  the  destrubtive,  but  the  antiphlogistic  or  vital  modifying 
effect  of  this  agent  that  is  required  in  such  cases,  as  has  been  so  admir- 
ably described  and  enforced  both  by  M.  Andral  and  Prof.  Meigs." 


428  The  Peninsular  and  Independent. 

From  the  facts  and  arguments  he  has  adduced,  Dr.  McR.  feels  war- 
ranted in  presenting  the  following  propositions  as  those  fully  sul^stan- 
tiatcd  by  the  testimony  of  the  most  eminent  observers  in  different 
parts  of  the  world,  and  corroborated  b}'-  legitimate  deductions  derived 
from  the  application  of  well  -  established  principles  in  physiology  and 
pathology  to  the  phenomena  connected  with  the  diseased  condition  in 
question. 

"1.  That  'ulceration'  is  a  lesion  presenting  an  excavation  or  solu- 
tion of  continuity,  produced  by  a  molecular  death,  the  lifeless  elements 
being  absorbed  back  into  the  circulation  through  the  action  of  the  ab- 
sorbents, and  is  generally  the  result  of  a  constitutional  cause ;  while  ab- 
rasions and  excoriations  are  produced  cither  by  mechanical  or  chemical 
agents  —  by  the  attrition  of  foreign  bodies,  or  the  escharotic  eltects  of 
morbid  secretions,  usually  the  product  of  other  parts,  and  coming  in  con- 
tact with  the  ulcerated  surface. 

"2.  That  while  abrasions  or  excoriations  are  of  frequent  occurrence 
on  the  cervix  uteri,  especially  in  the  pregnant  female,  ulceration  rarely 
exists  on  this  part,  excepting  from  mechnniciil  or  f<2iccific  causes ;  and  that 
all  of  these  lesions,  when  not  of  especial  character,  are  of  themselves  of 
trivial  importance,  only  demanding  by  their  complication  with  other  more 
important  diseases,  the  serious  attention  of  the  medical  practitioner. 

"3.  That  the  demonstrative  use  of  the  speculum,  or  the  direct  ap- 
plication of  caustics,  is  seldom  justifiable  or  required  in  the  diagnosis  or 
treatment  of  diseases  of  the  cervix  uteri ;  for  that  tactile  demonstration 
is  more  to  be  relied  upon  than  specular  examination,  and  that  the  ap- 
plication of  caustic  agents  for  the  cure  of  simple  lesions  ought  never  to 
be  made  destructive,  but  onl}^  to  produce  a  modification  of  the  molecular 
action  of  the  parts  diseased,  and  that  this  can  be  done  by  carefull}^  using 
solutions  of  a  strength  sufficient  to  produce  the  latter  effect  on  a  denuded 
surfiice,  without  the  possibility  of  endangering  the  adjoining  healthy  parts 
whose  epithelial  covering  has  not  been  destroyed. 

^^  Finally :  That  as  abrasions,  excoriations,  and  ulcerations  of  the 
cervix  uteri  are,  in  a  great  majority  of  cases,  the  results  of  constitutional 
disease,  or  functional  derangement,  therefore  the  treatment  of  these  lesions, 
to  be  permanently  successful,  must  be  principally  directed  to  the  general 
vitiation,  or  the  physiological  disturbance;  and  that  to  pronounce  the 
local  affection  a  disease  2^^^'  *^»  is*  to  encourage  a  practice  which,  while 
it  does  not  remove  the  organic  evil,  subjects  the  patients  to  a  greater 
injury  by  doing  violence  to  their  moral  sensibilities." 

[Am.  Journ  of  the  Med.  Sciences. 


RAW  MEAT  IN  THE  DIARRHCEA  OF  CHILDREX. 

TTe  are  assured  that  the  following  articles  on  the  efficacy  of  ravr 
meat  in  the  colliquative  diarrhoea  of  children  will  be  read  with  in- 
terest. We  have  recommended  raw  meat  as  proposed  by  Dr.  "Weisse, 
and  some  of  our  little  patients  have  rapidly  improved  under  its  use 
They  generally  prefer  the  scraped  or  grated  meat,  slightly  salted;  and 
this  addition  will  tend  to  remove  any  fancied  apprehensions  arising 
from  the  supposed  introduction,  with  the  raw  meat,  of  undeveloped 
parasites,  and  their  ultimate  growth  in  the  alimentary  canal.  Salt  is 
regarded  by  all  mothers  as    "good  against  worms." 


Selected  Articles^  Abstracts^  Sc.  429 

Raw  Meat  in  DiarrlicBa. — Our  readers  have,  doubtless,  not  forgotten 
the  interesting  history  of  the  two  little  twin  daughters  of  a  wealthy  Mul- 
house  merchant,  who  had  been  reduced  by  unconquerable  diarrhoea  to  the 
last  gasp  of  life,  and  who,  fed  with  the  pulp  of  raw  meat,  returned,  in  a 
few  months,  to  a  state  of  perfect  and  robust  health.  Many  facts  have,  since 
then,  confirmed  our  confidence  in  the  value  of  this  Russian  mode  of  treat- 
ment. Mr.  Trousseau  never  allows  an  opportunity  to  escape  of  recom- 
mending it,  and  of  pointing  out  the  best  manner  of  rendering  it  both  useful 
and  acceptable. 

The  meat  best  adapted  to  the  purpose  is  the  fillet  of  beef;  some 
patients,  however,  prefer  the  centre  part  of  mutton  chops.  It  should  be 
cut  fine,  pounded  in  a  mortar,  and  strained  through  a  sieve  or  cullender. 
The  pulp,  thus  separated  from  the  cellular  texture  of  the  muscular  sub- 
stance, is  then  gathered  with  a  knife,  and  rolled  in  salt  or  powdered  sugar, 
or  mixed  with  currant-jam. 

One  of  Mr.  Trousseau's  grandchildren  would  take  it  only  when  mixed 
with  racahout,  a  farinaceous  compound  of  cocoa,  ground  rice,  and  potato- 
flour,  sweetened,  and  flavored  with  vanilla.  Mr.  Trousseau  causes  it  some- 
times to  be  rolled  into  small  salted  balls,  of  the  size  of  a  hazel-nut,  or  in 
little  oblong  gobbets,  which  may  be  administered  in  soup,  to  the  number 
of  thirty  or  forty,  equivalent  to  four  or  five  ounces  of  meat  pulp.  In  grown 
persons,  and  particularly  with  ladies,  the  physician  will  probably  meet  with 
a  repugnance,  which  he  must  overcome  by  concealing  the  repugnant  charac- 
ter of  the  medication.  For  this  purpose,  some  appearance  of  cooking  may 
be  imparted  to  the  food,  by  exposing  a  thick  slice  of  the  meat,  for  twenty 
minutes,  to  the  action  of  a  brisk  fire  ;  its  surface  is  thus  roasted,  the  inte- 
rior parts  remaining  raw,  and  being  then  treated  as  we  have  said.  Mr. 
Trousseau  has  thus  caused  to  be  prepared  by  Mr.  Mialhe  (one  of  the  prin- 
cipal apothecaries  of  Paris)  meat-pulp  combined  with  confection  of  roses, 
destined  for  delicate  stomachs,  which  is  taken  without  disgust,  and  even 
with  pleasure,  under  the  agreeable  denomination  of  Damascene  Preserve. 

In  children,  the  dose  of  raw  meat,  the  first  day,  should  not  exceed 
2%  dr.  in  four  meals.  It  may  be  doubled  on  the  second  day,  and  on  the 
third  attain  eight  drachms  ;  and  so  on,  without  any  other  additional  food 
than  albuminous  water.  It  is  easy  to  measure  with  precision  the  quantity 
administered  daily,  by  means  of  a  small  balance  and  the  current  coins,  the 
weight  of  which  is  well  known — the  franc  being  equivalent  to  one  drachm, 
and  the  five-franc  piece  to  six  drachms.  The  dose  may  be  carried  as  far  as 
ten  or  twelve  ounces,  and  the  children  gradually  recover  their  good  looks, 
their  plumpness,  and  spirits.  At  the  end  of  a  month  or  six  weeks,  when 
diarrhoea  has  entirely  ceased,  the  quantity  of  raw  meat  can  be  gradually 
decreased,  and  broth  or  underdone  eggs  can  be  substituted,  so  as  to  reduce 
the  dose  of  meat  to  three  or  four  ounces  daily. 

It  is  necessary  to  be  aware  that,  at  first,  when  already  the  nature  and 
abundance  of  the  diarrhoea  has  undergone  a  favorable  change,  the  motions 
are  red  and  fetid.  In  one  of  the  little  Mulhouse  patients  we  above  referred 
to,  this  animal  diet  appeared  to  have  occasioned  the  developement  of  tape- 
worm, a  parasite  commonly  met  with  in  Abyssinia,  where  the  natives  feed 
on  raw  meat ;  but  this  kind  of  nutriment  not  being  so  long  persevered  in, 
generally,  as  was  the  case  in  the  instance  of  the  little  girl  alluded  to,  this 
circumstance  must  be  considered  exceptional  and  cannot  counterbalance 
the  decided  benefits  yielded  by  the  Russian  method  of  treatment,  in  cases 
of  chronic  disturbance  of  the  bowels,  and  especially  in  the  unconquerable 
diarrhoea  which   children   are  subject   to   in  their   second  year. 

[journ.  Pract.  Med.  and  Surg.  ^  Paris. 


430  The  Peninsular  and  Independent. 

Retrospect  on  the  use  of  Raw  Meat  in  the  Diarrhoea  of  Weaned  Chil- 
dren. By  Dr.  J.  F.  Weisse,  Director  of  the  Children's  Hospital  at  St.  Pe- 
tersburgh. — Seventeen  years  have  now  elapsed  since  I  first  directed  the  at- 
tention of  the  profession  to  this  invaluable  remedy  in  the  above  disease  ; 
but  it  was  not  until  I  had  five  years  later  treated  of  the  subject  at  greater 
length,  that  it  come  into  more  general  use.  Soon  after  the  publication  of 
the  latter  paper,  I  received  from  the  esteemed  editor  of  the  Journal  just 
now  quoted.  Dr.  Behrend,  of  Berlin,  a  letter  containing  the  following  pas- 
sage: "You  have  no  idea  what  interest  your  communication  on  diarrhoea 
ablactatorum  and  on  the  use  of  raw  meat  has  excited ;  we  now  use  the 
remedy  extensively." 

Not  long  after.  Dr.  Behrend  inserted  in  the  sixth  volume  of  his /owrTiaZ 
a  letter  of  M.  Marotte,  Physician  of  the  Central  Bureau  of  the  Parisian 
Hospitals,  from  which  it  appeared  that  this  subject  had  attracted  great  at- 
tention also  in  the  French  metropolis.  The  author  of  this  letter,  which  is 
addressed  to  Dr.  Trousseau,  has  moreover  had  the  kindness  to  suggest  a 
theory  explanatory  of  the  results  I  have  obtained.  From  this  time  the 
meat  cure  was  generally  received,  and  its  utility  admitted  on  all  sides.  Of 
the  numerous  favorable  reports  recently  published,  I  can  not  forbear  liter- 
ally transcribing  that  contributed  by  Dr.  Eichelberg,  because  the  author 
has  given  to  the  subject  the  appreciation  it  deserves.  He  says :  "In  conse- 
quence of  the  shortness  of  the  time  which  has  elapsed  since  this  article  of 
diet  was  first  recommended,  I  have,  it  is  true,  only  a  limited  number  of 
observations  (somewhat  more  than  twenty)  before  me,  but  they  all  corrobo- 
rate the  remarkable  advantages  of  the  plan  proposed.  It  is  only  in  excep- 
tional instances  that  such  children  refuse  raw  meat — the  great  majority,  in 
fact,  consume  it  with  manifest  relish.  I  have  observed  two  very  striking 
cases  where  the  children  for  several  weeks  readily  partook  of  this  food  with 
the  most  beneficial  results,  and  at  the  end  of  that  time  suddenly  refused  it. 
Natural  instincts  seems  in  such  examples  to  be  unmistakable,  as  in  the 
case  of  sick  dogs,  which  eat  grass.  The  want  of  osmazone  made  the  chil- 
dren greedily  consume  the  raw  meat,  but,  with  the  cessation  of  the  want, 
the  desire  for  that  principle  disappeared." 

As  Herr  Eichelberg,  moreover,  has  expressly  indicated  the  diarrhoea 
which  sets  in  soon  after  the  weaning  of  children  (according  to  my  observa- 
tions usually  in  two  or  three  weeks  after  that  event),  as  the  affection  in 
which  the  raw  meat  cure  is  attended  with  certain  success,  so  I  have  also, 
in  recommending  this  mode  of  treatment,  confined  myself  to  the  same  dis- 
ease ;  and  now,  after  nearly  twenty  years'  experience,  maintain,  that  raw, 
scraped  beef,  to  the  exclusion  of  all  other  medication,  is  a  true  specific  in 
in  this  destructive  diarrhoea,  I  therefore  consider  a  remark  made  by 
Charles  Hogg,  in  recommending  the  well-known  "beef-tea"  of  the  Eng- 
lish, to  be  quite  erroneous.  Thus  he  says  :  "Beef-tea  is  an  excellent,  nour- 
ishing, and  easily  digestible  article  of  food,  and  completely  replaces  the 
juice  of  meat  recommended  by  Weisse,  of  St.  Petersburgh,  obtained  by 
scraping  raw  flesh."  I  have  in  raw  beef  discovered,  not  an  article  of  food 
for  children,  but  a  remedy  against  the  diarrhoea  in  question ;  nor  have  I 
spoken  of  the  juice  to  be  obtained  by  scraping  meat,  but  the  muscular  sub- 
stance itself  must  be  given  to  the  children,  having,  however,  previously 
been  sufficiently  comminuted,  either  by  scraping  with  a  knife,  or  by  means 
of  a  grater,  in  order  that  it  may  be  swallowed  without  trouble.  But  the 
point  is,  that  the  muscular  substance  itself,  and  not  merely  its  juice,  should 
be  conveyed  into  the  digestive  tube.  The  English  beef-tea  has  as  little  bene- 
ficial effect  on  diarrhoea  ablactatorum  as  Liebig's  excellent  decoction  of 
meat.  Both  these  fluid  aliments  appear,  precisely  because  they  are  fluid, 
to  pass  too  quickly  through  the  intestinal  canal ;  while  the  meat  in  sub- 


Selected  Articles^  Abstracts^  cbc.  431 

stance  remains  longer  in  the  tube,  and  by  its  mechanical  irritation  may 
stimulate  digestion,  and  it  may,  perhaps,  also  neutralize  the  acridity  of  the 
gastric  juice.  Nor  can  I  participate  in  Dr.  Beer's  sanguine  hope  that  raw 
grated  beef  may  be  destined  one  day  to  dislodge  cod-liver  oil  from  the  Ma- 
teria Medica.  Each  of  these  excellent  remedies  has  its  definite  sphere  of 
medical  action  in  the  diseases  of  children  ;  raw  beef  in  the  diarrhoea  ablac- 
tatorum,  cod-liver  oil  in  rachitic  affections,  with  and  without  atropy. 

In  St.  Petersburgh,  the  meat  cure  in  the  affection  of  children  under 
consideration  has  become,  so  to  speak,  completely  naturalized ;  and  this 
has  taken  place  rather  through  oral  communication,  and  in  consequence  of 
the  favorable  results  of  the  treatment,  than  from  any  paper  or  essay,  as  I 
have  never  published  anything  in  that  capital  upon  the  subject.  Most  of 
my  colleagues  have  now  for  several  years  made  use  of  it,  and  they  all  as- 
sure me  thet  they  have  obtained  very  satisfactory  results,  even  in  cases 
where  the  employment  of  other  established  remedies  appeared  to  hold  out 
no  hope  of  cure.  I  have  myself  seen  this  treatment  adopted  in  about  two 
hundred  children,  and,  in  the  majority,  with  the  desired  effect,  provid  re- 
course was  had  to  it  at  the  proper  time.  I  say,  at  the  proper  time,  for  if 
the  disease  has  already  advanced  too  far,  and,  particularly,  if  it  has  assumed 
the  form  of  the  so-called  gastra-malacia,  it  is  only  in  exceptional  instances 
that  we  shall  obtain  a  cure.  But  even  in  this  case  there  is  no  other  remedy 
so  calculated  to  allay  the  most  tormenting  symptoms,  the  tantalizing  thirst, 
and  the  vomiting,  as  the  raw  beef.  This  beneficial  effect  is  produced  even 
after  a  few  meals. 

But  it  has  recently  been  stated,  as  I  have  already  publicly  remarked, 
that  in  many  children  saved  by  the  meat  cure,  tape-worm,  and  it  is  worthy 
of  note,  always  the  taenia  solium,  that  is  precisely  the  species  which  is  not 
indigenous  in  St.  Petersburgh,  has  shown  itself  A  Dr.  Braun  has  felt  him- 
self called  upon  to  question  this  statement;  two  years  later,  however,  an 
undoubted  authority  on  this  subject  appeared  in  favor  of  the  facts  reported 
by  me.  Prof  D.  Von  Siebold,  of  Munich,  says,  in  the  last  page  of  his  in- 
teresting work,  "  Uber  die  Band  und  Blasenwitemer,"  Liepsic,  1854 :  "  We 
can  no  longer  be  surprised,  or  consider  their  statements  fabulous,  when 
physicians  report  that  tape-worms  have  been  found  in  certain  patients  after 
the  use  of  raw  meat  prescribed  as  a  remedy  ; "  and  in  the  note  upon  this 
passage  he  adds  :  "  Compare  on  this  subject  Weisse's  communications, 
which,  notwithstanding  Braun's  objections,  are  worthy  of  all  credit."  Herr 
Von  Siebold  directs  particular  attention  to  the  fact  that  in  every  instance 
it  was  the  taenia  solium  which  was  passed :  and  he  considers  it  probable 
that  this  species  of  tape-worm,  which  is  not  indigenous  in  St.  Petersburgh, 
may  have  been  conveyed  thither  in  in  the  undeveloped  state  in  the  flesh  of 
oxen,  brought  from  Tacherkask  and  Podolia. 

Only  a  few  weeks  before  my  departure  from  St.  Petersburgh,  in  June 
of  the  present  year,  a  tape-worm,  more  than  four  feet  long,  was  sent  to  me 
by  a  colleague,  to  whom  I  had  warmly  recommended  the  meat  cure  in  the 
case  of  a  child,  aged  eighteen  months,  who  had  suffered  from  the  diarrhoea 
in  question,  and  was  already  very  much  run  down,  which  worm  was  passed 
after  the  use  of  the  etheral  oil  of  male  fern.  This  remedy  was  administered 
n  consequence  of  the  child,  who  had  long  ceased  to  get  the  raw  meat,  and 
was  cured  of  the  diarrhoea,  having  repeatedly  passed  joints  of  tape-worm. 
The  attendant  physician  had  already  correctly  diagnosed  the  worm  to  be 
the  taenia  solium  ;  I  found  that  it  was  voided  with  the  head,  on  which  the 
suckers  were  plainly  distinguishable  under  the  miscroscope. 

I  should  not  omit  to  state,  that  in  the  Children's  Hospital  under  my 
care,  in  the  diarrhoeas  of  older  children,  into  which  the  element  of  denti- 
tion no  longer  enters,  and  which  so  largely  contribute  to  fill  the  lists  of 


432  The  Peninsular  and  Independent, 

mortality,  raw  meat  has  been  repeatedly  and  successfully  tried.  These 
cases  of  diarrhoea  generally  depend  upon  ulcerations  in  the  intestinal 
canal. 

Lastly  I  may  be  allowed  to  call  the  attention  of  the  meeting  to  as  pala- 
table a  remedy  as  raw  beef,  in  the  lientery  of  adults ;  I  allude  to  oysters.  In 
two  cases,  an  amount  of  experience,  which,  I  must  admit,  goes  for  nothing, 
I  saw  the  patients  cured  by  the  moderate  use  of  these  mollusca.  From 
eight  to  twelve  oysters  were  taken  daily  in  two  meals. 

[Journcd  fur  Kinderh-anliTieiten^  Jan.  and  Feb.,  1858. 


TEEATMENT  OF  DIABETES. 

Dr.  Calhoun  of  St.  Charles,  Mo.,  writes  to  the  Editor  of  the 
American  Journal  of  the  Med.  Sciences,  that  he  has  successfully  treated 
Diabetes,  particularly  in  old  subjects  by  —  "Forbidding  the  use  of  fluids 
except  in  small  quantities,  and  enjoining  the  use  of  solid  food  and  the 
observance  of  quietude.  I  direct  the  following  powder  to  be  taken  three 
times  a  day,  viz:  Pulv.  Doveri,  gr.  v.  acetas  plumbi,  gr.  iij ;  sulph. 
quin.  gr.  ij.  If  necessary  the  bowels  are  to  be  kept  gently  open  with 
ol.  ricini.  I  have  never  found  it  necessary  to  continue  the  above  treat- 
ment more  than  four  or  five  days." 


ALUM  ON  BOUGIES  IN  STRICTURE. 

Dr.  E.  Mason,  Resident  Physician  of  the  Infirmary  of  the  Med. 
College,  Va..  details,  in  the  Ya.  Med.  Journ.  for  August,  a  case  of 
double  stricture  of  the  urethra,  of  nearly  four  years  standing,  produced 
by  genorrhoea.  The  first  stricture  "about  four  inches  from  the  orifice 
of  the  urethra,  yielded  in  a  few  days  to  ordinary  general  and  local  treat- 
ment ;  the  second  stricture,  some  three  or  four  inches  above  the  first, 
proved  obstinate  until  bougies  dipped  in  alum  were  used.  The  very 
first  attempt  was  successful,  when  every  other  admissible  means  had 
failed."     Dr.  M.  does  not  explain  the  rationale  of  the  treatment. 


MASTIC  IN  NOCTURNAL  INCONTINENCE  OF  URINE. 

Of  late,  several  writers  have  spoken  favorably  of  belladonna  in  this 
troublesome  affection.  "We  notice  an  article  in  the  2^.  Y.  Journ.  of 
Med.  translated  from  the  Bull,  de  Th'era^.  proposing,  on  the  recom- 
mendation of  M.  Debout,  the  following  remedy — "Formula;  —  Tears  of 
mastic  3  viij,  simple  syrup  q.  s.,  to  form  into  64  pills ;  or  if  the  child 
swallows  badly  the  mass  may  be  divided  into  128  pills,  or  the  mastic 
may  be  made  into  an  electuary  with  honey.  However  this  may  be,  if 
the  child  is  more  than  ten  years  old  it  must  take  the  whole  quantity 
in  four  days,  i.  e.  3  j.  morning  and  evening,  two  hours  before  or  after 
a  meal.  For  younger  children  the  dose  is  diminished,  so  as  to  extend 
the   3  viij  over  six  or  eight  days.     If  a  cure  is  not  operated  by  the  first 


Selected  Articles^  Abstracts^  <&c.  433 

Ibatch,  a  second  must  be  given  in  the  same  way,  but  there  is  no  use  in 
going  on  further.  In  more  than  two-thirds  of  the  cases  in  which  it  has 
been  used,  the  cure  has  been  complete,  and  that  in  persons  from  18  to 
24  years  old,  who  had  suffered  from  the  affection  from  infancy.  The 
powder  for  nocturnal  incontinence  of  urine  in  children  said  by  Dr. 
Faure  —  Bui.  Gen.  Iher.  —  to  be  generally  followed  by  a  cure  in  eight 
or  ten  days,  is  prepared  as  follows :  "  Carbonate  of  iron  fifteen  centi- 
grammes ;  extract  of  belladonna,  three  centigrammes ;  powdered  nux- 
vomica  three  centigrammes.     This  dose  to  be  taken  daily." 


TANNIN  IN  LARGE  DOSES  IN  ALBUMINOUS  ANASARCA  iArch.  Gen.  de  Med^ 
—Med.  Chir.  Rev.). 

The  conclusions  drawn  by  Dr.  Gardner  are  that  tannin  employed 
in  doses  of  from  two  to  four  grains  a  day,  (  3js.  to  3  j.)  cures  ana- 
sarca or  oedema  developed  passively,  and  occurring  simultaneously  with 
albuminous  urine ;  that  its  curative  action  is  manifested  by  abundant 
urine  gradually  resuming  its  physiological  characters,  by  perspiration, 
easy  alvine  evacuations,  return  of  appetite,  etc. ;  that  these  signs  ap- 
pear from  the  second  day  of  the  administration  of  the  tannin ;  that 
given  in  solution  of  doses  of  from  twenty  to  fifty  centigrammes  at 
a  time,  tannin  causes  no  unfavorable  symptoms  affecting  the  digestive 
passages;  and  lastly  that  the  action  of  tannin  appears  to  be  exerted 
primarily  upon  the  fluids  of  the  economy,  the  albuminous  principles 
of  which  it  coagulates  and  renders  plastig,  and  that  its  consecutive 
action   on  the   solids   appears  to   be   tonic   and   astringent. 


BIBRON'S  ANTIDOTE. 

The  journals  continue  to  confirm  the  favorable  opinions  hereto- 
fore expressed  of  the  power  of  this  remedy  as  an  antidote  for  the 
bane  of  poisonous  reptiles.  Dr.  Heery,  of  Atlanta,  Geo.  (Med.  and 
Surg.  Jour.).,  speaks  of  its  prompt  success  in  the  case  of  a  negro 
bitten   on  the   ankle   by  a   large   rattle-snake  (crotallus  confluentus). 

The  antidote  in  question  is  prepared  as  follows:  "5. — Potassi 
lodidi  grs.  iv;  hydrarg.  chloridi  corros.  grs.  ij ;  bromini  3  v. — M.  Dose 
"gtt.    X.  in  two   tablespoonsful   of  brandy,   repeated  if  necessary. 

HCEMOSTATIO  PROPERTIES  OF  PERCHLORIDE  OE  IRON. 

The  solution  of  this  persalt  is  now  almost  universally  employed 
to  arrest  arterial  or  venous  haemorrhage,  resulting  either  from  accident, 
or  as  a  consequence  of  surgical  operations.  It  has  also  been  found 
useful  in  intestinal  and  other  internal  hoemorrhages  where  the  bleed- 
ing had  resisted  the   ordinary   remedies. 

Vol.  XL  — 20. 


434  The  Peninsular  and  Independent. 

In  gonorrhoea  and  leucorrhoea  injections  of  the  perchloride  have 
been  tried  with  success  in  weak  and  lymphatic  subjects,  the  propor- 
tion of  the  perchloride  being  twenty  drops  to  three  ounces  and  a  half 
of  water.  .  ^  [Abstract  from  Lancet. 


MORTALITY  FROM  WnOOPING-COUGH. 

Infant  mortality  from  whooping  cough  is  often  a  puzzle  to  the 
faculty.  A  provincial  practitioner  at  Baziere  suspected  that  this  in- 
ternal organism  was  simply  the  consequence  of  supressed  cutaneous 
eruptions,  and  by  cultivating  an  external  rash  he  has  found  it  to 
yield  invariably.  The  eminent  Professor  Velpeau  of  Paris  has  stamped 
his   discovery   with   approval.  [N.    Y.  Med.  Press. 


WHITE  LEAD  PAINT  IN  CUTANEOUS  MALADIES. 

Mr.  Alfred  Freer  (Diihlin  Hospital  Gazette)  calls  attention  to 
the  value  of  the  common  pigment,  white  lead  in  oil,  in  treatment 
of    erysipelas,  carbuncle,  furuncle,    etc.     He  states : 

I  first  became  acquainted  with  its  great  eflQciency  in  the  treatment  of 
erysipelas  by  my  late  father  and  ni}'-  brother.  It  is  in  this  disease  that  the 
most  striking  benefit  results  from  its  application.  I  have  never  yet  met 
with  a  case  of  this  nature  where  it  has  not  done  immense  good.  I  find  it 
far  superior  to  lead  lotions,  mucilage,  hot  fomentations,  nitrate  of  silver,  or 
collodion.  After  erysipelas,  the  paint  proves  of  the  greatest  service  perhaps 
in  eczema  in  its  several  forms.  In  chronic  eczematous  eruptions  of  the 
aged,  it  affords  much  comfort,  and  often  speedily  effects  a  cure.  Of  late 
years  I  have  extended  its  employment  to  other  complaints  of  the  skin,  in- 
cluding herpes  in  its  several  forms.  I  have  tried  it  in  some  cases  of  small- 
pox, with  the  view  of  diminishing  the  number  of  vesicles  on  the  face,  and 
of  controlling  their  size ;  the  latter  indication  it  seems  likely  to  fulfil,  but  I 
can  not  speak  with  confidence  about  the  former,  the  papules  being  already 
numerous  at  the  time  of  my  visit.  I  have  also  used  it  in  several  cases  of 
carbuncle  and  furuncle.  The  first  was  in  an  instance  of  a  huge  Cv.rbuncle 
situated  on  the  loin  of  a  man,  and  rapidly  extending,  notwithstanding  free 
incisions,  linseed  poultices,  and  appropriate  constitutional  treatment.  I  ap- 
plied a  thick,  wide  circle  of  paint  round  che  swelling,  and  dressed  with 
resin  ointment  and  cotton  wool.  There  was  no  advance  of  the  disease  from 
that  time,  the  centres  rapidly  broke  up,  and  recovery  took  place.  It  is, 
however,  probable  that  the  omission  of  the  warm  poultice  may  have  contri- 
buted to  the  improvement,  for  I  have  often  observed  that  warm  poultices, 
however  well  made,  seem  to  foster  and  spread  carbuncular  inflammations. 

The  paint  seems  to  act  in  two  waj-s:  first  and  chiefly,  as  an  efficient 
excluder  of  the  air  —  that  great  irritant  to  the  cutaneous  surface  when  dis- 
ordered ;  and  secondly,  as  a  direct  sedative  to  the  sentient  nerve  filaments, 
rendering  them  less  prone  to  become  involved  in  inflammatory  action.  In 
boils  it  relieves  the  painful  tension,  and  favors  resolution.  In  some  forms 
of  painful  ulcers  of  the  leg,  of  a  small  size,  it  gives  great  relief  In  galling 
of  the  skin,  where  anasarca  is  present,  it  is  also  of  use ;  and  is  the  best  ap- 
plication that  we  have  in  burns  of  the  first  and  second  degree.  But  it  is  in 
erysipelas  that  its  triumph  is  most  manifest;  the  patient  soon  finds  the 


Selected  Articles^  Abstracts^  <&c.  435 

comfort  of  it.  The  tight,  shining  skin  soon  becomes  wrinkled  and  shrunken, 
indeed,  the  inflammation  very  rarely  extends  after  the  second  or  third  paint- 
ing. 

All  my  friends  to  whom  I  have  recommended  the  pigmentum  album 
speak  highly  of  it,  and  one,  who  is  a  Surgeon  in  the  Peninsular  and  Orien- 
tal Company's  service,  has  used  it  for  the  last  two  years  with  great  success. 
The'  manner  of  applying  it  is  by  means  of  a  feather,  painting  the  aLected 
parts  and  a  little  heyond^  and  laying  on  a  fresh  coat  every  two  hours  or  so, 
until  a  thick  layer  is  obtained,  and  then  sufficiently  often  to  maintain  a 
covering.  In  erysipelas  it  peels  off  in  a  week  or  so,  with  the  shed  cuticle, 
leaving  beneath  a  smooth,  clean,  healthy  surface.  Patients  are  struck  with 
the  benefits  they  derive  from  its  employment. 


•PREPARATION"  OF  OPIUM  IN  FRANCE. 

M.  Roux,  Professor  of  Botany  at  the  Naval  School  of  Rochefort,  has 
just  sent  in  an  interesting  paper  to  the  Academy  of  Sciences  on  the  cultiva- 
tion of  the  poppy  in  France  for  the  purpose  of  extracting  opium.  His  first 
researches  on  this  subject  date  from  1851,  but  were  more  especially  con- 
tinued by  him  during  1856,  1857,  and  1858,  on  eight  different  kinds  of 
poppy.  Ilis  results  are  stated  as  follows:  — 1.  The  Indian  poppy  furnishes 
a  considerable  quantity  both  of  opium  and  seed ;  the  cultivation  of  this 
vigorous  species  might  be  tried  in  those  departments  of  France  where  the 
oil  of  the  black  garden  poppy  is  a  staple  produce.  The  Indian  poppy  may 
be  easily  acclimatized  in  France.  A  quantity  sown  in  October,  1857,  has 
succeeded  perfectly,  and  the  young  plants  resisted  a  cold  of  10  degrees  cen- 
tigrade (18  degrees  below  Fahrenheit's  freezing  point)  in  the  following  win- 
ter. This  cold  proved  equally  harmless  to  the  white,  black,  and  red  species, 
which  were  sown  at  the  same  time.  2.  The  two  latter  produce  the  best 
opium,  and  their  juice  is  much  richer  in  morphine  than  is  the  case  with  the 
opiums  of  commerce.  3.  A  man  can  collect  100  grammes  of  opium  in  fif- 
teen hours ;  and  if  women  and  children,  who  are  so  often  in  want  of  em- 
ployment in  the  country  districts,  were  emploj^'ed  on  this  task,  the  opium 
necessary  for  medical  purposes  might  be  entirely  grown  in  France.  4.  The 
growing  of  opium  might  become  very  profitable  in  France,  where  poppy-oil  is 
manufactured  to  the  amount  of  from  25,000,000f  to  30,000,000f ,  and  where 
it  would,  consequently,  be  easy  to  add  a  new  branch  to  that  trade  by  the 
extraction  of  opium ;  and  it  might  even,  in  course  of  time,  become  an  arti- 
cle of  exportation.  Home-grown  opium  has  been  tried,  at  M.  Roux's  request, 
by  M.  Duval,  first  chief  Navy  Surgeon  at  Brest,  and  found  to  answer  very 
well,  owing  to  the  quality  of  morphine  it  contains. 


MEDICAL  ADMINISTRATION  OF  OZONIZED  OILS. 

In  a  paper  read  before  the  Royal  Medical  and  Ohirurgical  Society,  on 
Tuesday  the  28th  of  June,  Dr.  Theophilus  Thompson,  after  some  general 
remarks  on  the  properties  of  ozone,  describes  the  results  obtained  from  its 


436  The  JPeyimsular  and  Independent. 

administration  in  association  with  oils ;  the  oils  being  ozonized  by  exposure 
for  a  considerable  time  to  the  direct  rays  of  the  sun,  after  previous  satura- 
tion with  oxygen  gas,  according  to  the  process  adopted  by  Mr.  Dugald 
CiSMPBELL.  The  cases  of  fourteen  consumptive  patients  to  whom  the  ozon- 
ized oils  were  given  are  detailed ;  and  the  principal  facts  noted  are  also  ap- 
pended in  a  tabular  form.  The  conclusion  to  which  these  experiments  point 
is,  that  the  administration  of  ozonized  oils  has  a  remarkable  tendency  to 
reduce  the  frequency  of  the  pulse.  Of  the  fourteen  patients  whose  cases 
are  detailed  in  this  communication,  there  are  only  two  in  whom  no  such 
effect  was  observed  ;  and  although  in  a  few  instances  the  effect  may  have 
seemed  insignificant  or  transient,  in  a  larger  proportion  it  was  very  consid- 
cral)'!c,  and  must  be  attributed  to  the  ozone  rather  than  to  the  oil,  since  it 
was  repeatedly  manifested  in  patients  who  had  taken  cod-liver  and  other 
oils  without  any  reduction,  or  even  with  an  acceleration,  of  the  pulse ;  and 
further,  the  effect  on  the  pulse  was  nearly  as  distinct  when  the  ozone  was 
associated  with  the  oil  of  the  cocoa-nut,  or  of  the  sunflower,  as  with  that 
of  the  cod-liver.  This  circumstance  is  more  significant,  since  administra- 
tion of  sunflower  oil  without  ozone  has  not  appeared  to  the  author  to  mani- 
fest any  important  remedial  power.  The  reduction  of  pulse  was  usually 
observed  in  two  or  three  days,  and  often  continued  progressive.  A  reduction 
of  twenty  beats  was  observed  in  certain  cases  to  occur  respectively  in  two, 
three,  four,  and  six  days;  in  other  instances  a  reduction  was  noted  of 
twenty-four  pulsations  in  fourteen  days,  thirty-four  in  thirteen,  thirty-six  in 
twenty-two,  forty  in  eleven.  In  one  patient  the  pulse  fell  as  low  as  sixty — 
probably  considerably  below  the  natural  standard ;  but  in  most  of  the  favor- 
able instances  the  reduction  stopped  when  that  standard  was  obtained.  The 
apparent  effect  of  the  remedy  is  one  which,  prior  to  experiment,  the  author 
would  not  have  anticipated.  No  other  obvious  result  was  noticed,  except- 
ing a  general  improvement  in  the  patient's  condition.  In  some  of  the  pa- 
tients the  use  of  simple  and  of  ozonized  oils  was  alternated.  In  one  case 
the  alternation  was  made  three  times,  and  the  result  was,  in  each  inter- 
change of  treatment,  so  direct  and  remarkable  as  to  make  that  particular 
example  equivalent  in  force  to  three  experinients.  In  addition  to  the  pa- 
tients under  his  own  observation,  the  author  refers  to  four  instances  noted 
by  Dr.  Scott  Alison,  who  obligingly  pursued  the  investigation  during  Dr. 
Thompson's  absence  from  the  Hospital.  In  these  four  cases,  the  dis- 
ease was  in  the  third  stage.  In  two,  a  remarkable  reduction  in  the  rap- 
idity of  the  pulse,  amounting  to  about  twenty  beats,  occurred  under  the 
use  of  the  ozonized  oil,  while  the  improvement  induced  could  not  be  re- 
ferred to  any  other  cause.  Dr.  Alison  remarks  :  "  I  attach  some  value  to 
this  observation ;  for  I  prescribed  the  oil,  totally  divested  of  all  prejudice  in 
its  favor,  and  I  have  always  been  reluctant  on  imperfect  grounds  to  refer 
results  to  the  operation  of  medicines.  If  ozonized  oil  can  reduce  the 
ra;idity  of  the  circulation  —  a  feature  of  great  prominence  in  phthisis, 
—  this  remedy  possesses  a  most  valuable  property,  rendered    still  more 


Selected  Articles,  Abstracts,  dtc.  437 

valuable  by  its  contributing  at  the  same  time  to  improve  the  general 
health."  The  author  mentions  having  used  ozonized  oil  of  turpentine 
with  marked  and  prompt  advantage  in  some  cases  of  haemoptysis,  but 
has  not  sufficiently  repeated  the  experiment  to  feel  entitled  to  express 
an  opinion  as  to  its  remedial  superiority  over  ordinary  turpentine.  He 
adds  that,  should  more  extended  observation  establish  for  ozonized  oil 
the  property  indicated  by  these  experiments,  it  will  prove  a  valuable 
addition  to  our  list  of  remedies,  especially  in  consumption  (which  is  a 
disease  peculiarly  characterized  by  hurried  action);  but  not,  perhaps, 
exclusively  in  this  disorder,  since  there  are  other  morbid  conditions  iH' 
the  treatment  of  which  it  is  very  important  to  lower  the  pulse  without 
reducing   constitutional   strength.  ^  [Lo?id.  PJiar.  Journal. 


EXPERIMENTS  ON  THE  PHENOMENA  OF  RESPIRATION.  -  Br  Dr.  E.  Smith, 
In   this  paper,  the   author   describes  the   quantity  of  carbonic   acid 
expired,  and  of  air  inspired,  with  the  rate  of  respiration  and  pulsation 
in  reference  to  the  whole  day  and  night,  the  variations  of  the  day  with 
and  without  food,  and  the  variations  from  day  to  day,  and  from  season 
to    season.        The    total    quantity     of     carbonic    acid    expired    in     the 
twenty -four   hours    was   determined  in   four   gentlemen,    in    eight    ex- 
periments, some  of  which  were  continued  for  eighteen  hours,  with  short 
intervals  for   meals   only;    and    others   were   made   at  the  beginning  of 
each  hour  and  half -hour  during  that  period.    The  quantity  of  carbonic 
acid   exhaled  in  the   six   hours    of  the   night  is    1950  grains,  and  the 
total    amount    of    carbon    exhaled    in   the    twenty -four    hours    at  rest 
varied  from  5*1G  to  7*144  ounces  in  the  different  persons.    The  effect  of 
walking  at  two  and  three  miles  per  hour  is  found   to  be  equal  to  1  4-5 
and  2  3-5  times  that  during  rest ;    and  by  making  a  computation  of  the 
amount   of   exertion  made   by   different   classes   of    the  community,  the 
author  finds  that  in  the  non  -  laborious   class  the  carbon  was  increased 
from   7*144   ounces   when  at  rest,  to  8*68  ounces,   and  in  the  laborious 
class  to   12'19   ounces  daily.       During   profound    sleep,  the   amount  of 
carbonic   acid   is    lessened   to   the   extent   of   half   of  that  of  the  aver- 
age  of   the   day.      The   variations   of   the   day   with  food  are   so  great 
that   the   maximum   is   one -half   more   than   the  minimum,  and  in  one 
gentleman   it   was   nearly   double   the   minimum,  the  greatest  occurring 
after    each    meal,   but  particularly   after    breakfast    and    tea,    and    the 
least   immediately   before  the   meals.      During  a  fast  of   twenty -seven 
hours,  the  minimum   quantity   was  maintained   almost    without    change 
during  the  whole   period   of   wakefulness,   but  there  was  a  rise   at  the 
periods   when   the   quantity   usually  rose  with  food.      The    quantity   of 
carbon   evolved   in  twenty -four   hours   without    food    is    5*923    ounces 
instead   of    7*144   ounces   without  food  —  a   quantity  equal  to  that  con- 
tained in   20   ounces  of   bread.      The  blood  and  the  secretions  become 


438  The  Peninsular  and  Independent. 

unusually  alkaline.  The  variations  from  day  to  day  were  due  to 
temperature  and  the  state  of  the  system.  Sudden  increase  of  tem- 
perature caused  a  ^udden  decrease  in  the  respiratory  changes,  which 
continued  until  the  temperature  rose.  This  was  an  ever-  acting  cause 
of  variation,  but  was  the  greatest  after  the  cold  of  the  winter.  The 
state  of  the  system  caused  by  changes  in  the  proportion  of  waste 
and  supply,  varies  the  quantity  of  carbonic  acid  evolved  on  the  fol- 
lowing morning,  A  good  night's  rest,  a  feeling  of  health,  good  sup- 
ply of  food,  and  not  too  much  exertion,  give  an  increase  on  the 
following  morning  (hence  there  was  usually  a  high  state  of  system 
on  the  Monday),  and  the  reverse  under  the  contrary  conditions.  As 
these  conditions  vary  from  day  to  day,  the  amount  of  carbonic  acid 
evolved  varies  ever)'-  day.  The  variations  which  are  due  to  season  are 
very  remarkable  and  important,  since  it  was  shown  that  the  respiratory 
changes  vary  from  season  to  season  in  a  definite  and  periodic  man- 
ner, and  so  that  the  greatest  changes  occurred  in  the  cold  season, 
and  the  least  in  the  hot  season,  and  with  definite  periods  at  which 
this   variation   begins. 

Dr.  Smith  also  shows  the  amount  of  carbonic  acid  evolved  with 
the  exertion  of  the  treadwheel.  {^Proceedings  of  the  Royal  Society. 

SOLUBILITY  OF  ALKALOIDS  IN  FAT  OILS. 

At   ordinary  temperature,  100   parts   of  olive   oil   dissolves, — 

Morphine 0.00 

Narcotine  .         .         .         ,         .         .         .0.25 

Cinchonine  ......         1.00 

Quinine  .......    4.20 

Strychnine 1.00 

Brusinc  .......     1.78 

Atropine  2.62 

Veratrine 1.78 

The  solubility  of  alkaloids  in  fixed  oils  is  of  great  use  in  practi- 
cal medicine.  Very  often  ointments  are  used,  into  which  enter  ex- 
tracts of  belladonna,  hyosciamus,  cinchona,  etc.  Perhaps  effects  more 
sure  and  precise  would  be  obtained  if  oily  solutions  of  the  alkaloids, 
to  which  the   ointments   owe   their   properties,   were   used. 

Glycerine,  as   we   know,    possesses   the   property   of  dissolving   cer- 
tain  vegetable  alkaloids.     The   oleoles   like   the   glyceroles   can   certain- 
ly render  very  great  services  in  practical  medicine.     It  is  to  be  desired  . 
that  their  use  should  be  more  widely  spread.  —  Druggist. 


FCETID  BREATH.    BY  J.  Piddtjck,  M.  D. 

The    subject   of  foetid  breath    and    its   kindred   annoyances,   foetid 
perspiration,    particularly   that  of  the   feet,   is  of  too   much    importance 


Selected  Articles,  Abstracts,  <£'c.  439 

to  the  happiness  of  the  sufferers  from  this  cause,  and  their  friends,  to 
be  passed  over  lightly.  I  am  induced  to  send  you  the  result  of  my 
observations  upon  it: 

A  foetor  of  the  breath  and  of  the  feet  alternates  the  one  with  the  other. 
The  arrest  of  foetor  of  the  feet  is  followed  by  that  of  the  breath,  and 
mce  versa. 

A  foetor  of  the  breath  proceeds  from  the  subaceous  follicles  of  the  ton- 
sils ;  that  of  the  feet  from  the  subaceous  follicles  between  the  toes,  also  in 
the  armpits  and  illia.  This  in  some  cases  is  so  penetrating,  so  offensive,  as 
to  cause  the  subject  of  it  to  be  shunned  even  by  the  members  of  his  own 
family.  Several  cases  of  this  kind  have  been  successfully  treated  as 
follows :  — 

1.  To  avoid  all  strong  scented  articles  of  diet,  such  as  cheese,  hashes, 
meat  puddings  and  pies,  smoked  meats  and  smoked  fish,  fried  meats  and 
fried  fish,  and  the  outside  brown  fat  of  roast  or  boiled  meats. 

2.  To  promote  the  subaceous  secretion,  the  vapor-bath  has  been  pres- 
cribed ;  and,  as  an  alterative,  the  decoction  of  polygala  senega-root. 


TONIC  PROPERTIES  OF  HTPOPHOSPHITE  OF  QUINIA. 

Dr.  Archer  B.  Cook,  of  the  University  of  Louisville,  has  been 
employing  this  salt,  introduced  by  Prof  J.  Lawrence  Smith,  in  some 
cases  of  Phthisic.  He  gives  it  the  preference,  as  a  tonic,  stomachic 
and  ante  -  hectic  cover  the  other  salts   of   hypophosphian  acid. 


Ilrarmanutital  g^prtmat. 


Combination  of  Iodine  with  the  Extractive  Principle  of  Vegetable. 

Vegetables,  to  whatever  class  they  belong,  whether  tannifers  or  not, 
possess  the  singular  property  of  assimilating  iodine,  and  forming  with 
this  matalloid  a  true  combination.  According  to  some  researches  which 
I  have  made  upon  these  different  transformations,  the  presence  of  tan- 
nin appears  to  me  not  indispensable.  I  have  made  a  number  of  com- 
parative trials,  I  have  employed  vegetables  which,  according  to  chemii 
cal  analysis,  do  not  contain  any  or  contain  very  little  tannjn,  such  as 
menyerthes,  licorice,  tobacco,  etc. ;  on  the  other  hand,  I  have  chosen 
substances  eminently  astringent,  such  3^  catichu,  snakeroot,  rhatany, 
etc.,  etc.  The  results  have  been  the  same,  that  is  to  say,  that  in 
the  one  as  in  the  other  case  I  have  been  able  to  combine  enormous 
quantities  of  iodine. 

The  proceeding  that  I  employ  permits  of  obtaining  products,  al- 
ways identical,  that  can  serve  as  the  foundation  of  a  crowd  of  phar- 
maceutical preparations,  such  as  pills,  sirups,  extracts,  pastels,  etc. 
etc.,  from  which  the  art  of  medicine  can  draw  means  useful  for  com- 
bating certain  affections.  For  the  rest  it  is  for  practitioners  to  judge 
for   themselves. 

Here  are  many  formulas   which  I  give  as  types : 

lodated  Syrup  of  Guraco. 

Alcoholic  extract  of  curacao    . 

Pure  Iodine       ......       1 

Alcohol  of  86  ^ 

Concentrated  sirup  and  sugar 

lodated  Syimp  of  Walnut  Leaves. 

Extract  of  walnut  leaves  .... 
Pure  iodine       ...... 

Alcohol 

Sirup  and  sugar 

lodated  Pastels  of  Chocolate. 

lodated  extract  of  curacao 

Vanilla  chocolate       ..... 

Mix  and  make  into  pastels  of  about  1  grm. 


grm. 

30 
60 
98 

grms. 
centing. 

• 

870 

grms. 

oes. 

60 

grms. 

1  grm, 

.    60 
q.  s. 
940 

centig. 

♦ 

15 

485 

grms.. 

Pharmaceutical  Department.  441 

Fifteen  grammes  of  extract  contains  two  grammes  and  fifty  centi- 
grammes of  iodine.  Each  pastel  consequently  contains  half  a  centi- 
gramme of  iodine. 

The  iod?'.ed  sirup  of  hops,  gentian,  cinchona  and  saraparilla  may 
be  prepared   in   the  same  manner. 

\JouT.  de  Chim.  Med.  and  I'Tie  Druggist. 


Process  for  Silvering  Animal,  Vegetable,  or  Mineral  Substances. 

The  process,  of  which  we  have  already  said  a  word  in  the  Moniteur 
Scientijiqiie^  is  founded  upon  the  electro  chemical  action  exercised  by 
certain  liquors  in  which  the  objects  to  be  silvered  are  plunged.  Here 
is  the   mode   of  preparation  of  these  liquors. 

Liquor  No.  1. — Take  two  parts  by  weight  of  caustic  lime,  five  of 
sugar  of  milk  or  grape  sugar,  two  of  gallic  acid,  and  make  of  them  a 
mixture  in  650  parts  of  distilled  water ;  filter,  protected  from  the  air  as 
much  as  possible,  and  put  in  a  closely  stopped  bottle  until  moment  of 
using. 

Liquor  No.  2, — Dissolve  twenty  parts  of  nitrate  of  silver  in  twenty 
parts  solution  of  ammonia,  and  add  to  this  solution  650  parts  distilled 
water. 

When  it  is  intended  to  operate,  the  two  preceding  liquors  are  mixed 
in  equal  quantities,  and  after  having  been  well  agitated,  filtered. 

As  the  solution  of  ammonia  of  commerce  has  not  always  the  same 
degree  of  concentration,  it  would  be  better,  perhaps  to  dissolve  the 
nitrate  of  silver  destined  for  the  liquor  No.  2,  first  in  distilled  water, 
then  mix  this  solution  with  liquor  No.  1,  and  only  then  add  ammonia 
in  quantity  sufficient  to  entirely  clear  the  mixture,  taking  care  always 
not  to  maintain  an  excess  greater  than  is  necessary  to  prevent  the  sil- 
ver from  being  precipitated. 

Suppose  it  is  intended  to  silver  silk,  woolen,  cotton,  etc.,  we  com- 
mence by  washing  the  substance  clean;  this  done,  we  immerse  it  for  a 
moment  in  the  saturated  solution  of  gallic  acid ;  then  withdraw  it  to 
plunge  it  for  a  second  in  another  solution  composed  of  twenty  parts  of 
nitrate  of  silver  to  1000  parts  of  distilled  water.  These  alternate  im- 
mersions are  continued,  until  the  substance  from  being  dark  becomes 
of  a  brilliant  tint;  after  that  it  is  plunged  in  a  bath  composed  of  a 
mixture  of  the  two  liquors  Nos.  1  and  2.  When  completely  silver- 
ed, it  is  withdrawn,  and  boiled  in  a  solution  in  water  of  a  salt  of  tar- 
tar, and  there  remains  nothing  more  to  be  done  but  a  last  washing 
and  drying.  ^ 

Bone,  horn,  wood,  paper,  etc.,  silver  in  the  same  way,  with  this  dif- 
ference however,  that  in  the  place  of  the  alternate  immersions  above 
indicated,  we  may  content  ourselves  with  passing  over  the  objects  a 
brush  or  pencil  that  is  dipped  alternately  in  the  gallic  acid  solution  and 
in  that  of  nitrate  of  silver. 


442  The  Peninsular  and  Independent, 

For  leather  tanned  with  sumach,  in  the  place  of  nitrate  of  silver, 
the  chloride  mixed  with  a  few  drops  of  rosemary  oil  njay  be  employed 
with  advantage. 

Stucco  and  pottery  ought,  before  being  submitted  to  the  operation, 
to  be   covered   with   a  coat   of  stearin  or  varnish. 

To  silver  glass,  crystal,  or  porcelain,  we  commence  by  washing 
completely  the  object  with  distilled  water,  and  with  alcohol,  and  then 
operate  as  has  been  said  with  the  mixture  of  the  two  liquors.  In 
working  with  vases,  they  can  be  filled  with  the  mixture,  and  ob- 
jects with  plane  surfaces  are  placed  in  a  horizontal  position  and  the 
liquor  poured  on  them.  However,  to  silver  mirrors,  we  can  dispose 
the  plates  of  glass  in  a  vertical  position ;  place  them  two  and  two 
face  against  face,  in  double  troughs  of  gutta  percha,  taking  care  to 
prevent  all  contact  with  the  sides  ;  then  fill  with  the  liquid.  Quarter 
of  an  hour  after,  the  precipitation  of  silver  commences,  and  at  the 
end   of  a  few  hours  the  operation  is  finished. 

The  silvered  surfaces  are  then  washed  with  distilled  water,  dried  by 
free  air  and  heat,  in  the  last  place  covered  with  a  layer  of  varnish. 
The  deposition  of  silver  can  be  accelerated  by  the  employment  of 
heat;  in  this  case,  the  temperature  depends  upon  the  nature  of  the 
objects   to   be   submitted  to  the   operation. 

As  for  the  metals,  we  commence  by  cleansing  them  with  nitric 
acid;  rub  them  afterwards  with  a  mixture  of  cyanide  of  potassium 
and  powdered  silver ;  then,  after  washing  with  water,  they  are  plunged 
alternately  into  the  liquors  Nos.  1  and  2,  until  they  appear  sufficiently 
silvered.  If  working  with  iron,  it  should  be  first  immersed  in  a  solu- 
tion of  sulphate   of  copper. 

The  process  which  has  been  described  presents  above  all  others 
the  advantage  of  very  solid  results,  and  of  employing  chemical  agents 
of  low   price.  \Jout.  de  Chim.  Med.  and  The  Brugyist. 

Therapeutical  Action  of  Dulcamara  aud  Solanine. 

Prof.  Caylus,  of  Leipzig,  has  undertaken  a  series  of  experiments 
to  ascertain  the  exact  effects  of  Dulcamara,  and  its  active  principle  So- 
lanine. These  substances  belong  to  the  class  of  narcotic  acrids,  as  they 
produce  a  paralizing  action  on  the  medulla  oblongata,  and  an  excit- 
ing  action   on   the   nerves. 

They  cause  death  by  producing  paralysis  of  [the  respiratory  mus- 
cular apparatus,  by  an  action  analogous  to  that  of  coneine  and  nico- 
tine. They  possess  a  therapeutical  action  in  spasms,  and  in  irritable 
conditions  of  the  respiratory  organs,  in  simple  spasmodic  cough,  hoop- 
ing cough,  and  spasmodic  asthma.  Their  therapeutical  action  in  cer- 
tain morbid  conditions  of  the  blood,  as  gout,  rheumatism,  constitu- 
tional syphilis,   and  perhaps   in   certain  chronic  conditions  of   the  skin, 


Pharmaceutical  Department.  443 

may  be  owing  to  their  augmenting  the  excretion  by  the  kidneys,  of 
the  constituent  parts  of  the  blood  which  have  undergone  combustion, 
and  not  to  the  excitement  of  cutaneous  activity. 

Solanine  and  Dulcamara  may  be  given  without  danger  in  inflam- 
matory conditions  of  the  stomach  and  intestinal  tube,  as  they  exer- 
cise no  action  on  those  organs. 

Inflammation  of  the  respiratory  organs  present  no  contra-indication 
of  their  employment,  but  they  are  contra  -  indicated  in  inflammation 
of   the  kidneys. 

The  medium  dose  of  Acetate  of  Solanine,  which  M.  Caylus  pre- 
fers to  the  Solanine  itself,  on  account  of  its  greater  solubility,  is 
from  about  one -eighth  to  about  five -eighths  of  a  grain.  The  best 
form  for  administration  is  in  pill,  because  solutions  of  it  have  a  very 
disagreeable  taste.  The  Alcoholic  extract  is  much  better  than  that 
made  by  the  agency  of  water. 

[Presse  Medicate  Beige,  from  Medical  News. 


Nux  Vomica  as  a  Febrifuge. 

M.  Angels  Pogliani  has  tried  nux  vomica  in  thirty -seven  cases  of 
fever  which  should  be  divided  in  the  following  manner :  one  case  of 
quartan,  two  of  quotidian,  two  of  double  tertian,  thirty  -  two  of  sim- 
ple tertian. 

The  use  of  the  medicine  was  always  preceded  by  a  saline  or 
oily  purgation  and  acid  drinks.  The  dose  was  from  six  to  nine  grains 
of  nux  vomica,  divided  into  eight  papers,  one  taken  every  two  hours 
during  the  apeynxia.  If  the  fever  returned  another  dose  of  nux  vomica 
was  administered,  or  the  half  only  of  the  first  prescription  in  one 
or  two  times.  Under  the  influence  of  this  medicine  twenty  cases 
yielded  to  the  first  dose,  eleven  required  two,  four  required  three* 
and  two  were  absolutely  rebellious  to  the  medicine.  It  is  neces- 
sary to  add  that  with  the  last  two  subjects  quinine  was  equally  in- 
efficacious, an  effect  which  M.  Pogliani  attributes  to  a  strongly  marked 
state  of  gastric  inflammation. 

[Jour,  de  Ghim.  Med.  and  The  Druggist, 

Use  of  Glycerine  in  Dysentery. 

Dr.  Dante  expresses  himself  thus  in  the  Union  Medicate:  Encour- 
aged by  a  first  attempt,  I  have  employed  glycerine  in  potions  and 
clysters  with  many  patients  taken  with  commencing  dysentery,  and  I 
have  seen  with  pleasure  that  the  malady  has  often  been  stopped  by 
this  means  alone.  Many,  notwithstanding  they  went  to  stool  from  two 
to  four  times  an  hour,  had  tenesmus,  only  passed  with  much  efibrt 
bloody  mucus,   and   experienced  violent  colics. 


444  The  Pewhisular  and  Independent, 

Here   are  the  formulas  that  I  have  used: 

Clyster — Glycerine 30  grms. 

Decoction   of  flax-seed      ....  150      " 
Two  clysters  a  day. 

Dmz^^^^— Glycerine 45  grammes. 

Orange  flower  water     .         .         .         .  q.  s. 

Water  enough   to   make         .         .         .  150         " 
Two  spoonfuls  every  hour. 

There  is  wanting  here  a  sign  useful  for  deciding  if  the  glycerine 
alone  has  produced  the  eflfects  which  Dr.  Dante  has  verified,  or  even 
if  the  cure  would  not  have  been  sooner  obtained  with  glycerine  slight- 
ly acidulated  with  sulphuric  acid,  efficacious  from  that,  like  the  water 
of  Rabel. 

Glycerine  so  often  contains  a  small  quantity  of  this  acid  that  a 
preliminary  test  of  the  medicine  would  have  been  necessary  in  the 
case.  \Jour.  de  Chlm.  Med.  and  The  Druggist. 


PEEPARATION   OF  CAFFEIN. 

The  process  of  cafifein  most  used  consists  in  treating  ground  cof- 
fee with  boiling  water,  and  adding  to  the  infusion  a  salt  of  lead,  for 
the  purpose  of  precipitating  the  tannin.  The  precipitate  is  washed 
With  boiling  water,  and  the  filtered  liquid  treated  with  sulphuretted 
hydrogen,  to  remove  the  excess  of  lead.  The  liquid,  deprived  of  the 
sulphide  of  lead,  is  concentrated  by  a  moderate  heat,  and  crystals  of 
cafiein  obtained. 

To  prepare  this  substance,  M.  Vogel,  indicates  a  mode  more 
simple  and  less  costly ;  it  consists  in  treating  the  coffee  with  benzole ; 
we  isolate  by  this  means  the  caffein  and  an  oily  substance.  The 
benzole  is  separated  by  distillation  ;  the  residue  is  put  in  boiling  water, 
which  dissolves  all  the  caffein,  which  can  be  crystallized  by  the  con- 
centration of  the  liquid. — Jour,  de  Phar.  et  de   Chemie  and   Druggist. 


VERMIFUGE   PROPERTIES   OF  THE   CHINESE  AILANTUS. 

The  Chinese  ailantus  {Ailantus  glandulosa)  has  been  hitherto  known 
only  as  an  ornamental  tree  of  a  very  elegant  appearance  and  rapid  develop- 
ment. During  the  last  few  months  it  has  acquired  importance  by  yielding 
a  valuable  vermifuge  agent,  according  to  some  remarks  published  by  Mr. 
Hetet,  Prof,  at  the  Naval  School  of  Medicine  at  Toulon.  In  the  experi- 
ments which  he  describes,  he  makes  use  of  the  following  preparations, 
namely,  the  powdered  bark,  the  powdered  leaves,  the  watery  extract  of 
the  bark,  the  alcoholic  extract  of  the  bark,  the  oleo-resin,  and  the  resin. 
These  experiments  were  made  on  dogs,  and  afterwards  on  man.  M.  Hetet 
describes  three  cases,  in  all  of  which  the  powdered  bark  of  the  ailantus 


Pharmaceutical  Department.  445 

caused  the  expulsion  of  tape-worm.  The  powder  of  the  bark  was  given 
at  first  in  the  dose  of  half  a  gramme,  and  the  watery  extract  in  the  dose  of 
one-fourth  of  a  gramme ;  the  oleo-resin  in  the  dose  of  one-fifth  of  a  gramme  * 
the  resin  in  the  dose  ot  two-fifths  of  a  gramme  rarely  occasioned  the  expul- 
sion of  fragments  of  the  taenia.  M.  Hetet  thinks  that  it  is  to  the  volatile 
oil  aliantus  that  we  ought  chiefly  to  attribute  the  phenomena  of  weakness 
observed  in  man  and  in  dogs,  since  the  resin  alone  does  not  produce  them. 
He  also  observes  a  fact  deserving  of  recollection,  namely,  that  the  effect  of 
this  essential  oil  is  so  well  marked,  that  it  is  necessary  for  persons  to  take 
great  care  of  preserving  themselves  from  its  vapor  during  its  preparation. 
According  to  this  author,  the  ailantus,  taken  in  a  vermifuge  dose,  does  not 
exert  any  injurious  effect  upon  the  health,  and  does  not  distress  the  patient 
like  the  root  of  the  pomegranate  and  kousso.  The  local  effects  are  con- 
fined to  slight  colic,  and  sometimes  to  a  moderate  degree  of  purging.  — 
Journal  de  Pharmacie  et  de  Chemie  and  Druggist. 


NEW  MIXTURE  FOR  WHOOPING  COUGH. 

The  following  process  is  a  modification  of  the  formula  given  by 
M.  Dalaiiave,  which  he  asserts  will  be  successful  after  all  other  re- 
medies  have  failed. 

Dr.  CouRBASSiER  says  that  in  localities  where  whooping  cough 
appears  as  an  epidemic,  year  after  year,  he  has  rarely  been  disap- 
pointed  in   its    use   as   a   remedy   for   that   distressing   complaint: 

Take  of  Mocha  or  Martinique  Coffee,  slightly 

browned,  in  powder.  8  oz. 

Boiling  water,  q,  s. 

Treat  the  powdered  coffee  with  the  hot  water  by  displacement,  until 
sixteen  ounces  of  decoction  will  have  been  obtained,  in  which  dissolve 
Ext.  Belladonna,  Ale. 
*  "     Ipecac  "  of  each,  75  grains. 

"     Cinchona        "  36      " 

Sugar  16  oz. 

Dissolve  by  the  aid  of  a  gentle  heat,  and  filter. 

Dose  for  children  three  or  four  years  of  age,  a  tablespoonful  repeated 
three  times  a  day ;  under  that  age,  half  the  quantity  at  a  dose.  —  Eevue 
de  Therapeutique  and  Semi-Monthly  Med.  News. 


SULPHUR  AS  A  DENTRIFICE. 

Dr.  C.  W.  Wright  says,  in  an  article  on  this  subject  in  the  Louisville 
Medical  Gazette^  that  the  common  flower  of  sulphur,  of  the  drug  store, 
possesses  advantages  over  all  other  substances  on  account  of  its  antiseptic 
properties,  its  exerting  no  injurious  action  on  the  teeth,  either  chemical  or 
mechanical ;  its  ready  preparation  and  cheapness.     The  sublimed  sulphur 

*  A  suitable  quantity  of  Pulv.  Ipecac,  may  be  substituted  for  Extract.  — •  Eds. 


446  The  Peninsular  and  Independent. 

must  be  freed  from  any  acid  which  it  may  contain  by  agitating  it  in  water 
in  which  a  small  quantity  of  carbonate  of  soda  has  been  dissolved,  and 
then  freed  from  the  soda  by  repeated  washings  in  cold  water.  —  Medical 
and  Surg.  Re'porur. 


JTEWS    ITEMS. 

In  most  of  the  following-  instances  of  loss  of  life  and  property,  the 
"accident"  no  doubt  resulted  from  the  criminal  carelessness  of  filling  the 
the  lamp  with  fluid  while  it  was  burning :  and  yet  people  will  not  take 
warning ! 

Mr.  E.  Meriam,  of  Brooklyn,  states  that  he  has  kept  a  record  of  deaths, 
injuries,  and  conflagrations,  resulting  from  the  use  of  camphene  and  other 
burning  fluids  used  for  the  i)urpose  of  illumination,  since  July  22d,  1850. 
Since  that  date  he  has  recorded  the  deaths  of  three  hundred  and  seventy 
person,  and  the  injuries  of  four  hundred  and  sevent3'-sevcn  persons,  many 
of  the  latter  of  whom  the  accounts  stated  were  not  expected  to  survive  the 
injuries  they  received.  The  losses  by  fire  from  these  fluids  he  estiroated  at 
upwards  of  one  million  of  dollars.  Mr.  Meriam  says  that  when  the  weather 
becomes  hot,  in  summer,  the  danger  in  the  use  of  burning  fluids  will  in- 
crease. In  the  short  term  of  thirty-six  days  within  the  present  5'ear,  he 
had  recorded  the  death  of  nine  persons  by  camphene  and  burning  fluid. 

Dust  Floating  in  the  Air. — M.  Pouchet  finds  that  the  dust  floating  in 
the  air  contains  the  detritus  of  the  mineral  constituents  of  the  globe,  atoms 
of  animals  and  plants,  and  the  finest  debris  of  all  the  matters  we  make  use 
of  But  one  item  he  especially  points  out,  viz.,  icheat  starchy  which  is  inva- 
riably found  in  the  dust  whether  old  or  recent.  Surprised  at  the  quantity 
of  it  present  among  the  ^rial  corpuscles,  M.  Pouchet  investigated  the  dust 
of  all  ages  and  of  every  localit}^  and  everywhere  he  found  this  wheat  starch 
presented.  "  I  have  found  the  starch  in  the  most  inaccessible  corners  of 
old  Gothic  churches,  mixed  with  dust  blackened  by  six  or  eight  centuries 
of  existence.  I  have  found  it  in  the  palaces  and  caves  of  the  Thebiad, 
where  it  may  have  dated  from  the  time  of  the  Pharoahs  ?  I  have  found  it 
in  the  tympanic  cavity  of  the  tympanum  of  a  mummified  dog,  which  I  had 
found  in  a  subterranean  temple  of  Upper^  Egypt.  In  all  countries,  in  a 
w^ord,  where  wheat  forms  the  staple  of  food,  starch  always  penetrates  into 
the  dust,  and  is  met  with  in  greater  or  less  quantities.  Hence  therefore 
the  corpuscles  of  which  we  have  heard  so  much,  are  granules  of  starch  and 
silica. 

Twice  only  in  a  thousand  experiments  has  M.  Pouchet  observed  the 
large  ova  of  infusoria  in  the  atmospheric  dust. 

Disgraceful  Encounter  between  two  Physicians. — The  profession  has 
been  insulted  by  a  most  disgraceful  scene  between  two  surgeons,  at  New 
Orleans.  Dr.  John  D.  Foster  and  Dr.  Samuel  Choppin,  both  attached  to 
the  Charity  Hospital,  got  into  a  fight  on  the  27th  of  August,  over  a  patient 
who  applied  to  have  the  operation  of  tying  the  subclavian  artery  performed. 
After  an  interchange  of  injurious  and  profane  language,  they  drew  pistols 
and  fired  several  shots  at  each  other,  whereby  Dr.  Choppin  fell,  dangerously 
wounded  in  the  neck  and  hip.      They  were  about  finishing  the  fight  with 


N'ews  Items.  447 

knives,  when  they  were  separated,  like  dogs,  by  the  bystanders.  "What  be- 
came of  the  unfortunate  patient,  we  are  not  informed,  but  we  think  he  will 
be  slow  in  trusting  himself  again  in  the  hands  of  such  murderous  practi- 
tioners. Dr  Foster  was  arrested,  but  was  subsequently  released  on  bail  in 
the  sum  of  $5000. — Boston  Med.  Jour. 

Dr.  James  J.  Irby  being  in  Hamilton  (Ga.)  on  the  26th  ultimo,  was, 
while  taking  out  the  cushions  of  his  buggy  previous  to  a  rain,  struck  by 
lightning,  and  instantly  killed.  The  circumstances  were  rather  unusual 
and  strange,  nothing  being  struck  but  Dr.  Irby.  Although  the  place 
where  the  buggy  was  standing  was  an  open  one,  still  not  more  than  twenty 
steps  off  were  tall  houses  with  chimneys,  and  near  the  buggy  were  several 
posts,  yet  the  whole  charge  seemed  to  strike  the  Doctor,  entirely  mutilat- 
ing his  hat,  singeing  his  hair,  and  making  some  marks  of  violence  on  his 
body,  but  not  tearing  or  burning  his  clothing  in  the  least.  The  deceased 
leaves  a  wife  and  children,  together  with  a  large  circle  of  friends,  to  mourn. 

The  Dust  of  Ages — "  Mickographie  Atmospherique." — Under  this 
title  the  Gazette  Hebdom.^  April  1st,  in  its  report  of  the  meeting  of  the 
Academic  des  Sciences,  mentions  a  paper  furnished  by  M.  Pouchet,  entitled 
"Etude  des  corpuscles  en  suspension  dans  I'atmosphere."  The  atmosphere 
which  surrounds  us  holds  in  suspension  a  mass  of  corpuscles,  the  detritus 
of  the  mineral  crust  of  our  globe,  animal  and  vegetable  particles,  and  the 
debris  of  all  that  is  used  for  man's  purposes.  These  diverse  corpuscles  are 
proportionably  more  numerous  and  voluminous  as  the  atmosphere  is  more 
or  less  agitated  by  the  wind,  and  it  is  to  these  that  the  term  dust  has  been 
applied. 

The  author  enumerates  the  various  corpuscles  of  mineral,  animal,  and 
vegetable  origin  with  which  the  air  is  loaded.  Under  the  latter — the  vege- 
table products — he  mentions  especially  particles  of  wheat,  M^iich  are  always 
found  mixed  with  dust,  be  it  recent  or  old,  as  well  as  those  of  barley,  rye, 
potatoes,  which  have  been  discovered  in  rare  instances.  "  Astonished  at 
the  proportional  abundance  of  flour  which  I  have  found  among  the  atmos- 
pheric corpuscles,"  says  M.  Pouchet,  "I  undertook  the  task  to  examine  the 
dust  of  all  centuries  and  of  all  localities.  I  have  explored  the  monuments 
of  our  large  cities  those  of  the  shore  and  those  of  the  desert;  and  in  the 
midst  of  the  immense  variety  of  corpuscles  that  universally  float  in  the  air, 
almost  always  have  I  found  the  dust  of  grain,  in  greater  or  lesser  abundance. 
Endowed  with  an  extraordinary  power  of  preservation,  years  seem  scarcely 
to  have  altered  it. 

"Whatever  may  be  the  antiquity  of  atmospheric  corpuscles,  we  find 
among  them  the  dust  of  grain  yet  recognizable.  I  have  discovered  it  in 
the  most  innaccessible  retreats  of  our  old  gothic  churches,  mixed  with  their 
blackened  dust  of  eight  centuries ;  I  have  met  it  in  the  palaces  and  hypogees 
of  Thebes,  where  it  dates  back  perhaps  to  the  epoch  of  the  Pharaohs.  I 
have  found  it  even  in  the  interior  of  the  tympanal  cavity  of  the  head  of 
a  mummified  dog,  which  I  have  recovered  from  a  subterranean  temple  of 
Upper  Egypt." — Druggists'  Circular. 

Prof.  Napoli,  of  the  Academy  of  Naples,  has  discovered  that  in  the 
lava  issuing  from  Vesuvius  there  is  a  large  quantity  of  the  very  rare  metals, 
selenium  and  tellurium,  combined  with  with  titanium,  lead,  and  iron. — ^ 
Druggists'   Circular. 

M.  Bean,  an  hospital  physician  of  Paris,  has  found  that  workmen  who 
handle  lead  do  not  suffer  from  phthisis,  and  that  the  progress  of  this  disease 
has  been  stopped  by  symptoms  of  lead  poisoning. 


448  The  Peninsular  and  Independent. 

Humboldt's  Ltbkarv. — We  see  it  stated  that  Humboldt's  Library  has 
been  purchased  for  40,000  thalers  by  Lord  liloomfield.  minister  of  England 
at  Berlin.  It*  had  previously  been  announced  that  the  hbrary  had  been 
purchased  by  Mr.  \Viight,  the  American  Minister  at  Berlin. — ^eA.  &  Surg. 

Eej^orter. 

The  CnoLERA. — This  disease  is  steadily  advancing  through  Germany, 
westward.  In  some  of  the  villages  the  liarvest  operations  have  had  to  be 
suspended  for  want  of  hands.  At  Hamburgh  the  disease  carries  off  sixty 
to  seventy  persons  a  day.  Two  cases  have  occurred  at  North  Shields,  Eng- 
land, one  of  which  was  brought  from  a  Hamburgh  steamer  with  the  pre- 
monitory symptoms  of  tlie  disease,  and  the  other  occurred  in  the  house 
where  the  first  died. — Ibid. 

Chicago  City  Hospital,  is  now  open  (we  learn  from  the  Chicago  Medi- 
cal Jouritai)  for  the  reception  of  patients.  The  medical  staff  consist  of 
Brs.  Brinard  and  Miller. 

CuvAiioGA  County  Medical  SociETi'. — A  new  Medical  Society  has  been 
recently  established  in  Cuyahoga  county,  Ohio,  organized  April  7.  Dr.  C. 
A.  Terry,  President  Dr.  J.  A.  Sayle.s,  Vice-Prcbident ;  and  Dr.  T.  G.  Cleve- 
land, Secretary  and  Treasurer. 

Very  thin  perforated  elastic  tubes  are  extensively  used  in  England  and 
France  instead  of  tents  of  lint,  sponge,  etc.  They  keep  the  orifice  in  an 
abscess  open,  and  effect  its  complete  drainage.  They  are  readily  intro- 
duced, and  produce  no  irritation. 

The  New  Yorlc  Times  relates  the  case  of  a  man's  death  being  caused 
by  the  skinning  of  a  rattlesnake.  His  thumb  was  accidentally  cut  by  the 
knife  used  in  skinning  the  snake,  when  his  hand  and  arm  began  to  swell, 
and  in  a  few  days  death  took  place,  the  body  being  covered  with  livid 
spots. 

The  Middleboro'  (Mass.)  Gazetic  records  the  death  of  a  boy  in  Plymp- 
ton,  from  the  bite  of  a  snapping  turtle — death  taking  place  in  a  few  days 
after  the  bite,  with  all  the  symptoms  of  hydrophobia. 

The  Medical  Library  of  the  Pennsylvania  Hospital,  founded  in  the 
year  1703,  now  contains  about  11,000  volumes. 

Dr.  Longet,  well  known  by  his  valuable  contributions  to  science,  has 
been  appointed  Professor  of  Physiology  at  the  Faculty  of  Medicine  of  Paris. 


THE 


PENINSULAR  and  INDEPENDENT 


MEDICAL  JOURML. 


Vol.  II.  DETROIT,  NOVEMBER,  1859.  No.  8. 


©rtginal  C0ntmitnitati0ns» 


ART.  III.— Observations  on  the  Development  of  a  new  Species  of 

Halmlnth  (Mermis ). 


By  A.  Saoek,  Prof,  of  Obstetrics  in  the  University  of  Michigan. 

The  observations  here  recorded  were  made  in  the  latter 
part  of  the  year  1853,  prior  to  the  publication  of  the  elabor- 
ate essay  of  Meissner,  in  Siebold  and  Kolliker's  Zeit- 
schrift  far  Wissenscliaftliche  Zoologie. 

The  specimen  was  found  in  a  ditch  of  stagnant  water; 
and,  unlike  the  species  of  G-ordius  of  like  habitat,  was 
of  a  uniformly  milk-white  color.  It  measured  29  inches 
in   length   and  about   two    lines   in    diameter. 

Its  great  size  led  me  to  suspect,  at  first,  that  it  might 
be  a  species  of  intestinal  worm ;  but,  by  a  closer  inspection, 
I  could  discover  clearly  the  generic  characters  of  the 
Mermis   of  Dujardin. 

It   was  placed   in  a   phial^  with   clear   water,  about   the 

Vol.  II.— 2D. 


r 


450 


The  Peninsular  and  Independent. 


20th  of  September,  and  in  a  few  days  the  water  be- 
came slightly  turbid,  which  condition  was  found  to  depend 
upon  the  presence  of  an  immense  number  of  microscopic 
ova.  These  were  rendered  somewhat  opake  by  the  fine, 
granular  yolk;  but,  upon  slight  pressure  being  applied,  a 
defined  transparent  center  became  visible,  which  was  regard- 
ed as  the  embryonic  cell — but  no  nucleus  could  be  seen 
within  it.  The  yolk  in  some  of  the  ova  did  not  completely 
fill  the  chorion,  but  was  surrounded  by  a  clear  fluid,  like 
albumen. 

On  the   28th   of  September,    the   ova    already   presented 
the  first  stages  of  segmentation  —  some  being   but   slightly 

constricted,  as  represented  in  Fig. 
1,  while  others  had  already  be- 
come divided  into  two,  four  and 
even  eight  segments,  as  shown 
in  Figs.  2,  3,  and  4.  Segmen- 
tation proceeded  very  unequally 
in  different  ova :  in  some  it 
commenced  at  least  a  week  later 
than  in  others,  apparently  indi- 
cating different  periods  of  fecundation. 

Oct.  16.  In  some  of  the  ova  segmentation  was  now 
complete,  and  the  mulberry  structure  assumed,  as  seen  in 
fig.  5.  Up  to  this  period  the  development  process  involved 
no  change  of  form  by  which  the  embryo  could  be  distin- 
guished from  those  of  other  worms,  or  even  from  those  of 
most  other  invertebrata ;  and  is  strictly  comparable  to 
the  fissiparous  process  of  cell-multijolication.  The  vis- 
cicular  embr^^o  now  began  to  assume  an  elongated  and 
necessarily  curved  form,  being  flattened  upon  the  concave 
internal   surface. 

On  the  27th  Oct.  they  were  found  to  have  passed 
through  the  stages  represented  in  Figs.  6,  7,  and  8.  The 
borders  of  the  embryo  were  somewhat  clear  ;   but  the  mass 


Sager  on  the  Development  of  Halminth.  451 

was  still  composed  of  the  original  cells^  very  slight  xom- 
pression  being  sufficient  to  destroy  the  cohesion  of  the 
mass,  and  resolve  it  into  its  elementary  cells.  The  change 
of  form,  then,  was  a  new  exhibition  of  life -force  effect- 
ing a  new  and  specific  arrangement  of  the  blastodermic 
cells. 

Apparently  at  this  period  no  differentation  of  tissues 
had  taken  place ;  nor  even  when,  a  little  later,  spontaneous 
motion  occurred,  could  any  departure  from  the  primary 
oell   structure   be   observed. 

The  subsequent  changes  consisted  in  the  gradual  elonga- 
tion of  form,  becoming  at  the  same  time  terete,  and  coiling 
regularly  within  the  chorion,  until,  having  assumed  four 
or  five  coils,  it  finally  burst  its  chorion,  and  emerged,  capable 
of  quite  active  motion.  [See  Fig.  9.]  The  entire  process  was 
not  completed  until  the  25th  of  Nov.,  having  occupied  about 
two  months,  during  which  time  it  was  the  subject  of  very 
frequent   observations. 

In  the  process  of  segmentation  of  the  yolk,  fession  of 
the  central  clear  cell  of  each  yolklet  preceeded  the  division 
of  the  surrounding  mass,  each  yolklet  or  subdivision  appear- 
ed to  be  invested  with  a  distinct  limitary  membrane, 
sufficiently  firm  to  admit  of  some  flattening  of  the  cell,  by 
pressure,   without   rupture. 

That  the  ultimate  divisions  of  the  yolk  are  true  cells,  is 
admitted  even  by  those  embryologists  who  deny  the  ex- 
istence of  a  limitary  membrane  to  the  primary  or  larger 
segments  of  the  yolk  ;  but^  in  the  case  before  us,  and  prob- 
ably in  others,  the  cell  membrane  appears  to  be  a  mere 
^structureless  condensation  of  the  ovalbumen,  and  equally 
^0  whether  the  segments  be  the  larger  primary  divisions, 
or   the   ultimate   blastodermic   cells. 

The  developement  history  of  this  worm,  proves  conclu- 
sively that  the  ivliole  fecundated  egg  is  itself  as  really  and 
truly  the  animal,  capable  of  developement,  as  at  any  sub- 


452  The  Peninsular  and  Independent. 

sequent  stage  of  its  existence  ;  but,  whether  this  view  is 
applicable  to  the  large  yolk  of  reptiles  and  birds,  as  plau- 
sibly contended  by  Prof.  Agassiz,  in  opposition  to  the 
views  of  most  oiher  embryologists,  remains,  perhaps,  to  be 
decided  by  further  study  and  consideration  of  the  entire 
subject. 


Horton's  Meteorological  Register  for  Septemher.       453 


ART.  XXXI.— Meteorological  Register  for  Month  of  September,  1859. 


By  L.  S.  Horton,  House  Physician  to  U.  S.  Marine  Hospital. 


Altitude  of  Barometer  above  the  level  of  the  sea,  597  feet.     Latitude,  42<'24'N.;  and 
Longitude,  82''58' W.  of  Greenwich. 


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^Ht0rial  g^prtm^nt. 


University  of  Michigan. 

This  Institution  is  now  fully  organized,  the  last  of 
the  Three  Departments,  originally  contemplated  by  the 
Organic  Law,  being  now  in  full  and  successful  operation. 
The  Department  of  l^cience  and  Arts  was  organized  in 
1841 ;  of  Medicine,  in  1850 ;  of  Law,  during  the  current 
year.  The  number  of  students  in  attendance,  already  thus. 
early  in  the  year,  is  as  follows :  Department  of  Science 
and  Arts,  290  ;    Medicine,  150  ;  Law,  75  :    total,  515. 

It  is  certainly  highly  gratifying  to  the  old  friends  of 
the  University  to  witness  this  most  prosperous  condition 
of  its  affairs.  The  people  of  Michigan  may  well  be  proud 
of  the  Institution  ;  and  younger  States  may  well  pattern 
after  the  policy  which  cared  for  the  lands  and  the  fund 
arising  from  their  sale.  As  the  result  of  that  policy, 
the  University,  to-day,  throws  open  her  doors,  in  all  the 
Departments,  for  the  free  admission  and  education  of  all 
who  choose  to  enter,  and  avail  themselves  of  the  advan- 
tages offered.  A  Matriculation  fee  of  ten  dollars  makes 
a  man  a  perpetual  student ;  and  an  annual  tax  of  five 
dollars,  for  incidental  expenses,  covers  all  the  charges  for 
education.  When  the  Degree  sought  after  is  earned,  it 
is  granted  with  equal  freedom,  a  charge  of  two  dollars, 
for  the  expense  of  parchment,  being  all  the  expense  for 
graduation.     Certainly   Michigan   stands   alone   among   tha 


Editorial  Department.  455 

States  in  point  of  educational  freedom.  Not  a  year 
passes  but  witnesses  the  going  forth  of  a  score  of  men 
from  its  walls,  bearing  her  honors,  who  would  not  have 
been  able  to  attain  that  educational  stand  point  but  for 
her/ree  system. 


♦  o  • 


EBITOEIAL    CORRESPOJfBEJfCE. 

London,  August  Slst,  1859. 
Dear  Readers  of  the  Peninsular  and  Independent : 

My  last  letter  to  you  ^vas  dated  at  this  place,  a  little  more 
than  three  months  ago,  and  I  perhaps  owe  you  an  apology 
for  so  long  a  silence.  In  justice  to  myself,  I  must  say  that  I 
have  not  promised  you  to  write  regularly  and  monthly,  though 
it  was  my  intention  to  do  so  if  possible.  It  has  not  been 
convenient,  for  the  reasons  I  will  briefly  state.  On  the  10th 
of  June  I  left  London  for  Paris,  where  I  remained  until  the 
20th  of  July.  While  there,  literally  every  moment  was  occu- 
pied with  the  vast  number  of  objects,  professional  and  other- 
wise, whicli  must  be  seen  and  noted  on  the  spot,  and  even  a 
few  hours  occupied  in  writing  a  letter  would  have  prevented 
my  seeing  some  object  worthy  of  observation.  Besides,  the 
constant  excitement  and  labor  of  seeing  multifarious  objects  in- 
disposes and  almost  incapacitates  me  for  careful  composition. 
After  leaving  Paris,  which  I  did  at  the  time  above  indicatedy 
traveling  through  other  parts  of  France,  and  visiting  the  prin- 
cipal places  and  viewing  the  objects  of  most  interest  in  Bel- 
gium, Holland,  Southern  Germany,  and  Switzerland,  returning 
to  Paris  in  time  to  see  the  remainder  of  the  great  Army  of 
Italy,  led  by  the  Emperor  (who,  in  position,  in  influence,  in 
the  thoughts  of  men,  if  not  in  shrewdness  and  talents,  is  at 
present  the  "foremost  man  of  all  this  world"),  as  they  marched 
through  the  Boulevards,  to  receive  the  congratulations  of  the 
French  people.  There  was  of  course  no  time  for  writing  more 
than  my  daily  journal,  which  I  did  in  pocket  books,  with 
pencil,  in  coflfee- rooms,  waiting  halls,  steamboats,  and  rail- 
road cars,  and  even  after  retiring  and  before  rising,  as  oppor- 
tunities  presented.     After    spending   near    two  weeks   more  in 


456  The  Peninsular  and  Independent, 

Paris,  witnessing  the  great  Fete  N^cq^oleon  of  the  15th  (on  the 
evening  of  which  day  there  was  the  most  magnificent  display 
of  suhlimary  lights  and  fire -works  of  which  I  had  any  con- 
ception), and  three  days  in  the  beautiful  Isle  of  Wight  —  the 
Maderia  of  England,  I  find  myself  in  London  again,  where,  at 
this  season,  "everybody  is  away,"  yet  where  smoke  is  still 
rising,  and  where  the  rush  of  business  is  still  thundering  through 
the  streets.  To-morrow  morning  I  expect  to  leave  for  that 
"Gem  of  the  Ocean,"  the  Emerald  Isle — for  Cork,  and  Dublin, 
and  Limerick  —  the  Giant's  Causeway,  the  Lakes  of  Killarney, 
&c.,  bringing  up  at  Aberdeen,  in  Scotland,  on  the  14th  of  next 
month,  when  and  where  the  "  British  Association  for  the 
Promotion  of  ^cience''^  holds  its  annual  meeting  the  present 
year.  Being  accredited  to  tliat  body,  as  a  representative  of  the 
American  Medical  Association,  I  hope  to  attend  the  meeting, 
and  may  give  you  some  account  of  it ;  and  aftei'  its  adjourn- 
ment shall  probably  travel  about  different  portions  of  the  Brit- 
ish Isles — spending  considerable  time  among  the  Medical  Men 
and  Institutions  of  Edinburgh  —  hoi:)ing  to  cross  the  Atlantic 
in  November. 

I  give  these  details  to  show  how  I  have  been  and  shall  be 
occupied,  and  to  apologize  for  any  short- comings  in  corres- 
pondence—  promising,  after  my  return,  to  furnish  for  you, 
should  it  be  thought  advisable,  further  accounts  of  matters  of 
professional  interest  I  shall  have  noticed  in  my  travels  and 
sojourns. 

In  my  last  letter  I  made  some  general  remarks  respecting 
London  and  its  Medical  Institutions,  and  gave  some  account  of 
the  men  connected  with  "University  College,  Hospital  and 
Medical  School."  I  shall,  in  this,  give  a  somewhat  similar 
account  of  tlie  men  connected  with  .King's  College^  Hospital 
and  School  —  a  prominent  institution,  though  by  no  means  the 
largest  here. 

The  men  I  saw  here  were  Dr.  Todd,  Dr.  Budd,  Dr.  Geo. 
JohnsojS",  Physicians;  Mr.  Fekgusox,  Mr.  Bowmais-,  and  Mr. 
Paeteidge,  Surgeons.  Dr.  Todd  and  Mr.  Bowmax,  as  authors 
of  the  "  Physiological  Anatomy,"  are  known  to  all  of  you.  Dr. 
Budd's  work  on  the  Liver  is  or  should  be  in  the  hands  of 
you  all;  and  most  of  you  are  aware  of  the  careful  researches 
of  Dr.  JoHi^soi^,  a  younger  man  than  the  rest,  into  the  diseases 


Editorial  Department,  457 

of  the  Kidney.  Mr.  Fergusoi^  and  Mr.  Partridge  are  well 
known  Surgeons  —  every  body  having  at  least  heard  of  Mr. 
Ferguson.  I  have  seen  all  these  men  in  their  work  at  the 
Hospital,  and  received  an  impression  of  their  professional  char- 
acters and  modes  of  examining,  prescribing,  and  teaching. 

Dr.  Todd,  as  perhaps  the  oldest,  and  having  the  greatest 
pretentions,  is  first  entitled  to  mention.  He  is  a  man  approach- 
ing sixty,  of  very  dignified  and  genteel  appearance,  rather  re- 
served and  aristocratic,  about  medium  height,  and  somewhat 
full,  with  rather  thin  grey  hair.  He  is  not  particularly  com- 
municative to  his  students  in  the  wards,  yet  he  examines  into 
diseases  of  the  nervous  system  particularly  with  care,  and  had 
a  number  of  cases  of  Paralysis,  Epilepsy,  &c.,  under  his  charge. 
He  seems  to  be  giving  somewhat  particular  attention  to  this 
class  of  cases.  Being  deeply  tinctured  with  what,  in  many 
quarters,  are  the  leading  pathological  and  therapeutical  notions 
of  the  day,  he  is  profuse  and  general  in  his  use  of  stimulants, 
and  Brandy  and  Ammonia  are  his  most  frequent  prescriptions. 
Fevers  particularly,  I  am  told,  are  treated  from  the  beginning 
and  almost  exclusively  with  stimulants,  alcohol  being  the  chief 
article  used.  I  have  heard  him  spoken  of  by  some  of  his  old 
pupils  as  a  very  line  lecturer,  and  had  much  curiosity  to  hear 
him.  I  attended  one  of  his  advertised  lectures  in  the  amphi- 
theatre. It  was  called  a  clinical  lecture,  though  no  case  was 
before  him,  refering  however  to  one  which  sometime  before 
had  been  in  the  wards.  The  subject  was  Measles,  and  he 
spoke  of  this  disease  for  about  three  quarters  of  an  hour  in  an 
exceedingly  moderate,  prosy  style,  not  taking  ofi"  his  overcoat; 
and  he  certainly  mentioned  only  the  most  ordinary,  common- 
place facts  and  opinions,  respecting  the  affection,  to  his  class, 
consisting  of  a  dozen  or  fifteen.  I  was  forcibly  reminded 
that  there  was  a  vast  difference  between  working  for  a  repu- 
tation and  working  on  a  reputation,  in  cases  where  a  love  of 
teaching  for  itself  alone,  does  not  in  a  large  degree  exist.  It 
seemed  to  me  that  m  this  case  the  distinguished  gentleman, 
while  he  took  an  hour's  respite  from  his  large  fashionable  prac- 
tice, was  working  on  his  reputation,  if  he  was  not  actually 
Testing  on  his  laurels.  I  would  not,  in  any  of  these  remarks, 
detract  anything  from  the  just  meed  of  praise  which  is  im- 
questionably  due   Dr.  Todd.     The  whole    profession    are   under 


458  The  Peninsular  and  Independent. 

many  obligations  to  him,  for  his  industrious  researches,  and  his 
very  elaborate,  scientific,  and  literary  productions.  I  wish 
merely  to  give  an  impression  of  this  lecture,  as  it  appeared  to 
me.  It  might  suggest  the  impropriety  of  men,  however  able 
and  distinguished,  continuing  as  teachers  when  their  interest 
in  teaching  is  practically  gone,  being  absorbed  in  other  engross^ 
ing  pursuits.  Dr.  Todd's  practice  is  regarded  as  being  per- 
haps the  most  profitable  of  any  in  London;  and  this,  together 
with  his  writings,  occupies  so  much  of  his  time,  and  thought, 
and  feeling,  that  he  is  not  stimulated  to  exertion  when  in  the 
presence  of  a  dozen  students  in  a  lecture  -  room.  To  give  a 
good  and  impressive  lecture,  requires  an  amount  of  interest 
which,    on  this  occasion,  the  lecturer  did  not  feel. 

Dr.  BuDD  is  a  man  several  years  younger  than  Dr.  Todd, 
of  medium  size,  dark  hair  and  complexion,  very  affable,  rather 
active  in  manner,  but  not  giving  the  impression  of  a  man  of 
great  profundity.  Ilis  Avritings,  however,  show  that  he  is  a 
man  of  capacity,  and  the  fact  that  lie  is  the  successor  of  Wat- 
son", in  the  chair  of  practice  in  this  school,  indicates  a  favor- 
able opinion  of  his  abilities  on  the  part  of  those  having  the 
appointing  power.  He  is  said  to  be  an  agreeable  lecturer- 
but  I  have  not  had  the  pleasure  of  hearing  him  on  a  set 
occasion.  However  acutely  his  mind  may  operate  in  coming 
at  nice  conclusions,  respecting  his  patients,  those  operation, 
must,  to  a  large  extent,  be  liidden  from  common  observas 
tion,  for  at  the  bed-side  particularly,  rigid  investigations  and 
nice   distinctions    did   not   seem   to   be  made. 

I  saw  in  his  wards  several  cases  of  Rheumatism,  with  a 
due  proportion  of  heart  complications.  Leeches  and  blisters  were 
applied  locally,  the  blisters  a  little  distance  from  over  the 
immediate  seat  of  the  heart ;  the  ordmary  internal  prescrip- 
tion being  in  all  the  cases  of  Rheumatism,  heart  cases  in- 
cluded, Carb.  of  potash  grs.  xv,  Xitrate  of  potash  grs.  v.,  once 
in  from  two  to  four  hours.  Blisters  were  often  applied  in  the 
neighborhood,  though  at  a  little  distance  from  the  joints. 

He  had  several  cases  of  Epilepsy,  which  were  treated 
chiefly  with  sulphate   of  zinc. 

Sciatica,  and  other  forms  of  ISTeuralgia,  he  was  treating  by 
injecting  into  the  tissues,  over  the  painful  part,  with  a  fine 
sharp   syringe   made   for    the    purpose,    a    solution   of  muriate 


Editorial  Department,  459 

of  morphene,  a  fourth  of  a  grain  in  about  one-half  drachm  of 
water,  being  the  ordinary  quantity  used.  It  usually  produced 
a  speedy,  general,  as  well  as  local  effect,  relieving  the  pain.  In 
Paris,  they  are  injecting  in  a  similar  manner,  and  for  similar 
purposes,  solutions  of  salts  of  atropia. 

Dr.  JoHN^soisr  is  a  more  slender  man,  of  good  height,  how- 
ever, scarcely  forty,  with  a  very  pleasant  and  agreeable,  but 
earnest  manner.  I  saw  him  a  few  times  only,  but  with  what 
I  saw,  Avas  pleased.  He  is  a  close,  accurate  worker,  examines 
his  patients  carefully.  Drs.  Todd,  Budd,  and  Johnso:n",  had 
from  six  to  ten  students  following  them  in  their  wards  —  sel- 
dom  the  latter  number. 

Mr.  Fergusois"  is  a  tall,  rather  round,  almost  bullet-headed 
man,  with  a  decided  Scotch  brogue,  and  is  in  the  neighbor-, 
hood  of  fifty  years  old.  He  has  a  degree  of  unconcerned 
dignity  in  his  carriage,  which  gives  him  something  of  the 
appearance  of  indifference  to  his  patients.  He  said  very  little 
as  he  passed  about  among  them,  giving  the  twenty  students 
who  crowded  around  him  very  few  hints  as  to  the  nature  of 
the  cases  or  as  to  what  he  proposed  to  do.  His  students, 
however,  like  many  others,  on  both  sides  of  the  Atlantic, 
"walked  the  hospitals."  Saw  in  his  wards  one  case  of 
recent  fracture  of  the  leg,  put  up  in  plaster  of  Paris.  The 
patient  was  not  confined  to  his  bed  at  all.  He  said  there 
was  no  displacement  in  the  case,  and  in  some  such  instan- 
ces he  dressed  in  plaster,  immoveable  at  once.  He  had  sever- 
al cases  of  cicotraces  from  burns,  which  he  had  operated  upon 
in  the  old,  and  as  I  had  supposed,  exploded  way  of  cutting 
them  across.  I  enquired  if  he  had  found  perminent  benefit 
from  the  practice,  which  question  he  answered  with  one  mono- 
sylable,  yes.  At  the  London  Orthopiclic  Institution,  where,  it 
is  admitted,  they  have  been  remarkably  successful  in  such 
cases,  they  nse  only  mechanical  extension,  strong  and  persist- 
ent, with  proper  apparatus,  screws,  &c.  Mr.  Lawreis"Ce,  at  St. 
Bartholomew,  was  nsing  the  same  plan,  remarking  that  cut- 
ting did  no  good  in  the  end.  Surgeons,  as  well  as  physicians, 
will  differ  sometimes.  Mr.  Ferguson  had  a  case  of  goiter,  into 
which  he  had  made  an  inscision,  filling  the  wound  with  lint, 
with  the  view,  he  said,  of  exciting  suppuration.  He  did  not 
say  what  further  he  expected.     It  is  to  be   presumed,   that  on 


460  The,  Peninsular  and  Independent. 

some  occasions,  Mr.  F.  is  more  communicative  to  his  students, 
than  on  those  when  I  saw  him.  If  not,  he  must  act  on  the 
principle  of  allowing  them  to  see  and  judge  for  themselves,  a 
plan  which  may  have  its  advantages.  This  would  be  clinical 
observation,  but  hardly  comes  up  to  my  notion  of  clinical 
teaching. 

Mr.  Partridge  I  should  judge  to  be  forty-five  or  more,  light 
hair  and  complexion,  and  not  particularly  striking  in  his  ap- 
pearance. I  saw  but  little  of  him,  but  have  heard  him  well 
spoken  of  as  a  teacher  by  his  old  pupils. 

Mr.  Bowman  is  a  man  of  moderate  size,  with  small  fea 
tures,  diminishing  the  impressiveness  of  his  personal  appear- 
ance. He  is  however,  an  indefatigable  worker,  and  stands  well, 
not  only  with  the  profession,  but  in  the  estimation  of  the  pub- 
lic also.  He  is  not  only  one  of  the  surgeons  of  King's  College 
Hospital,  but  likewise  of  tlie  great  Eye  Infirmary  of  London, 
the  largest  institution  of  the  kind  in  the  world.  Mr.  Bow- 
MAisr  gives  much  attention  to  OjDthalmic  Surgery,  and  is  said 
to  have  a  large  and  j^i'ofitable  private  practice  in  this  de- 
partment. In  the  Moorfield  Eye  Infirmary  there  is  an  im- 
mense field  for  observation,  and  the  surgeons  having  charge 
of  it,  Messrs.  Dixox,  Crickett,  Boavmai;^,  and  HuTCHi:srsox,  all 
are  very  attentive  to  medical  men  and  students  who  visit 
them. 

Before  closing  this  letter,  I  will  mention  a  single  visit 
made  to  the  Middlesex  Hospital.,  in  London,  but  where  I  was 
much  interested.  I  saw  but  one  medical  man  there,  Dr. 
GooDFELLow,  going  to  the  institution  almost  by  mistake,  just 
as  he  was  about  enteriuG^  his  wards.  A  school  is  connected 
with  this  hospital,  as  with  so  many  of  the  others,  though  I 
believe  it  is  not  very  large.  The  hospital  is  a  fine  building, 
containiuo:  between  three  and  four  himdred  beds.  On  introdu- 
cing  myself,  Dr.  G.  took  me  about  the  grounds  and  showed 
the  Museum,  Lecture-rooms,  Laboratory,  cfcc.  They  were  all 
small.  Indeed,  the  buildings  for  the  lectures,  or  college  proper, 
are  all  small,  in  the  London  Medical  Schools  the  hospitals 
being  the  large  buildings,  the  school  a  mere  attachment  to  the 
hospital. 

Dr.  GooDFELLOw^  visited  a  large  number  of  patients  the 
morning  I  was  with  him,  more  than  I  had  seen  visited  in  the 


Editorial  Depaftinent.  461 

wards  of  a  hospital  by  any  physician  before.  He  was,  however 
careful,  and  very  fairly  accurate  in  his  examinations  and 
diagnosis.  In  these  respects,  he  did  not  differ  from  the  better 
class  of  medical  men  in  London.  He  was,  however,  more 
faithful,  and,  as  it  seemed  to  me,  discriminative  and  successful 
in  treatment  than  the  majority.  He  manifested  more  confi- 
dence in  therapeutical  measures  than  almost  any  other  one  I 
have  met  with  in  Europe,  and  gave  more  attention  and  thought 
to   their   application. 

He  spoke  warmly  of  the  muriated  tincture  of  iron  in  Ery- 
sipelas— said  it  was  his  chief  dependence  in  the  disease,  and 
he  also  used  it  much  in  scarlatina,  even  in  the  acute  stages. 
I  mentioned  to  him  that  I  had  used  it  in  bad  cases  of  small 
pox,  which  he  approved  of  strongly,  from  the  analogy,  though 
he  had  not  tried  it  in  such  cases.  He  said  he  had  used  it 
much  in  Brights  diseases,  even  in  comparatively  acute  cases,  and 
he  thought  very  beneficially.  These  are  passing  items  of  intelli- 
gence, but  of  course  were  not  verified  before  me.  I  saw, 
however,  a  large  number  of  rheumatic  cases  under  treatment, 
and  from  the  doctors',  the  nurses'  and  the  patients'  accounts, 
the  success  was  much  greater  than  I  saw  elsewhere.  Inter- 
nally, his  ordinary  prescriptions  were  carbonate  of  potash,  3j.; 
nitrate  of  potash,  grs.  viij.  to  x.;  wine  of  colchicum,  mxxx,  to 
XXX.,  sufficient  to  cause  a  laxative  effect,  given  once  in  four 
hours,  more  or  less.  Dover's  powder  at  night  if  necessary, 
externally,  using  the  water  dressi?ig.  A  cloth  dipped  in  water 
Avas  applied,  oil  silk  or  gutta  percha  cloth  over  that,  and 
still  over  all  a  thick  layer  of  cotton  batting,  to  keep  a  uni- 
form temperature.  If  effusions  had  taken  place  in  a  joint,  as 
in  the  knee,  he  nsed  a  flax-seed  poultice,  in  and  over  which 
nitrate  of  potash  was  sprinkled  freely,  the  oil  cloth  and  cot- 
ton  over  this,  as  over  the  simple  water  dressing.  This  poul- 
tice, after  a  day  or  so,  was  followed  by  water  dressing.  No 
mercury  was  given  to  produce  constitutional  effect.  For 
many  months,  he  said,  no  case  of  metatarsis  or  any  rheumatic 
disease  of  the  heart  had  come  on  in  the  hospital,  while  the 
patient  was  under  treatment.  In  cases  where  the  heart  was 
involved,  a  few  leeches  frequently  repeated,  and  blisters,  later, 
were  used. 

The  same  water  dressings  were  applied  locally  in  gout,  and 


462  The  Peninsular  and  Independent, 

I  saw  several  cases  where,  from  the  statements  of  patients, 
the  relief  was  very  speedy  and  very  great.  When  he  found 
much  superficial  deposit  of  murate  of  soda,  he  used  as  the 
dressing  a  solution  of  nitro-muriatic  acid,  instead  of  the  simple 
water,   of  such   strength  as   could   be  borne. 

I^Tow,  as  to  the  correctness  of  this  treatment,  or  its  great 
superiority  over  others,  I  need  not  further  commit  myself; 
but  it  was  certainly  refreshing  to  see  a  man  having  faith 
in  remedies,  and  being  zealous  in  their  apj)lication,  if  for  no 
other  reason  than  as  a  change.  It  is  true,  I  have  seen  several 
who  advocated  with  some  decision,  some  particular  modes  of 
treatment  for  particular  c^seases,  but  I  have  met  with  few 
or  none  in  any  public  position  here  who  seemed  to  give  so 
much  thought  and  attention  to  treatment  as  the  gentleman 
referred  to.  Many  seem  satisfied  to  learn  the  seat  and  na- 
ture of  the  disease,  and  watch  its  progress,  without  making- 
very  strenuous  efibrts  to  arrest  its  course.  Pathology  and 
diagnosis  are  truly  the  foundation,  but  are  not  the  entire 
structure  of  medical  science. 

Very  truly  yours,  &c. 

A.  B.  P. 


thttt^  §.x\uh^,  Jibtt^rt^,  ^t. 


~c-9-*- 


Attempteil  Abortion  and  Deatbfrom  Introiiuction  of  Air  into  the  Veins. 

One  of  the  most  painfully  familiar  topics  of  our  current  medi« 
Cal  experience  arises  from  the  familiarit}^  and  indifference  with  which 
the  large  mass  of  community  have  come  to  regard  the  production 
of  abortion  :  so  that  everywhere  we  hear  the  lament  of  the  honor- 
able physician  of  the  unconcern  with  which  he  is  consulted  for  this 
purpose,  by  both  the  unmarried  female,  who  may  be  supposed  to  have 
the  more  anxious  solicitude  to  hide  her  shame,  and  alike  the  res- 
pectably wedded  mother,  who  has  no  such  motive  to  afford  a  plaus- 
ible pretext. 

The  danger  which  is  associated  with  these  attempts  does  not  ap- 
pear to  be  duly  estimated,  even  by  the  members  of  the  profession,  in 
many  instances ;  and  popularly  a  great  many  expedients,  instrumen- 
tal and  medical,  are  used  and  regarded  as  perfectly  innocent  and  harm- 
less. Every  now  and  then,  however,  we  read  of  and  observe  sudden 
and  almost  inexplicable   death   to   ensue   in  cases   of    this   kind. 

An  instance  in  point  fell  under  our  observation  within  less  than 
a  year  in  this  city.  We  were  summoned,  about  11)^  o'clock  p.  m. 
(near  midnight),  to  see  a  lady,  and  found  her  already  dead.  Upon 
inquiry,  and  in  the  subsequent  details  of  the  coroner's  inquest,  it 
transpired  that  she,  although  a  happy  wife  and  mother,  had  deter- 
mined not  to  allow  any  further  additions  to  be  made  to  her  nursery 
cares.  Finding  herself,  therefore,  pregnant,  she  had  consulted  one  of 
those  dames  reputed  to  be  skilled  in  such  matters,  and  had  held  re- 
peated private  interviews  with  her  for  a  number  of  days  before  her 
decease.  The  night  of  her  death,  her  husband  was  engaged  away 
from  home  until  about  11  o'clock.  The  servant  girl  remained  up 
until  after  10  o'clock.  The  husband  arrived  at  home  at  11,  and  found 
his  wife  deceased,  and  the  girl  and  children  asleep.  Certain  instru- 
ments were  found  about  the  person  of  the  deceased,  which  indicated 
that  she  had  made  an  attempt  to  throw  up  a  strong  stimulating  in- 
jection  into   or  about  the  mouth   of   the  uterus.      What  she  actually 


464  The  Peninsiclar  and  Independent. 

did  is,  however,  left  in  some  conjecture,  but  death  must  have  been 
very  suddenly  produced,  considering  the  brief  time  in  which  she  was 
left  alone,  and  in  view  of  the  fact  that  the  girl  in  the  next  room 
was  unawakened. 

It  will  be  a  happy  time  when  this  truth  shall  become  impressed 
upon  the  popular  mind,  that  whenever  a  woman  places  herself  in 
the  hands  of  "abortion  procurers,"  she  positively  runs  the  risk  of 
her  life  in  every  instance. 

The  following  case,  reported  by  Dr.  John  Swinburne,  of  Albany, 
N.  Y.,  and  which  we  copy  in  full  from  the  Medical  and  Surgical 
Re'][)OTter^  is  in  point,  and  affords  some  especial  light  upon  the  char-- 
acter  of  danger  in  these  cases,  and  how  death  may  ensue,  and  very 
suddenly  : 

Miss  M.  A.  S.,  aged  twenty-three,  unmarried,  was  admitted  to 
the  house  No.  40  Franklin  street,  for  the  purpose  of  having  an 
abortion   procured,    on   or  about  the   thirteenth   of    March. 

It  is  ascertained  that  attempts  were  made  from  day  to  day  to 
rupture  the  membranes  with  a  blunt  steel  instrument.  These  efforts 
only  produced  slight  inflammation,  softening,  and  partial  separation  of 
the  membranes  and  placenta. 

On  the  evening  of  the  twenty-sixth  of  March,  Dr.  J.  H.  Case 
was  sornmoned  in  haste  to  the  above-mentioned  house,  where  he  fo  und 
that  the  j'^oung  woman  had  just  died.  An  examination  before  the 
coroner's  jury  the  next  morning  elicited,  among  other  testimony,  the 
following  statements  : 

Dr.  J.  A.  Case  sworn :  Knows  Mrs.  Masten ;  was  called  to  at- 
tend a  patient  at  her  house  about  six  months  ago ;  her  given  name 
is  Oscillea;  her  ostensible  business  is  an  astrologist.  The  patient 
whom  I  visited  six  months  ago  was  a  young  woman ;  she  had  in^ 
flammation  of  the  womb.  Was  called  by  Miss  Curry  last  night  at 
9  o'clock ;  said  that  Mrs.  Masten  wanted  I  should  call  as  soon  as 
possible,  that  a  lady  there  had  fainted,  and  was  very  sick.  Went  to 
No.  40  Franklin  street,  and  found  Mrs.  Masten  on  the  walk ;  she  said 
she  was  glad  I  had  come,  as  the  woman  was  very  bad,  and  she 
was  afraid  she  was  dead ;  she  said  it  was  only  an  india-rubber  that 
she  was  using,  and  that  the  deceased  fell  right  back  dead.  Foun4 
a  body  lying  on  the  bed  very  pallid,  and  dead  to  all  appearances; 
Mrs.  M.  did  not  go  in  with  me ;  thought  it  might  be  a  case  of 
suspended  animation ;  gave  her  some  stimulants,  but  they  did  her 
no  good — she  was  dead ;  told  Mrs.  M.  so,  and  she  said,  "  Oh,  Doc- 
tor, what  shall  I  do  ? "  The  girl  Curry  then  said,  wringing  her 
hands,  "What  shall  we  do?"  I  told  Curry  that  they  could  do 
nothing  with  her ;  Mrs.  Masten  said  to  her,  "  No,  I  am  to  blame ; 
I   shall  have   to   stand  it."     She   again   asked   me   what   she  must  do; 


Selected  Articles,  Abstracts,  (tc.  465 

advised  her  to  throw  herself  upon  the  mercy  of  the  law;  she  asked 
me  if  I  didn't  think  it  best  for  her  to  try  and  escape ;  told  her 
that  it  would  be  impossible  if  she  undertook  it;  she  also  said  it 
was  a  bad  time  for  her,  as  she  had  no  time  to  fight  it  out  or 
money  to  escape ;  but  that  she  expected  some  on  Monday,  and  if 
she  had  that  she  would  clear  right  out  in  half  an  hour ;  she  again 
repeated  that  she  didn't  know  how  deceased  came  to  die,  as  she 
could  show  me  the  instrument,  and  that  it  couldn't  hurt  her ;  went 
into  the  bed-room  again,  and  another  young  lady  said  she  thought 
deceased  was  reviving;  v/anted  me  to  try  and  revive  her;  Mrs.  Mas- 
ten  turned  down  the  bed-clothes  and  produced  a  gutta-percha  cathe- 
ter. [The  article  was  produced  and  identified.]  She  said  that  was 
the  instrument  she  used,  and  that  it  could  not  hurt  her ;  also,  that 
it  wasn't  the  one  she  generally  used ;  that  it  was  milder,  and  the- girl's 
death  surprised  her;  that  v^'-hile  using  it  the  patient,  as  she  thought, 
fainted  away ;  that  she  tried  to  fetch  her  to,  and  failing,  had  sent  for 
me ;  think  it  was  about  nine  o'clock  when  I  got  to  her  house  ;  don't 
think  that  over  fifteen  minutes  had  elapsed  until  I  saw  the  deceased, 
after  being  called.  Mrs.  Masten  indirectly  asked  me  to  loan  her  money 
to  escape  with;  I  found  three  or  four  young  girls  in  the  house  when 
I  first  got  there ;  one  of  them  said  that  she  had  got  through  with  her 
troubles,  and  that  she  thought  it  best  for  her  to  get  away  as  soon  as 
possible ;  asked  her  if  she  was  able,  and  Mrs.  Masten  said  she  was  all 
right ;  suppose  from  what  I  saw  and  heard,  that  all  the  young  ladies 
were  "in  trouble;"  think  I  know  one  of  the  young  ladies  I  saw  there ; 
believe  I  prescribed  for  her  some  time   since. 

Assisted  by  Charles  H.  Porter,  Professor  of  Chemistry,  Dr.  C.  P. 
Staats,  and  my  students,  Messrs.  Mosier  and  Covel,  I  made  a  post 
mortem  examination  fourteen  hours  after  death.  The  following  detailed 
description  is  given  for  the  benefit  of  medical  readers  : 

External  appearances  of  body  natural,  but  very  pallid.  On  cutting 
through  the  integuments  into  the  cellular  tissues,  air  was  observed  to 
issue  from  the  divided  veins  in  the  form  of  a  frothy  fluid.  On  expos- 
ing the  heart,  its  right  cavities  were  found  to  be  greatly  distended 
with  a  spumous  mixture,  of  blood  and  air,  and  slight  compression  of 
the  heart  was  seen  to  force  out  bubbles  of  air  from  the  divided  inter- 
costal veins.  A  thorough  examination  showed  that  the  jugulars,  and 
the  veins  emptying  into  them,  even  to  the  small  vessels  of  the  brain, 
were  all  distended  with  air. 

The  uterus  was  found  to  be  of  a  dark  livid  or  maroon  color  at  its 
lateral  portions,  and  its  veins  and  sinues  were  so  fally  distended  with 
air,  as  to  give  it  the  appearance  of  a  bag  of  angle-worms.  The  sensa- 
tion communicated  to  the  touch  was  analogous  to  that  of  varicocele, 
with  the  exception  that  in  the  latter  the  tissues  are  so  soft  and  dis- 
YoL.  II.— 2E. 


466  The  Peninsular  and  Independent. 

tended  with  liquid,  whereas  in  the  case  of  this  uterus  the  presence  of 
air  was  unmistakably  manifested  by  its  characteristic  crepitus  when  the 
vessels  were  compressed  by  the  finger. 

The  membranes  of  the  ovum  were  entire,  and  contained  a  normal 
amount  of  amniotic  liquor,  and  an  apparently  healthy  female  foetus  of 
about  five  months'  growth,  presenting  no  appearance  of  decomposition, 
nor  any  change  to  indicate  death  of  the  foetus  at  any  period  long  prior 
to  that  of  the  mother. 

On  the  internal  surface  of  the  membranes  was  a  slight  exudation 
of  lymph,  as  from  inflammatory  action.  Externally  they  were  separa- 
ted from  the  womb  on  its  right  latero-posterior  surface,  as  was  also  the 
placenta  in  part.  Beneath  the  lower  border  of  the  latter  was  an  effu- 
sion of  blood  in  the  form  of  several  small  coagula.  The  os  and  cervix 
were  open  to  the  extent  of  two  lines,  and  filled  with  bloody  mu- 
cus. 

On  examining  the  membranes  and  their  contents,  the  internal  sur- 
face of  the  womb  exhibited  the  following  appearances:  1.  Slight  soften- 
ing of  the  tissues ;  2.  Several  abrasions,  evidently  not  natural ;  3.  A 
perforation  communicating  directly  with  the  uterine  sinuses,  about  two 
inches  from  the  cervix,  and  in  the  right  latero-pasterior  region.  This 
opening  communicated  directly  with  the  veins  of  the  broad  ligament, 
and  thus  with  the  ascending  cava.  The  direction  of  the  perforation 
was  parallel  with  the  longitudinal  axis  of  the  uterus.  All  the  other 
organs  of  the  body  were  in  a  perfectly  healthy  condition. 

These  'j[)08t- mortem  appearances,  conjoined  with  the  description  of 
the  young  woman's  death,  can  not  be  accounted  for  by  any  other  cause 
than  that  of  "  air  in  the  veins."  Death  occurred  while  the  instrument 
was  in  the  uterus,  and  was  immediate^  for  the  woman  mistook  deatli 
for  syncojye. 

The  point  of  interest  in  this  case  is  as  to  the  manner  in  which 
the  air  was  introduced.  Several  deaths  have  been  reported  from  ingress 
of  air  into  the  large  veins  of  the  neck,  and  even  the  subclavian  is  lia- 
ble to  the  same  thing  under  favorable  circumstances,  such  as  tension 
upon  the  vein  from  the  subject's  positioii  during  surgical  operations,  or 
by  traction  upon  a  tumor  during  excision,  the  veins  being  temporarily 
canalized^  or  prevented  from  collapsing. 

Under  all  circumstances  this  canalization  of  vein,  or  its  conversion 
into  a  rigid  tube,  is  the  indispensable  condition  requisite  for  the  intru- 
sion of  air.  But  this  condition  is  inadmissible  in  the  case  of  the  uterine 
veins  and  ascending  cava,  from  the  nature  of  physical  laws  which 
govern  the  movements  of  the  fluids  in  the  body,  no  less  than  in  inor- 
ganic matter. 

In  the  twenty  -  second  volume  of  Braithwaite's  Retrospect^  on  page 
three  hundred  and  nine,  will  be  found  an  article  by  Dr.  J.  R.  Cormack, 
in   which   is   discussed  the   possibility  of   introduction   of  air   into  the 


Selected  Articles ^  Abstracts^  c&c.  46 T 

venous  system  through  the  medium  of  the  uterine  veins  immediately 
after  parturition.  He  instances  the  experiments  of  Legallois  upon  ani- 
mals, whereby  that  author  became  satisfied  of  the  possibility  of  the  in- 
trusion of  air  in  this  way,  and  by  analogy  conjectured  that  many  cases 
of  death  in  the  human  subject  might  be  accounted  for  in  a  similar 
manner. 

He  also  quotes  from  Dr.  Simpson,  of  Edinburgh,  who  reports  an 
autopsy  of  the  body  of  a  female  who  died  after  delivery,  where  the 
entrance  of  air  through  the  uterine  veins  was  conjectured  to  be  the 
cause  of  death.  The  examination,  conducted  carefully,  so  as  to  exclude 
all  apparent  sources  of  error,  resulted  in  the  discovery  that  the  lower 
cava,  hypogastric,  and  uterine  veins  were  distended  with  frothy  blood 
and  air. 

Dr.  Simpson  also  explains  the  manner  in  which  air  might  be  forced 
into  the  veins  by  the  contraction  of  the  uterus  after  having  been 
filled  with  air,  which  is  not  seldom  the  case.  This  organ  being  dis- 
tended with  air,  the  os  tincse  being  closed  either  by  its  own  sphinc- 
ter or  by  a  coagulum  of  blood;  the  uterine  veins  being  large  and 
patulous,  and  the  forcible  contraction  of  the  organ  —  these  furnish, 
in  his  opinion,  the  mechanism  capable^  of  accomplishing  the  fatal 
accident.  (See  Braithioaite's  Retros2:)ect^  xix.,  page  262).  In  the 
present  case  no  such  conditions  are  furnished,  and  throwing  aside 
the  hypothesis  of  spontaneous  ingress,  we  are  compelled  to  fall  back 
upon  the  presumption  that  the  abortionist  forcibly  inflated  the  entire 
venous  system,  by  means  of  the  catheter  introduced  into  the  uterus, 
perforating  its  parietes,  and  in  contact  with  the  lacerated  vessels  of 
that  organ.  And  this  presumption  is  strengthened  by  the  fact  that 
the  opinion  prevailed,  at  the  time  of  the  coroner's  inquest,  that  abor- 
tion might  be  produced  by  inflating  the  space  between  the  mem- 
branes  and   the  womb. 

The  fact  of  forcible  inflation  is  incapable  of  proof,  there  being 
no  third  person  present  at  the  time  of  death,  and  hence  no  witness. 
Absolute  certainty  can  only  be  arrived  at  from  the  confession  of  the 
guilty   woman  herself. 

{^Lancet  and   Observer. — Medical   Gazette. 


ON"  TWO  CASES  OF  OPENING-S  IISTTO  JOINTS  -Free  Admission  of  Air  in  one 
case;  No  evil  results.  ByRiCHAED  Barwell,  Esq.,  F.R.C.S.,  Assistant  Surgeon  to  the 
Cliaring  Cross  Hospital. 

Cases  occasionally   occur    which  are  hardly  to  be    accounted  for 
and   which   contradict   our    previously  -  conceived    notions   and   acquired 
experience.     Thus  wounds   piercing  into  joints  are  with  perfect  justice 
considered    dangerous ;    and    the    more    direct    the    opening,   and   the 
freer  the   admission  of  air,   the  more  likely  is  destructive    inflamma- 


468  The  Peninsular  and  Independent. 

tion  to  supervene;  yet  the  first  of  the  two  following  cases  will 
show  that  wounds  of  joints  are  not  always  productive  of  so  much 
evil. 

On  the  14-th  March  last,  I  saw  H.  L ,  a  young  woman,  upon 

whose  knee  was  a  boil,  which  had  been  that  morning  incautiously  in- 
cised, so  that  it  was  feared  the  knee-joint  was  opened;  the  circum- 
stance which  led  to  this  suspicion  being  a  plentiful  escape  of  synovia 
from  the  wound.  The  boil  was  inside  the  ligamentum  patella? ;  close 
to  and  running  parallel  with  which  was  an  incised  wound  a  little  more 
than  an  inch  long.  From  this  wound  synovia  oozed,  and  when  the 
knee  was  flexed  flowed  out  pretty  freely.  This  flux,  however,  proved 
nothing,  since,  although  rather  plentiful,  it  might  be  produced  by  the 
bursa  in  this  situation  ;  therefore,  to  place  the  matter  beyond  all  doubt, 
I  oiled  and  slightly  warmed  a  thin  probe,  and  introduced  it  with  great 
care  and  delicacy  into  the  wound,  when,  somewhat  to  my  surprise,  it 
penetrated  at  once  to  a  depth  which  clearly  showed  it  to  be  in  the 
knee-joint.  The  instrument  was  withdrawn;  guttta  percha  splint, 
slightly  bent,  was  placed  on  the  outside  of  the  limb  ;  and  the  wound 
was  closed  by  painting  it  over  with  collodion,  and  then  covering  it 
with  one  piece  of  soap  plaster ;  the  object  being  not  merely  to  exclude 
the  air,  but  also  to  prevent  the  flow  of  fluid  from  the  wound  which 
would  keep  it  open. 

During  the  week  I  saw  her  once  or  twice.     Not  a  single  untoward 

symptom  arose.       I    ceased   to   visit    the  patient;    but  have  since  heard 

that  the   wound   has   healed   without   any  trouble    or   evil   consequence. 

The  following  case  is  more  remarkable,  and  was  kindly  sent  to  me 

by  my  colleague,  Mr.  Canton: 

Henry    S ,  sailor,    aged   thirty -two,  came  to  me  on  the  25th 

of  April  last,  on  account  of  ulcers  about  the  right  elbow.     Three  years 
ago,  while  at  sea  between  Madi'as  and  Calcutta,  there  broke  out  a  com- 
plaint  which   he   calls    "scurvy    boils,''    and   several   of  the   crew  were 
affected.      He   had    on  several  parts  of  his  body  boils,  which  burst  and 
left    sores ;    they  were   worst    on  his  elbow,  and  about  a  fortnight  after 
they  had   opened   into  an   ulcer,  the   bone  began  to  get  bare.       On  his 
arrival   at    Cr.lcutta    he   went   into   hospital.      Xo   bone,  he   says,  came 
away.      There  is  now  a  large  scar  at  the  back  of  the  elbow,  the  edges 
of    which   are   ragged    and   uneven ;    four    small  ulcerations  have  again 
formed    upon   this   cicatrix,  one  of  which,  near   its  centre,  is   deep  and 
fistulous.       Around   this    spot  the   elbow    is  deformed  by  a  depression, 
which,  judging   by  eyesight   merely,  appears   to    result  from  absence  of 
bone.     On  examining  the  part  more  closely  by  touch,  it  is  evident  that 
a  part  of  the  olecranon  is  absent;   the  portion  still  left  is  attached  like 
a   sesamoid   bone    to    the  tendon  of  the  triceps  extensor;   between  that 
detached  piece  and  the  rest  of  the  ulna  is  an  interval,  which  corresponds 
to    the  depression    above    mentioned,    and   which   varies   in  length  from 


Selected  Articles^  Abstracts^  <te.  469 

three-quarters  of  an  inch,  when  the  arm  is  straight,  to  an  inch  and  a 
quarter,  when  the  limb  is  bent,  and  even  \o  nearly  two  inches,  when 
the  cubit  is  strongly  flexed.  In  the  centre  of  this  space  is  the  deep 
fistulous  ulcer  already  spoken  of,  out  of  which  s^movla  flows  pretty 
freely.  When  he  bends  and  straightens  the  arm  rather  quickly,  air  is 
alternately  .sucked  in  and  driven  from  the  opening  with  aa  evident  im- 
pulse, and  at  the  same  time  the  synovial  sac  is  separated  from  and 
propelled  against  the  bones  of  the  joint,  making  a  flapping  sound  like 
the  dry  valve  of  a  pump  before  the  water  has  risen.  When  he  had 
continued  this  action  some  time  the  joint  looked  a  little  swollen,  and, 
by  pressing  it  with  the  hands,  air  could  be  expelled  from  the  synovial 
sac.  The  man  experienced  no  pain  nor  any  stiffness  in  the  joint,  and 
seemed  surprised  when  told  to  keep  it  at  rest. 

The  treatment  adopted  was  simply  to  close  the  opening  into  the 
joint  with  a  piece  of  soap  pbsler,  and  to  give  iodine  internally.  The 
ulcei'S  gi'iidually  diminished  ia  size — that  leading  into  the  joint  very  slightly 
slower  than  the  others.  The  flow  of  synovia  ceased  in  about  three  weeks, 
and  on  the  30th  of  May  he  came  to  say  that  he  was  quite  well,  and 
about  to  start  on  another  voyage  to  the  East. 

This  case   is  remarkable  for  the|  insensibility  of  the  synovial  mem- 
brane   to    the    contact    of    air;    the   secretion   from   it  was,    however, 
more    abundant    than    usual,    and   was   increasing,   so   that    an   inflam- 
mation,   probably   chronic   and  hydrophical,    would   have   shortly    been 
established,    had  not  measures   been   taken   to   exclude   the   air,  and  to 
prevent  the   irritating   drain   of  ^synovia  from   the   sac.       The  free   ad- 
mission of   air  into  the  joint  cavity   gives  rise  to  considerations  which 
ought   to   be   followed   out   in   their  bearing   upon  that    doctrine   of    a 
vacuum   supposed  to  be  constantly   maintained  by  means  of  the  syno- 
vial  membrane   in   the   joint   cavity,   whereby   a   pressure    is   exercised 
on   its   surfaces.     Now  it   is  a   certain  fact   in  Physics,  that,  when  two 
surfaces   closely   adapted   to   each  other   in  shape  are   pressed  together, 
there  is   established  between  them  cohesion   of   contact.      Such  a   con- 
dition  in  all  joints  aids  in  keeping  the  cartilaginous  surfaces  together; 
but   this   cohesion   does   not  in  any  way  depend  upon  the  bones  being 
surrounded    by  a    membrane    in    the   shape   of   a   closed    bag,    as   the 
theory  runs.     It  has  even   been   affirmed  by   some,    that   if   the   syno- 
vial  membrane  be  punctured,   this   cohesion  is  destroyed,  and  the  joint 
surfaces    may  be   [easily  separated.     The   case  just  detailed  shows  the 
fallacy   of   such   a  theory,    and  that  the   cohesion  of  joint  surfaces  ex- 
ists,   according  to   the  common  physical  law,    only  between   the   parts 
actually   in   contact  at   the  moment ;    and  therefore   that  a  vacuum   in 
the  whole    synovial    sac    would    not  assist  in  retaining   the   parts   in 
situ.     That  the  synovial   membrane  probably   does  not  form  a  vacuum 
at  all,   may  be   gathered  from  the   consideration    that,    if   it    were   so, 
it  would  frequently  be  forced   with   a  pressure   of   fifteen    pounds    to 


470  The  Peninsular  and  Independent. 

the  square  inch  between  the  joint  surfaces,  and  thus  be  pinched  and 
bruised  —  a  circumstance  which  we  know  very  rarely,  if  ever,  hap- 
pens. Altogether,  then,  the  doctrine  of  a  vacuum  in  the  synovial  sac 
is,  firstly,  unnecessary ;  secondly,  improbable  ;  therefore  should  be 
erased  from  amongst  our  physiological  theories. 

{London  Lancet. 


CASE  ILLUSTRATIVE  OF  THE  POST-  MORTEM  ACTION  OF  GASTRIC  JUICE 
ON  THE  STOMACH  AND  DIAPHRAGM.  By  W.  Grant,  M.B.,  Assistant  Sur- 
geon H.  M.  Slst  Regiment,  Pooua. 

Private   Edward  V ,   of  II.    M.    31st    Regiment,    aged   thirty 

has  been  in  the  service  for  five  years;  was  a  shoemaker  by  trade 
before  his  enlistment  ;  has  a  fair  complexion ;  is  a  stout-built,  mid- 
dle-sized man,  of  rather  strumous  appearance.  He  was  admitted  into 
the  Regimental  Hospital,  Poena,  on  the  15th  of  March  last,  com- 
plaining of  acute  headache,  with  vertigo,  nausea,  heat  of  skin,  thirst, 
&c. ;  tongue  foul ;  bowels  irregular ;  pulse  9G.  He  was  treated  with 
aperients  and  quinine,  and,  in  three  days  after,  was  convalescing,  when 
he  had  an  attack  of  slight  catarrhal  ophthalmia,  from  sleeping  near 
an  open  window.  From  this  affection  he  made  a  satisfactory  recovery, 
and  was   discharged   for   duty   on   the   24th   of   March. 

On  the  morning  of  April  1st  he  was  re- admitted,  complaining 
of  headache,  and  seemingly  much  in  the  same  state  as  on  the  15th 
of  March.  Soon  after  admission,  he  had  a  severe  rigor,  accompanied 
with  most  acute  throbbing  pain  in  the  right  side  of  the  head.  He 
was  ordered  some  calomel  and  James's  powder,  followed  in  three 
hours  by  a  dose  of  compound  powder  of  jalap,  with  sulphate  of 
quinine.  After  the  action  of  the  purgative,  he  felt  considerably  re- 
lieved. 

On  the  morning  of  the  2nd  of  April,  he  complained  of  shooting 
pain  in  the  right  eye  and  ear,  and  along  the  right  side  of  the  face, 
and  tenderness  on  pressure  over  the  scalp  on  the  right  side.  Leeches 
were  applied  to  the  right  temple,  and,  in  the  evening,  he  had  a 
warm  bath,  followed  by  ten  grains  of  Dover's  powder,  and  a  large 
blister   behind  the  right  ear. 

Next  day  the  pain  had  in  a  great  measure  subsided.  The  blis- 
ter had  acted  well,  and  was  ordered  to  be  kept  open.  From  this 
time  up  to  the  13th  he  seemed  to  mend  slowly.  He  had  occasional 
pain  in  the  head,  of  a  shooting  character,  but  said  he  felt  himself 
recovering.  He  had  no  chest  or  abdominal  symptoms  of  an  unto- 
ward nature,  and  was  able  to  eat  some  arrow -root,  or  beef- tea,  with 
a  little  bread,  from  time  to  time.  He  was  taking  two  grains  of 
iodide  of  potassium,  with  an  ounce  of  infusion  of  chirretta,  three 
or  four  times    a  day,   and  an   occasional   aperient. 


Selected  Articles^  Abstracts^  dc.  471 

On  the  evening  of  the  13th  of  April,  he  lapsed  into  a  state  of 
coma,  and  his  pulse  became  slow,  and  labored.  From  this  time  he 
never  rallied,   but  died  on  the   15th  of   April,   at  7   a.  m. 

Sectio  Cadaveris  Five  Hours  after  Death.  —  General  appearance  of 
the  body:  Limbs  and  trunk  well  developed  and  muscular;  marks  of 
leeching  and  blistering  on  the  right  side  of  the  head;  no  other  cica- 
trices or  marks  on  any  part  of  the  body.  Head  :  On  opening  the  skull,  the 
dura  mater  was  found  adherent  to  several  portions  of  the  right  hem- 
isphere of  the  brain  by  processes  of  well -organized  lymph.  On  re- 
moving the  brain,  an  abscess  of  the  size  of  a  hen's  egg,  containing  thick 
pus,  was  found  in  its  substance,  just  over  the  petrous  portion  of  the  right 
temporal  bone,  the  subjacent  part  of  which  was  in  a  state  of  caries.  The 
lateral  ventricles  contained  a  quantity  of  grumous-looking  serum ;  choroid 
plexus  much  congested.  The  rest  of  the  brain  seemed  healthy.  Chest : 
No  pleuritic  adhesions  on  either  side;  the  left  pleural  cavity  contained 
nearly  a  pint  of  blackish,  fluid  blood  ;  the  lungs  had  a  few  crude  tubercles 
scattered  through  out  their  substance ;  their  posterior  portions  were  engorg- 
ed with  blood;  pericardium  and  heart  healthy.  The  diaphragm  pre^ 
sented  a  remarkable  appearance ;  it  contained  a  large  ragged  aperture, 
with  dark  edges  immediately  to  the  left  of  spinal  column,  and,  further  to 
the  left,  a  small  aperture  of  a  similar  character.  The  stomach,  which  seem- 
ed lacerated,  protruded  into  the  thoracic  cavity  through  the  larger  opening 
in  the  diaphragm.  Abdomen :  No  traces  of  inflammation  in  the  perito- 
neum ;  intestines  much  distended  with  flatus.  Nearly  the  whole  of  the 
stomach,  at  its  great  curvature,  seemed  to  have  been  dissolved  away  by 
the  post-mortem  action  of  the  gastric  juice,  and  this  process  appeared 
to  have  extended  to  the  diaphragm ;  the  edges  of  the  aperture  in  the 
stomach  were  of  a  blackish  or  deep  ash  -  grey  color,  soft,  and  very 
ragged.  The  vessels  in  some  parts  of  the  remaining  mucous  membrane 
presented  a  peculiar  brownish,  arborescent  appearance.  (There  was  no 
traces  of  inflammation  in  the  mucous  membrane  of  the  oesophagus.) 
The  liver,  spleen,  kidneys,  and  other  abdominal  viscera  were  perfectly 
healthy. 

Remarlcs. — In  the  greater  portion  of  cases  where  extensive  solution 
of  the  stomach  and  neighboring  parts  by  the  post-mortem  action  of 
the  gastric  juice  has  been  found  to  exist,  the  individual  had  died  shortly 
after  having  taken  food  into  the  stomach ;  but,  in  this  instance,  nothing 
in  the  shape  of  food,  except  an  occasional  teaspoonful  of  wine-and- 
water,  had  been  taken  after  the  evening  of  the  13th,  nearly  thirty  -six 
hours  before  death.  It  is  probable  that  an  excessive  elimination  of  the 
gastric  secretion  was  produced,  through  reflex  action,  by  the  diseased 
brain,  as  suggested  by  Dr.  Budd.  The  chemical  action  would  also  take 
place  more  readily  in  a  climate  of  high  temperature,  where  the  heat  of 
the  body  is  longer  retained.  The  temperature  in  this  case  was  76" 
Fahr.  in  the  shade  at  the  time  of  death,   and   94°    when   the   examina- 


412  The  Peninsular  and  Independent. 

tion  of  the  body  was  made.  The  protrusion  of  the  stomach  into  the 
thorax  (which,  according  to  Dr.  Amfred  Taylor,  aniformly  takes  place 
in  extensive  wounds  of  the  diaphragm  during  life)  was  most  probably 
produced  by  the  gaseous  distension  of  the  intestines.  The  blood  found 
in  the  left  pleural  cavity  must  liave  oozed  from  the  severed  edges  of 
the  stomach  and  diaphragm.  [London  Lancet. 


ON  CHLOROFORM  IN   LITHOTOMY   AND   AMPUTATION.    By  James   Abnott, 

M.  D. 

There  is  not,  probably,  in  the  history  of  medicine,  any  instance  so 
remarkable  of  extreme  diversity  and  rapid  change  of  opinion  on  a  prac- 
tical point  as  that  furnished  by  the  revival  and  subsequent  progress  of 
etherization.  When  Dr.  Hickman,  about  five -and -thirty  years  ago,  sug- 
gested the  production  of  insensibility  in  operations  by  the  inhalation  of 
carbonic  acid  (a  method  again  very  lately  recommended  by  a  French 
physician),  it  was  declared  to  "  be  utterly  impossible  to  find  any  sur- 
geon so  great  a  fool,  and  so  unwarrantably  bold,  as  to  undertake 
an  operation  on  such  terms."  The  subject  was  brought  before  both 
the  Eoyal  Society  in  London  and  the  Academy  of  Sciences  in  Paris, 
but  neither  of  these  learned  bodies  paid  the  slightest  attention  to  it, 
notwithstanding  that  many  of  their  members  must  have  been  aware 
of  the  experiments  with  carbonic  acid  made  on  dogs,  a  hundred  years 
before,  at  the  Grotto  del  Cane,  near  Naples,  and,  what  is  still  more 
singular,  notwithstanding  that  Dr.  Hickman's  paper  was  read  at  the 
Royal  Society  by  Sir  Humphrey  Davy,  who  had  himself,  twenty 
years   before,   suggested  a  similar   expedient. 

Fortunately,  about  twenty  -  five  years  after  this  proposal  of  Dr. 
Hickman,  the  idea  occurred  to  Mr.  Horace  Wells,  that  the  sudden 
and  extreme  intoxication  produced  by  the  inhalation  of  the  gas  which 
had  been  suggested  by  Davy  might  produce  an  insensibility  as  com- 
plete as  that  which  follows  extreme  intoxication  from  alcohol,  with- 
out its  immediate  and  ultimate  dangers.  In  prosecuting  the  inquiry, 
he  did  not,  like  Dr.  Hickman,  confine  himself  to  speculation  and  ex- 
periments in  animals.  He  boldly  tried  his  n.ethod  on  his  patients, 
and  found  that  as  respected  the  insensibility,  his  opinion  was  per- 
fectly correct.  As  no  danger,  either  immediate  or  remote,  had  as 
yet  been  discovered,  his  invention,  modified  and  improved  by  one 
of  his  pupils,  was  received  with  much  applause,  and  at  once  pro- 
nounced to  be  only  second  to,  if  not  the  equal  of,  vaccination.  Dr. 
Simpson,  who  merely  substituted  one  intoxicating  vapor  for  another, 
was  deemed  to  have  made  an  important  medical  improvement,  and 
the  statistical  evidence  which  he  adduced  to  show  that  chloroform 
saves  life  as  well  as  pain  was  eagerly  received  as  conclusive  proof  of 
its    inestimable  value. 


Selected  Articles^  Abstracts^  <&c.  473 

Before  ten  years  had  elapsed,  a  great  change  had  occurred  in 
the  opinions  of  surgeons.  The  fallacies  of  Dr.  Simpson's  statistics 
had  been  detected,  about  a  hundred  sudden  deaths  had  been  reported 
as  having  occurred  from  the  administration  of  ether  and  chloroform, 
and  a  rule  had  been  very  generally  adopted  not  to  employ  either 
of  these  substances  except  in  the  severer  operations.  Sulphuric  either 
is  again  resorted  to  in  lieu  of  chloroform  in  many  parts  of  Europe 
and  America,  and  a  proposition  lately  brought  forward  in  the  Medi- 
cal Society  of  Lyons  that  chloroform  should  be  altogether  abandoned, 
was  adopted  without  one  dissentient  voice.  A  persuasion,  founded  on 
their  knowledge  of  its  use  in  their  own  city,  that  by  far  the  greater 
number  of  accidents  from  chloroform  have  been  concealed,  appears  to 
have  had  considerable  influence  on  the  members  of  the  society  in 
producing   this   decision. 

In  the  above  observations  allusion  has  been  made  to  two  kinds 
of  danger  from  etherization  —  that  which  is  immediate  and  that  which 
is  remote.  The  latter,  or  the  effects  of  anaesthetic  vapors  on  the 
result  of  operations,  can  only  be  discovered  by  statistics.  When  a 
comparison  is  made  between  the  results  of  lithotomy  on  the  adult, 
and  amputation  of  the  larger  members  performed  before  and  after  the 
introduction  of  chloroform,  we  find  that  there  has  been  a  great  in- 
crease of  mortality  during  the  latter  period.  The  published  statistical 
facts  or  data  which  have  been  used  in  this  comparison  are  suflB- 
ciently  numerous  for  the  purpose,  and  great  care  has  been  taken 
that  the  other  essential  points  in  statistical  evidence,  as  well  as  the 
number  of  facts,  should  be  duly  regarded.  Those  who  have  opposed 
this  opinion  of  an  increased  mortality  have  also  had  recourse  to  sta- 
tistics, but  they  have  erred  in  several  respects  in  their  employment 
of  them.  In  all  of  their  reports,  the  number  of  the  data  adduced  is 
much  too  small  to  justify  their  drawing  inferences  from  them,  especially 
when  these  are  opposed  by  inferences  drawn  from  a  ten  -  times  greater 
number  of  facts.  The  returns  brought  forward,  not  having  been  previ- 
ously published,  and  having  been  drawn  up  by  themselves  for  an  especial 
purpose,  are  deficient  in  authenticity ;  and  there  is  dissimilarity  between 
the  facts  compared.  In  some  of  these  reports  there  are  still  greater 
errors,  proving  that  their  authors  could  not  have  anticipated  any  very 
strict  criticism  ;  and  they  are  well  adapted  for  preventing  the  due  weight 
that  ought  to  attach  to  extended  and  accurate  calculation.  A  cursory 
reader  is  easily  so  misled,  and  in  this  way  only  can  I  account  for  Mr. 
Skey's  assertion,  in  his  recently  published  treatise  on  Operative  Surgery, 
that  the  evidence  of  an  increased  rate  of  mortality,  after  the  severer 
operations,  since  the  introduction  of  chloroform  is  not  satisfactory.  Med- 
ical evidence  is  proverbially  uncertain ;  but  it  can  not  be  denied  that 
no  point  in  medicine  has  been  more  clearly  proved  than  that  of  an  in- 
crease of  mortality  from    chloroform. 


4Y4  The  Peninsular  and  Independent, 

The  rate  of  mortality  after  lithotomy  in  the  adult  was  formerly 
(calculating  from  775  cases)  22  1-2  per  cent.  For  several  years  past, 
in  London,  "the  cures,"  to  use  the  expression  of  Sir  B.  Brodie,  "have 
been  balanced  by  the  deaths."  By  an  elaborate  statistical  report  lately 
published,  it  appears  that  the  mortality  after  these  operations  in  the 
London  hospitals  is  more  than  50  per  cent.  ;  and  that  the  explanation 
which  has  been  attempted  of  this  great  mortality  —  that  the  more  fa- 
vorable cases  have  been  selected  for  lithotrity  —  is  perfectly  unfounded. 
Only  a  few  cases  have  been  operated  upon  by  lithotrity,  and  it  has 
been  adopted  in  many  of  these  because  they  were  deemed  unfavorable 
for  lithotomy. 

From  a  subsequent  report  by  the  same  inquirer,  we  learn  that 
lithotomy  in  the  adult  has  not,  during  the  same  period,  been  nearly  so 
fatal  in  the  provinces  as  in  London  ;  in  these  the  mortality  has  been 
only  25  per  cent.  But  when  this  fjict  is  recorded,  it  ought  to  be  men- 
tioned, also,  that  chloroform  has  fallen  into  disuse  in  several  of  the 
provincial  hospitals.  Mr.  Smith,  senior  surgeon  of  the  Leeds  Infirmary, 
and  whose  success  as  a  lithotomist  has  been  very  great,  informs  us,  in 
his  recently  published  Lectures  on  Lithotomy,  that  the  fatal  results  of  capi- 
tal operations  have  been  much  decreased  in  that  institution  since  chlo- 
roform has  been  sparingly  employed  ;  and  to  this  change  of  practice, 
probably,  as  well  as  to  his  peculiar  manner  of  forming  the  flaps,  may 
be  the  remarkable  success  of  Mr.    Teale's  amputation  be  due. 

That  so  fatal  an  operation  as  lithotomy  on  the  adult  under  chloro- 
form should  be  persisted  in,  is,  it  must  be  acknowledged,  a  very  ex- 
traordinary fact.  Whether  chloroform  would  have  an  equally  injurious 
effect  on  the  result  of  the  dilating  operations  for  stone  remains  to  be 
ascertained.  It  is  probable  that  it  would  not ;  and  by  its  aid  the  great 
objection  in  such  operations  —  namely,  their  painful  protraction  —  would 
be  overcome,  it  is  to  be  hoped  that  they  will  now  be  more  frequently 
performed.  In  the  Marian  operation  the  parts  were  doubtless,  often  se- 
verely bruised  and  torn  by  the  rapidity  with  which  it  was  performed, 
as  well  as  by  the  imperfect  dilating  means  employed.  The  argument 
against  the  revival  of  the  dilating  operation  was  much  stronger  before 
the  introduction  of  chloroform  than  it  now  is.  The  cutting  operation 
was  then  more  than  twice  as  successful  as  it  is  at  present ;  and  no 
means  existed  for  preventing  the  pain  that  would  be  caused  by  dilata- 
tion effected  with  moderate  speed.  That  the  finger  alone  will  dilate 
sufficiently  in  the  cases  of  children,  and  in  those  of  adults  where  the 
stone  is  small,  has  been  proved  by  the  experience  of  Mr.  Allarton 
De  Borsa,  and  others;  but  when  the  prostrate  is  unyielding  and  the 
stone  is  large,  a  dilator  of  fluid  pressure  should  be  substituted.  If 
chloroform  be  used  with  such  an  instrument,  and  the  operation  be  thus 
rendered  painless,  there  will  be  no  necessity  for  a  dilatation  so  gradua 


Selected  Articles^  Abstracts^  &c.  4cl5 

and  slow  as  would  otherwise  be  advisable.  Even  granting  that  it  were 
so  quick  as  to  tear,  I  question  whether  the  danger  of  the  operation 
would  be  nearly  so  great  as  that  of  the  present  proceeding.  The  more 
resisting  parts  only  would  be  torn ;  the  more  yielding  would  be  stretch- 
ed. The  danger,  therefore,  of  urinary  infiltration  and,  perhaps,  conse- 
quent pyagmia,  would  be  less.  The  use  of  a  blunt  instead  of  a  sharp 
knife  in  lithotomy  would  have,  to  a  certain  degree,  a  similar  ad- 
vantage. 

I  am  glad  to  perceive,  by  a  dispute  respecting  priority  in  a  con- 
temporary journal,  that  the  attention  of  accoucheurs  is  novv^  being  di- 
rected to  the  advantages  of  fluid  pressure  as  a  dilating  means  in  mid- 
wifery. I  have  often  adverted  to  its  utility  in  this  department  of  medi- 
cal practice.  The  difiSculty  to  be  overcome  will,  as  in  its  employment 
in  strictures  of  the  passages  and  in  stone,  be  the  construction  of  proper 
instruments.  For  this  the  practitioner  will  be  obliged  to  rely  on  his 
own  mechanical  dexterity. 

Chloroform  appears  to  be  injurious  in  amputation  in  proportion  to 
the  danger  of  the  operation  itself,  whether  this  proceeds  from  the  par- 
ticular amputation  performed,  the  injury  or  disease  requiring  it,  or  the 
general  condition  of  the  patient.  The  danger  from  amputation  of  the 
forearm,  in  a  healthy  subject,  is  probably  very  little  augmented  by 
the  depressing  action  of  this  agent;  but  that  from  amputation  of  the 
lower  extremity,  in  an  unhealthy  patient,  may  be  more  than  doubled 
by  it.  When  the  data  accummulate,  it  will  be  possible  to  judge  of 
the  effects  of  chloroform  in  various  amputations  and  under  various 
circumstances.  At  present  they  are  only  sufficient  in  number  to  show 
that  the  average  mortality,  from  all  the  severer  operations  of  this 
description,  is  greater  by  more  than  ten  per  cent,  than  before  the 
introduction  of  chloroform. 

It  is  almost  unnecessary  to  remark  that  the  fact  of  the  inju- 
rious effects  of  chloroform  or  ether  on  the  results  of  the  severer 
operations,  is  not  a  reason  why  it  should  never  be  employed  in  them. 
Patients  may  refuse  to  submit  to  such  operations  unless  they  are 
performed  under  complete  anaethesia;  and  it  must  be  confessed  that, 
on  certain  occasions,  only  a  limited  degree  of  insensibility  can  be 
produced  by  local  and  safe  measures,  although  applied  in  the  most 
dexterous  manner.  The  objection,  however,  which  has  been  made  to 
congelation  in  amputation,  that  even  if  its  angethetic  action  were 
rendered  complete  by  combining  pressure  with  it,  the  peculiar  nature 
of  such  wounds  might  prevent  their  healing  favorably  after  its 
use,  does  not  appear  to  be  well  founded.  Mr.  Robert,  of  the  Hotel 
Dieu,  in  Paris,  states,  in  the  Moniteur  des  Hospitaux  of  the  7th 
April  last,  that  "he  has  often  had  recourse  to  congelation  in  amputation 
of  the  fingers  and  toes,  aad  that  he  has  never  seen  any  trouble- 
some  consequences."      No  objection  can  be  made  to  the  use  of   cold 


476  The  Peninsular  and  Independent. 

for  rendering  the  outer  or  more  sensitive  textures  painless.  AVere  its 
action  limited  to  these,  a  great  odvanta^e  would  be  gained;  for  with 
its  ana3sthetic  there  is  combined  a  powerful  antiphlogistic  virtue.  The 
swelling  of  the  part  from  effusion  of  serum  in  its  looser  textures, 
caused  by  a  deeper  congelation,  might  oppose  union  by  the  first  in- 
tention, unless  care  be  taken  to  have  a  redundancy  of  skin;  and  the 
subsequent  dressing  of  the  wound  must  then  be  suitably  modified 
When  congelation  is  properly  used,  under  common  circumstances,  it 
greatly  promotes  the  healing  process;  itij  improper  use  may  have  the 
opposite  effect.  {London  Lancet. 


REMARKABLE  CASE  OF  AD.TPOCERE. 

At  a  meeting  of  the  New  York  Pathological  Society,  held  Sept. 
14th,  Dr.  Dalton  presented  a  body  which  had  undergone  complete  trans- 
formation into  adipocerc.  As  far  as  could  be  ascertained,  the  body  was 
buried  in  1832.  It  was  found  in  a  cemetry,  or  rather  in  a  pit,  in  the 
upper  part  of  the  city,  which  was  dug  out  for  the  reception  of  cholera 
patients.  The  bodies  were  placed  in  separate  coffins,  but  not  in  separate 
graves.  The  coffin  containing  this  body  was  found  about  twenty  feet 
beneath  the  surface ;  underneath  it  were  three  tiers  of  coffins,  and  above 
it  nine  or  ten.  The  uppermost  tier  of  coffins  was  covered  by  three  or 
four  feet  of  solid  earth.  The  soil  directly  under  the  coffin  in  which 
the  bod}--  was  found  was  very  watery;  above  this  level  there  was  but 
little  water,  although  the  ground  was  very  moist.  The  bones  of  the 
bodies  contained  in  this  pit,  and  in  some  cases  the  tendons,  were  melted 
together  in  a  semi-lKiid  mass,  the  usual  result  of  decomposition  under 
ordinary  circumstances 

At  the  water -mark  there  were  several  bodies  converted  into  this 
adipocere.  The  specimen  presented,  however,  was  the  most  pevfect.  The 
hands  and  feet  have  been  rattled  off  during  transportation.  When  the 
body  was  first  taken  out,  its  color  was  almost  precisely  the  same  as 
now  (a  dullish -white);  if  anything,  it  has  become  a  little  moie  brown- 
ish. -  It  has  now  been  exposed  to  the  ~air  for  three  months.  Its  con- 
sistency was  decidedly  less  when  first  removed ;  it  was  then  like  cheese 
of  medium  consistency,  a  mixture  of  the  ductile  and  the  brittle.  In 
handling  it  great  care  had  to  be  used.  At  that  lime  it  exhaled  a  tole- 
rably strong  odor,  partly  cheesy,  ammoniacal,  and  earthy.  Since  that 
time  the  cheesy  and  the  earthy  odors  have  disappeared ;  the  ammoni- 
acal smell,  however,  is  still  perceptible.  In  other  respects  it  appears 
not  to  be  altered  in  the  least,  and  Dr.  Dalton  presumes  it  will  remain 
in  the  same  condition  for  years,  for  centuries,  if  pioperly  taken  care  o£ 

The  body  is  that  of  a  large,  fat  woman,  between  45  and  oO  years 
of  age,  evidently  a  woman  past  the  prime  of  life.     The  anterior  parietes 


Selected  Articles^  Abstracts^  cbc.  477 

have  sunk  very  much,  particularly  those  of  the  abdomen,  which  appear 
to  be  in  contact  with  the  spinal  column.  The  anterior  portion  of  the 
chest  is  also  collapsed.  The  change  of  animal  tissue  to  the  adipocere 
is  absolutely  complete  in  all  the  tissues,  except  the  hair,  nails,  and 
bones.  The  papillae  of  the  skin  can  be  distinguished,  but  the  other 
tissues  cannot  be  made  out. 

The  substance  of  which  this  mass  is  composed  is  known  by  the 
name  of  adipocere,  or,  as  the  French  call  it,  '■'■  graiHse  de  cadavre^''''  (fat 
of  dead  bodies).  It  is  exceedingly  light,  so  that  one  can  easily  raise 
the  whole  subject. 

It  is  somewhat  curious  that  all  the  bodies,  which  aie  reported  as 
having  undergone  this  degeneration,  have  been  interred  under  precisely 
the  same  cii'cumstances.  The  first  case  was  observed  in  a  similar  pit 
at  a  cemetery  in  Paiis. 

The  chemical  composition  of  the  substance  is  such,  that  it  is  re- 
gnrdcd  as  an  ammoniacal  soap,  sometimes  soap  composed  of  ammonia 
and  lime,  in  other  instances  almost  exclusively  a  lime -soap.  Orfila  and 
FouRCUOY,  who  had  paid  particular  attention  to  this  subject,  assert  that 
at  first  it  is  almost  exclusively  ammoniacal,  the  ammonia  being  sup- 
plied by  the  decomposition  of  the  nitrogenized  muscular  tissue.  This 
unites  with  the  Hit  coming  from  the  adipose  tissue,  which  has  become 
rancid,  and  produces  an  ammoniacal  soap.  Some  French  chemists  re- 
gard it  as  a  transformation  of  the  muscles  into  oleic  acid,  so  that  adi- 
pocere may  be  produced  by  simple  decomposition  of  the  muscular  tis- 
sue. The  more  generally  received  opinion  is  that  it  is  simple  de- 
composition of  the  muscular  tissue  into  ammonia,  which  unites  with 
the  fat  of  the  adipose  tissue.  This  opinion  is  favored  by  the  fact, 
that  in  almost  every  instance  of  this  kind  the  bodies  are  those  of 
extremely  fat  persons.  Such  was  the  fact  in  a  case,  the  only  case 
of  the  kind  which  Dr.  Dalton  has  previously  seen,  where  the  body 
was  that  of  an  enormously  fat  man.  Another  reason  which  makes 
it  probable  that  the  fat  must  com.e  from  the  adipose  tissue  is  that,  as 
Orfila  ascertained,  adipocere  does  not  take  place  when  the  animal 
matter  consists  of  muscular  tissue  only. 

A  body  buried  by  itself  will  rarely  be  converted  into  adipocere, 
because  the  ammonia -compounds  produced  by  the  decomposition  of  the 
muscular  substance  are  dissolved  in  the  fluids  of  the  body,  and  these 
fluids  absorbed  by  the  soil,  and  do  not  unite  with  the  fat  so  as  to  form 
adipocere.  But  if  a  body  is  surrounded  by  other  bodies,  the  bodies 
above,  decomposing,  produce  ammoniacal  fluids.  These  being  washed 
down  by  the  rain,  filter  through  to  the  ninth  or  tenth  coffin,  the  water 
of  course  in  its  descent  becoming  more  and  more  loaded  with  ammo- 
nia, and  this  uniting  with  the  Ait  of  the  lowermost  bodies,  produces 
adipocere.  The  bodies  under  the  surface  of  the  water  do  not  undergo 
the  transformation,  probably  because  this  substance  is  soluble  in  water. 


478  The  Peninsular  and  Independent. 

This  material,  of  which  the  body  is  composed,  is  very  inflammable. 
A  piece  put  on  charcoal,  placed  before  the  flame  of  the  blow -pipe, 
takes  fire  and  is  consumed  readily,  leaving  scarcely  any  appreciable  re- 
sidue. {Fldl.  Med.  ami  Surg.  RexjoHer, 


ABSTRACTS  AND  SELECTIONS  for  the  PEMXSILAU  AXD  INDEPENDENT. 


By  M.  A.  Patteuson,  M    D.,  Tccumeth. 
DIABETES.    By  Dr.  A.  Clakk. 

Dr.  Clark  called  the  attention  of  the  members  of  the  N.  Y.  Medi- 
cal &  Surgical  Society  to  the  history  of  two  cases  of  diabetes,  in  which 
he  had  resorted  to  a  somewhat  novel  method  of  treatment  with  apparent 
benefit.  The  first  ca.se  was  that  of  a  physician,  aged  sixty-two,  residing 
in  the  central  part  of  the  State  of  New  York.  He  had  naturally  a  robust 
constitution,  and  when  in  health  had  an  average  weight  of  220  pounds. 
He  stated  that  for  the  past  forty  years  he  had  been  actively  engaged  in 
the  practice  of  his  profession,  and  that  he  had  enjoyed  uninterrupted 
health  until  last  spring,  when  his  suspicions  were  excited  by  the  occur- 
rence of  frequent  micturition,  accompanied  with  an  increase  in  the  amount 
of  urine  passed.  He  examined  some  of  his  urine,  and  detected  the  pre- 
sence of  sugar,  fermentation  taking  place  readily  when  the  fluid  was 
allowed  to  stand  in  a  warm  room.  Its  specific  gravity  was  103.  Gra- 
dually he  grew  worse,  muscular  power  being  considerably  diminished, 
and  during  the  months  of  June  and  July  the  urine  still  continued  sac- 
charine, and  increased  in  quantity  to  a  gallon  per  diem.  At  this  time 
his  strength  was  overtasked  in  attending  the  practice  of  another  physi- 
cian. Pie  continued  at  work,  however,  until  about  three  weeks  ago, 
when  his  fliiling  health  induced  him  to  abandon  his  practice,  and  come 
to  New  York  for  advice.  He  arrived  here  three  weeks  since,  and  con- 
sulted Dr.  Clark.  The  quantity  of  urine  passed  at  this  time  was  about 
the  same,  as  also  its  specific  gravity,  and  chemical  examination  revealed 
the  presence  of  a  considerable  amount  of  sugar.  The  fluid  responded  to 
the  fermentation  test  in  twelve  hours,  torula?  were  formed  in  six  hours, 
and  the  application  of  Trommer's  test,  yielded  a  pretty  abundant  deposit 
of  the  red  oxide  of  copper.  Amongst  the  prominent  symptoms  were 
dryness  of  the  mouth  and  skin,  thirst  and  constipation  of  the  bowels, 
the  faeces  being  unnaturally  hard.  In  the  management  of  his  case,  Dr. 
Clark  was  led,  from  the  experience  of  a  previous  one,  to  advise  the 
use  of  bi-carbonate  of  soda  in  doses  of  11  grains,  repeated  as  often  as 
possible,  provided  the  urine  was  not  rendered  alkaline,  or  the  stomach 
nauseated.  He  also  ordered  counter  irritation  to  be  established  at  the 
back  of  the  neck,  the  idea  of  doing  this  having  been  suggested  by  the 


Selected  Articles^  Abstracts^  <Jbc.  479 

experiments  of  Bernard,  vrho  was  able  to  cause  a  diabetic  state  of  the 
urine  by  irritating  the  medulla  oblongata.  A  mixed  diet  was  allowed, 
vegetables  in  moderation,  and  hard  biscuit  being  included,  and  the  pa- 
tient was  cautioned  respecting  the  use  of  water,  which  was  to  be  taken 
only  at  meal  times,  and  at  no  time  freely.  With  these  directions,  he 
went  into  the  country  on  the  31st  of  August,  and  remained  until  Wed- 
nesday of  that  week,  when  he  again  visited  Dr.  Clark.  During  the 
interval  of  absence  a  vast  improvement  had  taken  place.  He  could  now 
sleep  eight  hours,  and  on  rising,  pass  less  than  a  pint  of  urine,  the 
quantity  passed  daily  not  exceeding  three  pints.  He  complained  no 
longer  of  thirst,  his  lassitude  was  gone,  his  bowels  were  natural,  and 
his  weight  had  increased  seven  pounds ;  his  urine,  when  examined,  was 
found  to  have  a  specific  gravity  of  102.20,  and  when  subjected  to 
Trommer's  test,  gave  the  black  instead  the  red  oxide  of  copper.  The 
absence  of  sugar  was  farther  evidenced  by  the  fact  that  the  fluid  was 
allowed  to  stand  in  a  warm  place  over  48  hours  without  fermentation. 
Torulaj  were  likewise  absent,  and  in  their  place  was  a  moderate  number 
of  crystals  and  oxalate  of  lime.  The  patient  was  sent  home  to  continue 
the  same  plan  of  treatment. 

The  second  case  was  not  as  striking  as  the  first,  but  j'-ct  was  one 
of  diabetes,  treated  in  a  similar  way  and  with  similar  results.  The  patient 
was  a  gentleman,  who  had  once  been  under  the  care  of  Dr.  Van  Buren, 
and  was  seen  b}^  Dr.  Clakk  two  years  ago.  He  then  stated  that  he 
had  suffered  from  the  disease  nine  years  previously,  and  that,  under 
the  use  of  bi-carbonate  of  soda,  he  had  recovered  and  remained  well  for 
more  than  six  years.  At  the  time  he  applied  to  Dr.  Clark,  he  was 
passing  about  a  gallon  of  urine  dail}'',  which,  on  examination,  was  found 
to  contain  sugar;  he  also  suffered  the  usual  symptoms  of  the  disease. 
He  was  put  upon  bicarb,  soda,  and  a  stimulating  liniment,  which,  when 
rubbed  upon  the  back  of  the  neck,  produced  a  sore  that  lasted  for 
several  weeks.  During  this  period,  he  improved  rapidly.  Dr.  Clark 
remarked  that  the  results  in  these  two  cases  were  so  satisfactory  that 
he  thought  himself  waranted  in  recommending  the  same  means  of  treat- 
ment for  further  trial. 

At  a  subsequent  meeting  of  the  Society,  Dr.  Clark  made  a  further 
report  concerning  the  treatment  of  diabetes  by  blisters  to  the  neck 
and  administration  of  bi-carbonate  of  soda.  Since  the  time  of  the 
last  notes  he  had  had  three  cases,  in  which  to  test  it.  The  first 
passed  a  gallon  of  urine  a  day,  and  used  soda  for  three  weeks  with- 
out benefit.  The  stomach  was  disordered  by  it,  and  the  patient  un- 
able  to   continue  the  treatment. 

The  second  passed  seven  quarts  a  day,  of  specific  gravity  100.43, 
took  soda  for  two  and  a  half  weeks,  after  which  amount  went  up  to 
eight  quarts  of  specific  gravity  100.4.  This  case  left  the  hospital 
before  treatment  could  be  conducted  to  a  close,  or  the  remedy  fairly 
tested. 


480  The  Peninsular  and  Independent. 

The  third  case,  which  passed  ten  pints  per  diem,  under  blisters  and 
soda,  did  not  improve  at  first,  but  the  do.se  of  soda,  being  carried  up  to 
3  iiss,  a  day,  the   urine  soon  diminished  in  amount  to  six  pints  of  spe- 
cific gravity  of  100.28.     That  day  only  two  quarts  had  been  passed,  an^ 
he  seemed  improving. 

Dr.  Maukoe  stated  that  he  had  tried  this  treatment  in  a  case  of 
simple  diuresis  with  very  decided  advantage.  Under  it  the  urine  rapidly 
decreased  from  six  to  three  (quarts.     No  blisters  were  used. 

\N.    Y.  Med.  Press. 

LECTURE  ON  BI'INAL  DISEASES. 

AVc  take  the  following  extracts  from  a  lecture  delivered  at  the 
Cooper  Institute,  by  Cn.vs.  F.  Taylor.  We  consider  them  interest- 
ing  and    instructive. 

Dr.  Taylor  commcnoed  by  saying  that  the  common  impression  that 
exercise  affected  only  the  muscular  tissue  was  entirely  wrong;    for  as  the 
muscles  act  only  under  the  stimulus  of  the  nerves,  the  latter  first  receive 
the  impression  of  the  will,  and  consequently  are  reall}'  affected  before  the 
muscles aic  reached.     Injure  the  nerve,  as  in  paralysis,  so  that  the  will  can- 
not reach  the  muscles,  and  the  latter  forever  reniain  unmoved,  and  thus 
waste  awny.     Now,  this  j(»int  action  of  the  nervous  and  muscular  s^'stem 
must  be  taken  into  consideration  in  proposing  any  exercise  for  an  invalid  or 
or  physically  undertoned  person  ;  for  we  have  it  in  our  power  so  to  separate 
these  manifestations  that  we  need  not  employ  both  together,  but  can  use 
that  which  is  most  desirable  in  any  given  case.      Practically,  we  find  it  ne- 
cessary, f>s  disease  is  always  attcnde(l  with  debility  of  the  nervous  system, 
to  use  sucli  exercise  as  will  accomplish  the  n)OSt  change  in  the  muscles, 
while  making  the  least  draughts  on  the  nervous  system.     We  have  an  un- 
erring rule  to  guide  us  in  this  respect.     Rapid  movements,  implying  rapid 
will,  exeicise,  and  therefore  exhaust  principally  the  nervous  system;    but 
any  the  greatest  amount  of  fatigue  does  not  imi)ly  that  there  has  been  a 
corresi)onQing  change  in  tiie  mu.'-cles.     For  example,  a  person  ill  of  a  chronic 
disease,  consumption,  maj/  be  wholly  incapable  of  taking  enough  exercise 
to  aHect  sensibly  the  muscles  —  that  is,  to  cause  them  to  take  up  an  in- 
creased amount  of  nutiition  from  the  blood  ;    but  still,  wouM  not  the  effect 
of  exercise  upon  the  muscles,  on  the  circulation  and  the  general  nutrition, 
be  just  as  desirable  as  though  he  were  able  to  obtain  it?     The  patient  has 
a  serious  disease  of  the  lungs  —  with  cold  hands  and  feet,  contracted  chest 
and  feeble  muscles.     AVhat  shall  he  do  V  ^  It  is  de>irable  to  make  those 
muscles  hungry  for  the  blood  which  would  be  sent  them  could  they  only 
be  used.     x\ny  trifling  ordinary  exercise,  however,  exhausts  him,  so  that 
very  little  benefit  is  derived  from  it,  and  often  positive  damage.     But  let 
such  a  person  be  seated  in  an  easy  position  and  his  muscle  be  put  into  the 
proper  action  by  an  assistant  bending  the  various  joints  of  the  body.     This 
should  be  done  easily  and  gently,  because  the  longer  a  contracting  muscle 
is  held  in  that  state,  the  greater  its  effect  on  its  substance.     Thus  his  mus- 
cles may  one  by  one  be  made  to  act  in  the  most  powerful  mmner  —  many 
times  more  powerful  than  if  all  acting  at  the  same  moment,  with  very  little 
effort,  and  no  fj\tigue  on  the  patient's  parts,  till  all  have  been  brought  under 

the  same  influence 

The  application  of  this  philosophical  mode  of  treating  disease  is  ex- 
tremely simple 


Selected  Articles^  Abstracts^  dc.  481 

Thus  debility  and  irritability  of  the  nervous  system  is  relieved  by  ir- 
ritating the  muscles — that  is,  by  directing  the  nervous  power  to  be  expend- 
ed on  the  muscles,  instead  of  being  wasted  in  receiving  external  impressions. 
Lateral  curvature  of  the  spine,  said  to  atflict  so  large  a  proportion  of  board- 
ing school  girls,  and  caused  by  weakness  and  unequal  action  of  the  spinal 
muscles,  is  only  partially  benefitted  by  ordinary  exercise;  but,  by  under- 
standing the  anatomy  of  the  parts,  and  how  to  put  the  different  groups  of 
muscles  into  proper  motion,  and  make  them  act  equally  and  harmoniously, 
the  curvature  is  speedily  restored.  To  effect  this,  no  violent  motion,  but, 
on  the  contrary,  gentle  action  is  required 

Anything  which  will  gently,  gradually,  almost  unconsciously,  give 
tone  and  vigor  to  the  circulation  and  the  muscles,  plumpness  to  the  form, 
fullness  to  the  chest,  steadiness  and  grace  to  the  carriage,  and  instead  of 
that  lassitude  and  the  languid  expression  so  common,  a  tone  of  life  and 
health,  while  relieving  those  peculiar  maladies  arising  from  their  common 
weakness,  would  be  a  great  boon  to  our  countrywomen.  This  treatment 
does  not  clash  with  any  existing  theories,  but  comes  in  merely  to  fill  up  a 
void.  [iV.  Y.  Med.  Press. 


EMBOLI. 

The  substance  of  Prof  Schctzembergen's  conclusions  respecting  this 
singular  affection  of  the  arteries  is  embraced  in  the  following  summary, 
published  in  the  Medical  Times  and  Gazette  of  July  23 : 

1.  Fibrinous  concretions  or  solid  bodies  formed  in  the  heart  or  great 
vessels,  may  be  detached  from  their  seat,  carried  along  in  the  current  of 
blood,  and  so  obstruct  ditleient  secondary  branches  of  the  vascular  system. 
2.  This  fact  is  neitlier  absolutely  rare  nor  exceptional;  it  constitutes  a 
special  and  very  peculiar  alfection  of  the  arteries,  which  has  been  called 
by  ViKCiiow,  -'Emboli."  3.  This  affection,  which  was  for  a  long  time 
misunderstood,  is  now  shown  to  exist  both  b}'"  scientific  induction,  and  by 
clinical  and  microscopic  observation.  4.  It  has  been  observed  as  a  conse- 
quence of  gangrenous  inflammation  of  the  pulmonary  veins ;  of  organic 
affections  of  the  left  side  of  the  heart ;  and  of  atheromatous  degeneration 
of  the  large  arterial  trunks.  5.  Its  most  frequent  cause  is  derived  from 
fibrinous  or  calcareous  concretions,  and  polypoid  excresences  developed 
on  the  mitral  valve,  and  carried  along  in  the  current  of  blood.  6.  When 
the  patient  does  not  succumb  under  a  first  attack,  another  generally  fol- 
lows; thus  the  attacks  are  multiplied.  7.  The  arteries  most  frequently 
found  atlected  aie  :  The  Sylvian  artery,  the  internal  carotid,  the  arteries 
of  the  upper  and  lower  extremeties,  the  splenic  renal,  external  carotid,  and 
mesenteric.  8.  The  obstruction  ordinarily  occurs  at  contracted  points  of  the 
arteries.  9.  If  in  consequence  of  the  obstruction  a  collateral  circulation  is 
establi>hed,  only  temporary  disturbance  is  produced.  10.  But  if  no  col- 
lateral circulation  is  established,  then  follow  organic  alterations,  mortifi- 
cations and  gangrene,  dry  or  humid,  partial  or  general.  11.  In  the 
parenchymatous  organs  the  obstruction  of  the  arterial  branches  produces 
sanguinary  or  circumscribed  fibrinous  infarctus.  12.  In  the  brain,  the 
infarctus  usually  occasions  yellow  softening.  13.  In  the  spleen  and  in 
the  kidney  the  infarctus  produces  a  special  lesion,  exactly  circumscribed, 
ordinarily  of  a  conical  shape,  varying  in  color  according  to  its  age,  and 
often  denser  than  the  rest  of  the  parenchyma.  14.  Emboli  in  the  cere- 
bral arteries  produce  functional  disturbances  analogous  to  an  attack  of 

Vol.  II.— 2F. 


482  The  Peninsular  and  Independent. 

apoplexy.     The  symptoms  do  not  differ  from  those  of  cerebral  hemorrhage, 
or  acute  softening. 


TREATMENT  OF  HEMORRHOIDS.  —- 

A  correspondent  of  the  Semi  -  Monthly  Medical  News  writes  as 
follows : 

As  several  medical  journals  have  recently  called  attention  to  M.  Cleas- 
SAiGNAc's  treatment  of  hemorrhoids  by  the  use  of  the  ecraseur,  I  am  in- 
duced to  present  to  your  readers  what  I  regard  as  a  more  excellent  way, 
making  the  operation  an  exceedingly  simple  one — almost  bloodless — and 
rarely,  if  ever,  pieventing  attention  to  ordinary  business. 

This  operation  consists  in  dividing  with  the  scalpel  the  integument, 
whether  cuticle  or  mucous  membrane,  covering  the  tumor  to  an  extent  in 
length  of  incision,  about  double  that  of  the  tumor,  carefully  avoiding  di- 
vision of  the  vein;  gently  separating  with  the  handle  of  the  scalpel  the 
sides  of  the  tumor  fiom  the  cellular  tissue;  and  then,  with  a  small,  goose- 
bill  forceps,  seizing  the  tumor  and  jerking  it  out.  The  dilated  knuckle  of 
vein  constituting  the  tumor,  brings  with  it  from  one-fourth  to  half  inch  of 
the  vessel  on  each  side  of  itself  The  vein  usually  retracts  instantly  with- 
out the  escape  of  a  single  drop  of  blood  from  either  of  its  ruptured  extremi- 
ties.    A  piece  of  wet  lint  applied  for  a  few  days  completes  the  cure. 

This  operation  was  first  performed,  so  far  as  I  know,  on  myself,  in  1851, 
by  a  young  professional  fiiend  under  my  direction,  conducted  by  the  aid 
of  a  mirror,  and  without  interruption  to  attendance  upon  a  large  country 
practice. 

In  1853  it  was  again  attempted  in  another  attack  by  a  student  in  my 
office,  who  failed  in  the  essential  point.  He  opened  the  vein  and  merely 
removed  the  contents  of  the  tumor.  I  was  obliged  to  mount  my  horse  im- 
mediately afterwards,  and  ride  about  thirty  miles  over  very  muddy  roads, 
extending  my  absence  from  home  to  a  period  of  nearly  twenty-four  hours, 
during  the  whole  of  which  time  blood  escaped  slowly  from  the  incision, 
and  severe  inflammation  followed.  Quite  a  number  of  tumors  were  quickly 
developed,  some  of  them  at  a  point  several  inches  above  the  external  sphinc- 
ter in  the  bowel,  threatening  destruction  of  life  for  a  while.  Relieved 
by  the  application  to  the  anal  region  of  a  dozen  leeches,  but  complete  re- 
covery was  tedious,  occupying  some  months. 

Since  the  first  operation  1  have  removed  about  thirty  tumors  in  this 
manner,  with  trifling  pain  and  without  loss  of  blood,  except  from  the  divi- 
sion of  integuments,  and  without  confinement  in  a  single  instance. 

I  have  avoided  its  performance  while  considerable  surrounding  in- 
flammation existed,  first  reducing  that  by  ^laxatives  and  leeches  when  ne- 
cessary. 

This  operation,  I  am  confident,  will  be  found  by  all  who  will  try  it  in 
the  manner  here  recommended,  and  under  the  conditions  named,  to  ac- 
complish all  that  is  attainable  or  desirable  by  operative  procedure,  with- 
out any  of  the  difiiculties  which  the  ecraseur  is  designed  to  obviate  or 
avoid. 


ON  THE  TREATMENT  OF  CHRONIC  ORGANIC  DISEASES  OF  THE  HEART, 

Br  Professor  Lebert. 

The   treatment  of  chronic   organic    diseases  of  the  heart  offers  one 
of  the  most  diflBcult  tasks  to  the  practicing  physician.    It  is,    neverthe- 


Selected  Articles ^  Abstracts^  So,  483 

less,  certain  that  a  proper  and  thorough  treatment  of  these  diseases  may 
do  a  great  deal  toward  alleviating  the  condition  of  the  patients,  and  to- 
ward prolonging  their  lives.     Prof  Lebert  advises  especially  great   care 
with    blood-letting,    purgatives,  and    all    debilitating    measures    in   the 
treatment  of  organic  diseases  of  the  heart.       In  valvular  disease  he  em- 
ploys venesection  but  very  rarely.    If,   in    the  course  of  the  disease,  an 
acute  inflammation,  in  the  form  of  pericarditis  or  endocarditis,  occurs,  it 
is  often  useful  to  abstract  blood  to  the  amount  of  six  ounces,  by  means 
of   cups  or  leeches ;    if,  after    this,  an  energetic  treatment  is  still  neces- 
sary,   much   advantage    will  be  obtained  from  the  application  of  a  large 
blister,  and  the  endermatic  use  of  half  a  grain  of  morphia  daily.     The 
author's  observations  on  the  use  of   digitalis  we  may  omit,  as  generally 
known.       Most   allied    to  digitalis,  in  regard  to  its  therapeutic  effect,  is 
aconite.     Although  it  acts  less  heroically  and  more  slowly  than  digitalis, 
and  does   not  decidedly  diminish  the  frequency  of  the  pulse,  aconite  is, 
nevertheless,  a    remedy  which    is    capable   of  lessening  considerably  the 
dyspnoea,    palpitation,  and   the   various    subjective  symptoms  of  the  pa- 
tient, even  the  tumultuous  excitement  of  the  heart.      A  very  important 
point    to    be   considered   in    the   treatment   of    advanced  diseases  of  the 
heart,  is  the  general  cachexia  and   debility  of  the   patient    gradually  de- 
veloped.    Lebert  has  examined  for  several  years  the  muscular  structure 
of  diseased  hearts,  in   order  to  see  how  far  the  gradual  decrease  of  the 
functional  capacity  of  the  same  depends  upon  changes  in  the   muscular 
fibre  itself     From  these  investigations,  it  results  that  very  frequently  a 
small  degree  of  fatty  degeneration  of  the  primitive  cylinders  of  the  mus- 
cle of    the   heart  exists,  even  in  cases  where  the  color  and   consistency 
of  it  does  not  indicate  the  fact.       The   gradual   increase  of   general  de- 
bility and  of  the  local  weakness  of  the  heart,  the   progress    of  anaemia 
and  hydrsBmia,  lead  to  the  question,  what  effect   tonics,  especially  iron, 
would  have  in  organic  disease  of  the  heart  ? 

The  better  patients  are  nourished  (with  avoidance  of  strongly  stimu- 
lating food)  the  longer  they  resist  the  evil  influence  of  the  disease.  The 
patient  should,  therefore,  not  be  restricted  to  a  vegetable  diet,  but  a 
moderate  amount  of  animal  food  should  be  allowed  with  it.  Of  bever- 
ages, tea,  coffee,  alcoholic  liquors,  and  wine  in  large  quantities,  ought  to 
be  avoided ;  whereas,  infusion  of  cocoa,  or  decoction  of  roasted  acorns, 
are  very  appropriate,  particularly  for  breakfast.  Light  beer,  or  small 
quantities  of  old  wine  mixed  with  water,  may  be  allowed  at  the  table. 
Besides  an  analystic  diet,  the  use  of  iron  is  indicated,  particularly  in 
the  later  anaemic,  and  cachectic  period  of  the  disease.  Lebert  recom- 
mends especially  iron  reduced  by  hydrogen,  (gr.  ij.  at  each  meal),  or 
twenty  to  twenty -five  drops  of  the  tinctura  ferri  pomati,  if  necessary, 
in  connection  with  equal  parts  of  tincture  of  aconite.  The  tartrate  of 
iron  and  potassa  (three  to  five  grains  three  times  daily)  is  a  very  use- 
ful preparation ;  and  as  the  effect  of  iron  is  perceptible  only  then,  when 


484  The  Peninsular  and  Independent, 

its  use  is  persisted  in  for  a  long  time,  it  is  necessary,  occasionally,  to 
make  a  change  in  the  preparation  employed.  The  author  has  not  de- 
rived much  advantage  from  the  application  of  blisters,  setons,  and 
moxas. —  Wein.  Medizin.  Wochemchrift^  1858,  iVb.  51;  Mendiz.  Neuigh^ 
April  2,  1751,  and  New  Orleans  Med.  News  and  Ho&'piial  Gazette. 


NEW  DISINFECTING  AGENT. 

A  correspondent  of  the  New  York  Express^  in  a  recent  letter  from 
Paris,  describes  a  new  method  of  treating  ulcers,  abscesses,  &c.,  in  the 
Hospital  de  la  Charite  of  that  cit}^  It  is  said  to  be  the  discovery  of 
two  former  internes  of  the  Hospital,  Messrs.  Ckome  and  Demeaux,  and 
its  action  is  represented  as  arresting  the  progress  of  decomposition,  and 
preventing  the  generation  of  insects,  thus  making  the  substance,  in  fact, 
a  commplcte  and  instantaneous  disinfectant  of  animal  matter.  The  formula 
is  thus  given  by  the  inventors  : 

Plaster  of  commerce,  reduced  to  a  fine  powder,  100  parts  ;  coal  tar, 
one  to  three  parts.  The  mixture  of  the  two  substances  is  effected  with 
ease  by  the  aid  of  a  mortar,  or  by  any  other  appropriate  mechanical  means. 
The  application  of  this  composition  to  the  dressing  of  sores  or  wounds  re- 
quires a  particular  preparation.  A  certain  quantity  of  the  powder,  pre- 
pared according  to  the  formula,  is  diluted  with  olive  oil  to  the  consistency 
of  a  paste  or  ointment.  This  species  of  paste  or  salve  is  of  a  dark  -brown 
color,  has  a  slightly  bituminous  odor,  and  may  be  kept  in  a  closed  jar  for 
an  indefinite  period.  The  oil  unites  the  powder  without  dissolving  it,  and 
the  composition  has  the  property  of  absorbing  infectious  liquids  the  instant 
it  is  applied  to  the  sores  which  produce  them.  The  application  may  be 
mediate  or  immediate.  In  the  latter  case,  that  is  to  say,  placing  the  com- 
position directly  in  contact  with  the  sore,  no  pain  whatever  is  produced ; 
on  the  contrary,  the  salve  has  a  detersive  action,  cleanses  the  sore,  and  favors 
circulation.  [Uoston  Med.  &  iSurg.  Jour. 


SATURNINE  MEDICATION  IN  THE  TREATMENT  OF  PDXMONARY  FHTHI- 
SIS  :  A  Clinical  Lecture.  By  M.  Bbau,  at  La  Charit6.  Tranelated  by  James 
Dunn,  M.  D.,  of  Petersburg,  Va. 

I  announced  to  you  for  to-day  a  lecture  relative  to  some  therapeu- 
tic experiments  on  pulmonary  consumption,  upon  which  I  have  been 
engaged   for  some  months. 

You  may  have  remarked  that  for  some  time  I  haye  prescribed  for 
certain  consumptives,  in  my  service,  the  pills  of  Morton.  This  is  only 
a  euphonism  to  disguise  from  the  patients  the  true  nature  of  the  medi- 
cine. The  pills  of  Morton,  as  you  know,  are  composed  of  balsamic  sub- 
stances; those  that  I  employ  contain  only  white  lead,  in  the  dose  of 
10  centigrammes  to  the  pill.  Till  now,  this  substance  has  never  been 
used  internally  as  a  therapeutic  agent.  You  will  no  doubt  ask  what 
notion  suggested  its  employment  in  tuberculosis.  This  is  the  explana- 
tion.    Pulmonary  tuberculization   is  not,    by  a   great  deal,  an    affection 


Selected  Articles^  Abstracts^  c&c.  485 

necessarily  mortal ;  each  day  pathological  anatomy  furnishes  us  proofs 
of  it.  At  Salpetriere,  among  180  women  arrived  at  the  natural  term  of 
life,  I  found  only  three  the  summits  of  whose  lungs  had  not  been  at- 
tacked by  this  disease.  But  the  cicatrization  which  takes  place  in  such 
cases,  in  lesions  of  small  extent,  may  equally  take  place  where  the  or- 
gans have  been  more  gravely  compromised ;  cadaveric  inspection  again 
demonstrates  it.  What  is,  then,  the  organic  action  which  permits  the 
cure  of  tuberculosis  ?  It  may  act,  without  doubt,  in  several  ways ;  and, 
in  the  majority  of  cases,  the  re-establishment  of  the  digestive  functions, 
which  renders  to  nutrition  its  physiological  activity,  is  the  necessary 
prelude ;  in  fact,  pulmonary  phthisis  is,  in  my  eyes,  the  product  of  two 
factors,  of  which  the  first  is  anemia  —  the  second  the  tubercular  diathe- 
sis. Suppress  the  first,  and  you  will  suppress  the  manifestation  of  the 
second.  Without  being  formulated  in  terms  so  precise,  this  proposition 
has  before  now  been  in  vogue  in  science ;  in  fact,  the  best  authors  re- 
cognize, in  a  general  way,  that  tubercles  are  developed  particularly  in 
those  who  have  been  for  a  long  time  sybject  to  debilitating  causes  — 
that  is  to  say,  persons  who  are  more  or  less  anemic.  It  is  thus  that 
we  can  understand  why  a  crowd  of  apparently  differing  means  have 
succeeded  in  the  treatment  of  pulmonary  phthisis  ;  such  as  quinine,  cod 
liver  oil,  common  salt,  proto-iodide  of  iron,  generous  wine,  certain  min- 
eral waters,  &c. — all  means  which  have  triumphed  over  the  disease  by 
re-establishing  the  digestive  functions,  the  color  and  forces.  Here,  then, 
you  have  a  first  method  of  cure  for  tuberculosis.  But  cannot  the  re-es- 
tablishment take  place  under  other  circumstances  ?  We  know,  in  fact, 
that  in  pathology  there  exist  incompatible  affections;  each  malady,  or 
rather  each  diathesis,  may  have  its  antipode.  We  wish  to  show  that 
phthisis  pulmonalis  does  not  escape  this  general  law.  There  exist  cer- 
tain anemias,  which  never  lead  to  tuberculization,  but,  on  the  contrary, 
seem  to  offer  an  almost  complete  immunity  in  this  respect. 

In  his  very  remarkable  researches  upon  miasmatic  diseases,  M. 
BouDiN  has  called  our  attention  to  the  fact,  that  phthisis  pulmonalis  is 
entirely  exceptional  in  this  affection.  Arrived  at  the  last  degree  of  de- 
bility, the  inhabitants  of  marshy  countries  may,  without  doubt,  suc- 
cumb to  miasmatic  cachexia,  but  they  do  not  become  tuberculous  be- 
fore d3ing. 

There  are,  without  doubt,  some  exceptions  to  this  rule,  but  in 
medicine  we  ought  hardly  to  expect  to  find  absolute  laws.  For  a  long 
time  I  have  remarked  that  there  existed  a  similar  antagonism  between 
saturnine  intoxication  and  pulmonary  tuberculization ;  and  since  the 
time  when  I  made  public  the  results  of  my  investigations  on  this 
subject,  my  attention  has  been  constantly  aroused  upon  this  point. 
Nothing  is  rarer  than  to  meet  with  consumption  among  workmen 
whose  profession  compels  them  to  work  in  lead;  and  for  some  time 
no  fact  of  this  kind  has   presented    itself  to  my   observation.     Never- 


486  The  Peninsular  and  Independent, 

theless,  last  year  I  received  into  the  Cochin  Hospital  a  house  painter 
who  was  phthisical ;  but  in  this  case  the  exception  was  only  appa- 
rent; for,  according  to  the  patient's  account,  he  had  never  experienced 
any  symptoms  of  intoxication.  His  disease  had  then  undergone  no 
modification  under  the  influence  of  saturnine  preparations.  I  showed 
you  not  long  since,  in  No.  22,  St.  Felix  Ward,  a  lead  founder  attack- 
ed with  pulmonary  tuberculosis,  which  had  been  rapidly  developed 
after  a  casting  of  metals  whose  irritating  vapors  he  had  inhaled. 
One  might  have  thought  that,  in  this  case,  the  phthisis  had  resulted 
from  an  acute  saturnine  intoxication  ;  but  it  was  not  so  at  all ;  it 
was  a  casting  of  mixed  metals,  containing,  according  to  the  patient, 
antimony,  arsenic,  and  mercury;  which  proves,  in  passing,  that  the 
inspiration  of  certain  metallic  vapors  can  give  rise  to  phthisis ;  but 
lead  has  nothing  to  do  with  this  case.  It  is  not  very  singular  to 
see  persons  pale,  emaciated,  and  so  profoundly  debilitated  —  as  the 
workers  in  the  preparations  of  lead  generally  are  —  never  contract  a 
disease  which  is  particularly  severe  on  feeble  persons;  and  ought  not 
we,  therefore,  to  conclude,  that  between  these  two  morbid  states 
there  exists  an  insurmountable  opposition  ?  From  the  notion  of  a 
special  antagonism  between  tubercle  and  saturnine  intoxication 
springs  the  idea  of  creating  an  artificial  intoxication  of  the  same  kind, 
with  a  therapeutic  object.  I  had,  nevertheless,  for  a  long  time  defer- 
red the  realization  of  this  idea,  [when  two  most  remarkable  facts, 
which  have  presented  themselves  to  my  observation  this  year,  in  my 
ward  service  at  La^  Charite,  dissipated  all  my  hesitation.  We  re- 
ceived a  man,  at  the  commencement  of  the  year,  who,  after  having 
exercised  another  profession,  found  himself  obliged  by  poverty  to 
work  at  the  manufacture  of  ceruse.  But  the  patient,  who  had  been 
phthisical  for  some  time,  and  whose  haemoptysis  dated  back  to  1848, 
has  been  freed  from  all  symptoms  of  his  thoracic  affections  since 
having  the  lead  colic.  Since  this  time  he  has  followed  several  trades, 
and  his  poverty  has  caused  several  relapses  ;  but  there  is  a  complete 
cessation  of  the  spitting  of  blood.  He  is  lying  at  No.  3,  where  you 
can  examine  him.  For  some  time  the  tuberculization,  dormant  with 
this  patient,  appears  to  me  to  experience  a  recrudescence,  which  is 
due,  doubtless,  to  the  fact  that  the  saturnine  cachexia  has  had  time 
to  exhaust  itself  My  intention,  then,  is  to  revive  it  by  administering 
to  him   daily   some  ceruse   in   pills. 

A  second  patient  entered  the  hospital  to  be  treated  for  lead  colic. 
"We  found  he  had  been  phthisical  for  some  time,  and  we  have  left 
him  under  the  influence  of  the  saturnine  intoxication,  contenting  our- 
selves with  giving  him  nourishment  only.  But  the  daily  examination 
of  this  patient  shows  us  the  gravest  symptoms  gradually  disappearing, 
above  all  those  that  auscultation  offered  us.  The  marked  rales  (crack- 
ling) formed   at  both  summits   at   the   time  of  his  entry,    have   ceased 


Selected  Articles^  Abstracts,  <&c.  487 

entirely.  A  slight  recrudescence  manifested  itself  under  the  influence 
of  the  notable  depression  of  temperature  during  the  first  days  of  the 
month  of  April;  but  the  patient  considerably  improved  without  having 
submitted  to  any  treatment,  has  just  left  for  the  Asylum  for  Convales- 
cents at  Vincennes.  His  cough  had  almost  entirely  left  him;  the  quan- 
tity expectorated  had  considerably  diminished  ;  and,  as  we  showed  you, 
there  were  no  longer  any  rales  in  the  summits  of  the  lungs.  The  pa- 
tient now  congratulated  himself  on  the  happy  change  brought  about  in 
his  condition;  and  it  was  this  that  induced  him  to  request  his  removal 
to  the  Asylum  for  Convalescents. 

The  consideration  of  these  two  last  facts  decided  me  to  impregnate 
some  of  the  patients  in  my  service  with  lead.  I  have  done  it  with  suc- 
cess. I  had  prepared  some  pills  containing  10  centigrammes  of  ceruse ; 
and,  by  a  rapid  but  progressive  augmentation,  I  have  come  to  give  8 
per  day.  We  suspended  or  diminished  the  dose  as  soon  as  arthralgia 
manifested  itself,  or  when  the  patient  appeared  to  us  sufficiently  im- 
pregnated—  that  is  to  say,  at  the  simultaneous  appearance  of  the  lead 
lines  of  the  gums  and  of  the  icteroid  tint  which  characterizes,  as  you 
know,  the  first  degree  of  saturnine  poisoning. 

It  remains  for  me  to  speak  to  you  of  the  results  obtained  in  the 
course  of  my  experiments.  And  I  will  reply  now  to  any  objections 
which  may  be  addressed  to  me.  Can  we,  with  a  clear  conscience,  re- 
sort to  saturnine  impregnation  in  the  treatment  of  phthisis  ?  Yes,  with- 
out doubt,  for  we  employ  daily  poisons  much  more  dangerous  (arsenic, 
nux  vomica,  and  mercury)  to  obtain  the  cure  of  different  diseases, 
which  are  far  from  having  the  same  gravity  as  tuberculosis.  Besides, 
our  experiments  have  never  been  pushed  to  a  point  at  which  they 
might  become  dangerous  to  the  patients.  By  suppressing  the  adminis- 
tration of  the  toxical  agent  at  the  appearance  of  the  first  serious  symp- 
toms, we  suspended  promptly  the  effects.  We  can  now  communicate 
to  you  the  result  of  five  observations — three  men  and  two  women. 
You  may  judge  of  the  results  obtained. 

At  No.  15,  St.  Felix  Ward,  is  lying  a  patient  with  whom  the  treat- 
ment commenced  the  29th  of  March.  On  the  I7th  of  April  the  intoxi- 
cation seemed  to  us  sufficient.  At  the  commencement,  auscultation 
showed  us  several  friction  sounds  (craquements)  at  the  summit  of  the 
right  lung  behind.  He  had  had  haemoptysis,  and  presented  habitually 
vomitings  in  the  attacks  of  coughing.  To-day  all  these  symptoms  have 
nearly  entirely  disappeared ;  the  phthisis  is  dry ;  there  exist  only  dull- 
ness, and  prolonged  suppuration  in  the  right  supra  spinal  fossa.  It  is 
worthy  of  remark  that  this  patient,  habitually  constipated,  goes  more 
easily  to  stool  since  his  saturnine  impregnation.  It  is  a  phenomenon 
thai  we  will  find  in  the  others.  Lead  does  not  seem  to  act  upon  con- 
sumptives as  upon  individuals  in  death. 

A  second  patient,  at  No.  12,  St.  Felix  Ward,  who  offered  a  phthisis 


488  The  Peninsular  and  Independent. 

but  slightly  advanced,  although  he  had  had  several  hasmoptyses,  has 
been  rapidly  impregnated.  At  the  commencement  of  the  treatment,  he 
offered  moist  crackling  at  the  right  summit,  behind  and  before.  To  day 
there  exists  only  dullness  and  respiratory  weakness  in  the  same  place. 
The  cough  and  expectoration  have  diminished  simultaneously  in  a  re- 
markable manner,  even  for  the  patient,  who  has  ceased  to  complain  of 
them. 

With  a  third  patient.  No.  1,  St.  Felix  Ward,  who  has  just  left 
the  hospital,  the  results  of  the  treatment  have  been  much  less  satis- 
factory. He  presented  a  phthisis  of  the  febrile  form,  the  symptoms  of 
which  we  found  it  impossible  to  improve.  All  that  we  can  say  is,  that, 
after  a  stay  in  the  hospital  of  two  months,  the  patient  left  in  almost 
the  same  state  as  at  the  time  of  his  entry.  AVe  may  ask,  conse- 
quently, if  the  saturnine  treatment  did  not  assist  in  stopping  the  pro- 
gress of  this  disease,  habitually  so  rapid  in  its  march  when  it  as- 
assumes  the  febrile  form,  as  it  did  in  this  case  ?  AYe  will  add,  that 
he  resisted,  a  longer  time  than  all  of  the  others,  the  saturnine  modi- 
fication, and  that  six  weeks  of  treatment  were  necessary,  before  the 
said  lines  and  other  signs  of  a  sufficient  impregnation  appeared  with 
this  patient;  the  diarrhoea,  which  existed  from  the  first,  was  in  no 
wise  modified  by  the  medication  at  the  time  of  his  leaving.  He  still 
had   four  or  five   liquid  stools  daily. 

It  would  seem,  so  far,  that  women  are  more  susceptible  than 
men  to  the  modification  caused  by  this  medicament.  We  can  to  the 
present  time  only  cite  the  results  of  his  observations,  although  we 
have  many   other   patients   in  process  of  treatment   in   our   wards. 

At  No.  4,  St.  Felix  Ward,  is  a  woman,  30  years  of  age,  who 
presented,  at  her  entry,  the  symptoms  of  a  well  marked  phthisis, 
without  complications.  She  offered  to  auscultation  prolonged  and  rude 
respiration,  and  four  or  five  crackling  sounds  in  the  right  supra- 
spinal fossa,  with  corresponding  dullness.  There  existed  besides,  a 
spasmodic  cough,  very  fatiguing  to  the  patient,  and  giving  rise  to  a 
great  abundance  of  muco  -  purulent  expectoration.  For  some  time  she 
had  haemoptysis,  nocturnal  sweats,  wasting  and  fever  in  the  evenings. 
The  patient,  who  yielded  readily  to  the  impregnation,  continued  to 
suffer  for  about  fifteen  days  after  the  suppression  of  the  pills ;  but, 
in  the  height  of  her  sufferings,  although  very  much  disturbed  on  ac- 
count of  the  arthralgia  pains,  the  constipation  and  colic,  she  said  to 
us,  of  her  own  accord,  in  the  midst  of  her  complaints,  /  cough  no 
more  noio.  She  left  to  -  day  in  a  very  decided  state  of  amelioration. 
There  is  no  longer  any  crackling  at  the  two  summits ;  the  expector- 
ation has  completely  ceased;  but  there  exists  still  a  little  comparative 
dullness   at  the  right   summit. 

Finally.  — At  No.  12,  St.  Felix  Ward,  we  have  a  young  woman 
who   presents   the   gravest   case  of  all   those   whose   treatment  we  have 


Selected  Articles^  Abstracts^  cbc,  489 

undertaken.  She  had,  in  fact,  an  enormous  cavity  under  the  right 
clavicle.  Already,  for  three  years,  the  progress  of  the  tuberculosis 
had  been  suspended  by  hygiene,  voyages  to  warm  countries,  and  a 
rational  treatment.  But  seven  months  ago  this  young  v^^oman  unfor- 
tunately became  pregnant;  and  the  moral  pre -occupation  which  re- 
sults from  such  a  state,  joined  to  all  the  material  causes  of  debility 
which  are  the  consequence  of  it,  have  exposed  her  to  a  new  relapse. 
The  patient  commenced  coughing  again  in  January ;  she  entered  on 
service  in  March ;  the  treatment  commenced  the  8th  of  April.  In 
spite  of  her  repugnance  to  the  pills,  the  impregnation  was  quick,  as 
soon  as  she  took  them  in  good  faith.  The  arthralgic  pains,  which 
promptly  supervened,  obliged  us  to  suspend  the  treatment;  and  the 
patient  herself  notified  us  that  the  character  of  the  expectoration  had 
been  sensibly  modified  by  the  operation  of  the  pills.  The  sputa, 
whose  foetid  odor  excited,  in  passing,  a  repulsion  almost  amounting 
to  vomiting,  had  lost  all  disagreeable  odor,  and  sensibly  increased  in 
consistence,  in  proportion  as  it  increased  in  abundance.  It  would  be, 
without  doubt,  interesting  to  test  the  character  of  it  before  and  af- 
ter treatment,  by  the  aid  of  the  microscope,  and  by  chemical 
analysis. 

Such,  then,  are  the  facts  we  possess,  while  waiting  to  observe 
others.  To  recapitulate,  I  will  say,  that  the  influence  of  lead  seems 
to  exert  its  action  above  all  on  the  purulent  secretion,  which  con- 
stitutes in  great  part  the  expectorated  matters.  In  phthisis  it  dimin- 
ishes the  quantity  of  it,  and  thus  causes  the  cough  to  disappear  with 
all  its  consequences.  We  cannot,  evidently,  pronounce  the  word  cure^ 
because  tubercular  lesions  do  not  consist  alone  in  a  secretion  of  muco 
pus,  but  more  in  an  induration  of  pulmonary  tissue,  which  results 
from  an  infiltration  of  accidental  products.  It  would  require,  conse- 
quently, a  more  prolonged  treatment  and  a  more  extended  experience 
than  ours  has  been,  to  be  able  to  announce,  with  some  appearance  of 
reason,  that  we  have  completely  triumphed  over  pulmonary  phthisis. 
But  we  cannot,  it  seems  to  me,  deny  the  useful  influence  of  the  treat- 
ment. We  have  at  least  stayed  the  progress  of  the  disease  —  we  have 
gained  time;  and  this  is  one  of  the  principal  indications  in  therapeu- 
tics. We  add,  as  auxiliary  to  this  treatment,  that  it  is  necessary  to 
try  and  nourish  the  patient  the  best  possible  —  to  give  to  him  wine 
tonics,  and  to  observe,  with  regard  to  him,  all  the  rules  of  a  rational 
hyiene.  The  only  serious  inconvenience  that  the  treatment,  so  far, 
has  produced,  is  the  anorexia  that  it  inevitably  leads  to.  We  might 
try  to  administer  the  medicament  by  frictions,  as  we  do  for  mercury, 
with  persons  whose  stomachs  will  not  support  it.  The  administration 
of  lead  in  pulmonary  phthisis  is  not  an  entirely  new  idea  in  science. 
Every  body  knows,  in  fact,  that  the  acetate  of  lead  has  been  employed 
for  a  long  time  in  this  disease ;   but  we   know,  also,  that  it  was  consi- 


490  The  Peninsular  and  Independent, 

dered  as  an  astringent;  it  was  not  given  as  an  alterative;  there  was 
no  attempt  to  produce  a  decided  modification  in  the  organism,  amount- 
ing to  saturnine  cachexia.  It  was  definitely  a  palliative,  designed  to 
combat  the  sweats  and  the  colliquative  diarrhoeas  of  consumptives.  In 
a  memoir  published  in  1831,  Fouquier  extols  the  employment  of  this 
medicine  with  the  objects  which  have  just  been  indicated.  We  find  in 
this  work  some  observations  of  consumptives  in  the  third  stage,  whose 
sweats  and  diarrhoea  have  been  improved  and  suspended  by  the  use  of 
aeetate  of  lead,  in  the  dose  of  five  or  six  grains,  who  have  finally 
succumbed,  after  having  experienced  a  momentary  relief  You  see 
there  exists,  in  this  respect,  no  correlative  between  the  ideas  of  Fou- 
QUEiR,  and  those  which  have  just  been  enunciated.  I  should  doubtless 
have  been  able  to  employ  the  acetate  of  lead,  but  I  preferred  to  use 
the  ceruse,  whose  action  on  the  mucous  membrane  of  the  stomach  is 
much  less  irritating.  The  researches  which  we  have  just  undertaken, 
we  will  follow  to  the  end.  We  desire  that  our  hopes  may  be  re- 
alized. {Ya.  Med.  Journal. 


TJVA  URSI  IN  LINGERING  LABOR. 

The  Editor  of  the  Nashville  Journal  of  Med.  &  Surgery  for  Sept. 
states  that  "M.  Gauchet  has  found  a  substitute  for  ergot,  by  which 
the  dangers  to  the  foetus  may  be  avoided.  He  has  tried  it  in  at  least 
one  remarkable  case,  a  patient  of  fortyy  ears,  in  her  fourth  labor, 
and  found  it  successful.  Taking  half  an  ounce  of  the  beans  of  Uva 
Ursi,  he  infused  them  in  a  quart  of  water,  and  gave  a  teaspoonful 
of  the  infusion  every  half  hour.  After  three  doses  the  contractions, 
which  had  ceased,  became  vigorous,  and  in  three  hours  a  living  child 
was  born." 


CHL  OROFORM  IN  THE  TREATMENT  OF  ITCH. 

Professor  Back  reports  the  great  advantage  that  has  resulted  from 
his  treatment  of  itch  by  painting  the  surface  with  chloroform.  Not 
only  does  the  chloroform  act  beneficially  by  killing  the  acari,  but  by 
relieving  the  irritation  of  the  skin  which  has  been  induced  by  scratching. 
The  painting  of  even  large  surfaces  was  unattended  with  ill  effects, 
and  the  temporary  burning  sensation  produced  was  very  supportable 
compared   with   the    itching   which   it   superseded. 

\_3Ied.  Times  and  Gaz..,  Jan.  15.,  1S59, /rowi-  Schmidts  Jahr^.  No.  xi. 


SPINA  BIFIDA  TREATFD  BY  COLLODION., 

A   translation  from  the  Journal  fur  EinderTcr..,    of  an   interesting 
description,  of  a  case  of  Spina  Bifida  successfully  treated  by  collodion, 


Selected  Articles^  Abstracts^  dtc.  491 

appears  in  the  Sept.  No.  of  the  Va.  Med.  Journal^  from  which  we 
learn  that  "  a  strong,  healthy  child  was  brought  to  Dr.  Behrend  when 
seven  weeks  old,  having  a  swelling  over  the  last  lumber  vertebra  "and 
the  upper  part  of  the  scrotum.  It  was  the  size  of  a  small  orange, 
of  a  roundish  form,  with  a  broad  base,  and  disappeared  under  pressure 
of  the  finger.  The  skin  over  it  was  very  delicate,  transparent,  and 
of  a  palish  red.  The  aperture  in  the  vertebra  could  be  distinctly 
felt."  Collodion,  rendered  less  energetic  by  admixture  with  castor  oil, 
was  painted  over  the  whole  surface  of  the  tumor,  and  some  distance 
beyond.  Similar  applications,  the  compression  from  which  was  ulti- 
mately increased  by  "  a  small  plate  of  caoutchouc  wrapped  in  muslin, 
laid  over  the  tumor,  and  kept  on  by  a  roller,"  removed  the  tumor 
in  a  few  weeks,  merely  leaving  some  "thickened  skin  and  a  subcu- 
taneous mass  of  almost  cartilaginous  hardness  in  its  place,  allowing 
the  edges  of  the   bony  aperture   only  to  be  very  imperfectly  felt." 


NAUSEA  AND^VOMITING  DURING-  PREGNANCY. 

In  an  article  on  [this  subject,  published  in  the  Sept.  No.  of  the 
Boston  Med.  &  Surg.  Journal,  Dr.  Warren,  after  speaking  of  the  modern 
recommendation  of  applications  of  tinct.  of  iodine  to  the  os  uteri  in 
cases  attended  with  inflammation  of  the  mouth  and  neck  of  the  womb, 
objects  to  the  use  of  iodine  as  the  complaints  of  the  patient  "of  a 
metallic  taste  of  the  iodine  in  the  mouth,  show  it  to  be  about  as  great 
an  annoyance  as  the  sickness  we  endeavor  to  remedy  by  its  use." 
SHght  pencillings  with  nitrate  of  silver  is  regarded  as  equally  efficacious, 
without  liability  to  the  same  objection. 

In  cases  attended  'with  much  neuralgic  pain  and  excessive  leucor- 
rhoeal  secretion  Dr.  Warren  strongly  recommends  the  following:  ^ 
Tinct.  Benzonii,  3  ij ;  chloric  ether,  3j;  acet.  morphia,  grs.  ij.  M.  It 
should  be  painted  upon  the  os  and  cervix  once  in  three  or  four  days. 
Dr.  W.  remarks  that  he  has  also  used  with  benefit,  injections  of  ferri 
alumenis,  3  j  ;  inf  opii,  3j;  aqua  dist.  |  viij.  M.  He  substitute,  iodide 
of  zinc  for  the  alum  —  five  grains  to  the  ounce,  when  there  is  a  degree 
of  spasmodic  action  in  this  organ  or  in  the  neck  of  the  bladder. 


ON  THE  USE   OF  POTASH  IN  SOME   CUTANEOUS  DISEASES.— By  James  O. 

White,  M.  D.* 


It  may  be  seen  by  the  microscope  that  a  drop  of  a  solution  of  an 
alkali,  when  in  contact  with  animal  tissues,  causes  their  solution  and 
disappearance.  The  same  effect  is  produced  if  we  apply  caustic  potash 
to    the  livmg   skin,  the  fatty  tissues  being  saponified,  and   the  albumin- 

*  Read  before  the  Boston  Society  for  Medical  Observation,  October  3d,  1659,  and 
oommunicated  for  tbe  Boston  Medical  and  Surgical  Journal. 


492  The  Peninsular  and  Independent, 

oid  principles  forming  also  definite  chemical  compounds,  which  are 
soluble  in  the  excess  of  serous  fluid  poured  out  under  the  influence  of 
this  stimulant.  Hence  its  caustic  properties,  so  valuable  when  portions 
of  living  tissue  are  to  be  destroyed,  and  the  knife  may  not  be  used. 
Of  potash,  however,  in  its  dry  form,  or  as  Vienna  paste,  we  do  not  in- 
tend to  speak,  but  to  consider  its  use  in  solution,  by  which  the  severity 
of  its  action  may  be  exactly  controlled  and  delicately  graduated,  or  in 
the  form  of  sapo  viridis  applied  externally  in  the  treatment  of  certain 
afifections  of  the  skin. 

The  application  of  the  stronger  solutions  of  potash,  one  part  to  two 
of  water  for  instance,  to  the  living  skin,  acts  as  a  proper  caustic,  de- 
stroying the  superficial  layers  of  epidermis,  and  producing  an  abundant 
liberation  of  fluid  in  which  the  albuminate  of  potash  and  soapy  matter 
are  found  dissolved.  The  skin,  under  its  action,  looks  as  if  its  sweat- 
glands  wore  working  vigorously,  like  the  forehead  on  a  summer's  day. 
This  same  drastic  action  of  many  of  the  potash  salts  on  the  mucous 
membrane,  explains  their  cathartic  and  diuretic  effect  when  given  inter- 
nally. The  lymph,  which  is  poured  out  over  the  raw  surface,  soon  har- 
dens and  forms  a  thin  pellicle  like  collodion,  beneath  which  granulation 
goes  on,  protected  from  the  free  air.  The  weaker  solutions  and  the  soap 
fortunately  do  not  act  vigorously  upon  the  healthy  skin,  but  in  a  most 
discriminating  manner  affect  the  dried  and  diseased  tissues. 

Sai^o  wridis^  or  schmier  -  seife,  plays  a  most  important  part  in  the 
treatment  of  cutaneous  diseases  in  Germany,  in  hospital  and  private 
practice.  Especially  does  Heb  ,  Professor  in  the  Department  of  cuta- 
neous Diseases  in  the  Vienna  School,  and  who  is  about  to  publish  a 
work  on  their  pathology  and  treatment,  which  in  point  of  magnificence 
and  extent  will  far  surpass  any  medical  work  ever  published,  especially 
does  Hebra  show  its  efficacy  in  many  of  the  many  cases  which  make 
his  clinique  so  celebrated.  It  is  prepared  by  boiling  fish  or  other  ani- 
mal oils  with  an  excess  of  lye  composed  of  caustic  potash  and  the 
crude  carbonate.  It  varies  in  color  and  purity,  according  to  the  ingre- 
dients and  mode  employed  in  its  manufacture,  and,  as  found  in  com- 
merce, IS  often  of  a  dark  green  or  black  color.  The  present  specimen, 
obtained  of  L.  Babo,  German  apothecary,  311  Tremont  street,  is  a  first- 
rate  article,  and  contains  no  free  potash,  which  secures  its  even  action 
upon  the  skin,  and  prevents  the  excoriations  which  sometimes  follow 
the  violent  inunction  of  this  remedy  when  the  alkali  exists  in  an  un- 
combined  state.  The  best  preparations  have  a  bright  amber  or  green 
color,  a  uniformly  soft  consistence,  and  a  strong  odor  of  potash.  Rubbed 
upon  the  healthy  skin,  it  produces  a  slight  reddening  only,  but  if  the 
friction  be  continued  a  long  time  and  vigorously  pushed,  excoriations 
and  various  eruptive  appearances  (as  miliaria,  urticaria  and  eczema)  may 
present  themselves. 

The  affections  of  the  skin  in  which  these  alkaline  preparations  are 


Selected  Articles,  Abstracts,  Sc.  493 

most  useful,  are  the  following:  molluscum  contagiosum,  or  seborrhoea; 
acne ;  eczema  ;  scabies  ;  prurigo  ;  psoriasis  ;  pityriasis  versicolor.  When 
the  openings  of  the  sebaceous  glands  are  stopped,  we  very  often  find  a 
plug  of  sebum  distending  the  duct  and  mouth,  which,  acting  as  a  for- 
eign body,  produces  inflammation  of  the  gland  and  surrounding  skin. 
This  is  followed  by  degeneration  of  the  follicles,  and  forms  the  disease 
called  seborrhoea,  or  strophulus  albidus  of  Willan.  These  comedones 
are  most  often  met  with  on  the  nose,  aud  aflPect  principally  persons  of 
a  gross  habit.  Not  unfrequently  many  such  diseased  follicles  unite  to 
form  a  single  tumor,  from  which  exudes  a  milky  fluid.  This  is  the 
molluscum  contagiosum  of  some  writers,  and  is  best  treated  by  snipping 
off  its  head,  pressing  out  the  contents  of  each  sac,  and  applying  a  so- 
lution of  potash,  one  part;  water,  two  parts.  When  a  great  number  of 
comedones,  or  black  points,  exist  on  the  face  or  elsewhere,  a  steam  bath 
should  be  first  taken,  and  subsequently  the  surface  be  smeared  with  the 
soap,  or  washed  with  a  solution  of  potash  in  glycerine.  In  this  way  the 
sebaceous  matter  is  removed,  and  the  skin  may,  by  the  after  use  of  a 
wash  of  ether,  alcohol  and  sulphur,  be  restored  to  its  natural  state. 

Acne  disseminata,  which  is  an  inflammation  of  the  hair  follicles,  is 
generally  caused  by  the  formation  of  comedones,  which,  if  not  emptied, 
produce  suppuration,  and  subsequent  scars.  The  treatment  must,  there- 
fore, be  first  directed  to  the  removal  of  the  comedones,  which  is  best 
done  by  a  wash  of  one  part  of  potash  to  eight  parts  of  water,  or  by 
use  of  the  soap.  Afterward,  the  sulphur  lotion  above  mentioned  may 
be  used  over  night,  and  washed  off  the  following  morning  with  the 
potash  solution.  When  the  eruption  is  extensive,  we  may  rub  in  this 
soap,  and  leave  it  as  a  fomentation  two  or  three  days.  When,  by  this 
means,  the  epidermis  has  been  removed,  the  sulphur  preparation  should 
be  applied. 

AgBiinst  prurigo,  which  is  an  incurable  disease,  returning  always  in 
the  same  individual,  though  often  driven  away  by  treatment,  external  ap- 
plications are  our  only  offensive  weapons,  and  among  these  schimer-seife 
is  perhaps  the  most  reliable.  It  should  be  rubbed  into  the  affected  por- 
tions of  the  skin  the  first  three  days  of  the  week  twice  daily,  and  be 
allowed  to  remain  in  contact,  without  washing  away,  the  remaining  four. 
This  method,  in  connection  on  alternate  weeks  with  daily  morning  dress- 
ings of  cold  water  and  cold  baths,  if  continued  for  months,  will  be 
found  by  far  the  most  effectual  in  banishing  this  distressing  dis- 
order. 

In  psoriasis,  also,  either  this  same  mode  of  treatment  is  adopted  by 
Hebra,  or  the  use  of  the  soap  combined  with  applications  of  some  form 
of  tar,  and  with  most  excellent  results.  The  internal  administration  of 
arsenic  or  cantharides  he  considers  of  questionable  advantage. 

It  is  in  the  treatment  of  eczema,  however,  in  its  varied  forms,  that 
the  curative  effects  of  applications   of  potash  is  most  marked,  and  the 


494  The  Peninsular  and  Independent. 

mode  of  their  employment  is  very  simple.  Of  these,  the  following  solu- 
tions are  those  generally  used  in  the  Vienna  Klinik,  which  has  done  so 
much  to  simplify  the  treatment  and  classification  of  cutaneous  diseases: 

No.  1.  Potassa  pura  3  i.  aqua  Oi.,  as  bath  or  fomentation. 
No.  2.  Potasoa  pura  3  i.,  aqua  §  ss.,  for  circumscribed  patches. 
No.  3.  Potassa  pura  3  i.,  aqua  3  ij.,  a  caustic  application. 

In  addition,  potash  in  the  form  of  schmier-seife  and  spiritus  sapo- 
natus.  Selection  from  these  is  made  according  to  the  extent  and  nature 
of  the  case.  The  two  forms  of  eczema  rubrum  and  eczema  squamosum, 
into  which  the  primary  and  acute  stages  generally  run,  are  those  which 
present  themselves  after  the  removal  of  the  crusts,  which  is  the  first 
step  in  the  treatment.  This  is  easily  effected  by  the  application  of  warm 
oil  and  spiritus  saponatus.  We  then,  for  the  first  time,  can  ascertain  the 
condition  of  the  skin,  which  is  the  seat  of  the  disease.  If  the  cutis  is 
much  thickened  by  exudation,  as  we  find  by  lifting  a  fold,  the  severer 
remedies  must  be  chosen.  The  excessive  vascularity  and  enlargement 
of  the  capillaries,  which  cause  the  redness,  heat,  swelling,  and  large 
effusion  in  eczema  rubrum,  must  first  be  overcome  by  the  constant 
application  of  cold  water,  either  in  form  of  fomentation  or  douche.  Then 
solution  No.  2  should  be  applied  once  or  twice,  by  means  of  a  hair 
pencil,  or  the  soap  be  substituted  thrice  a  day;  using,  at  the  same  time, 
cold  water  to  heal  the  excoriation  they  may  perchance  cause.  Eczema 
on  the  face  must  often  be  treated  by  the  caustic  solution  No.  3,  quench- 
ing the  subsequent  reaction  by  cold  water.  Scars  never  follow  its  use. 
If  the  disease  affect  the  whole  surface  of  the  limbs  or  body,  it  may  be 
treated  by  saturating  flannels  with  schmier-seife,  and  applying  them,  cover- 
ed with  gutta  percha  cloth,  to  the  patches.  These  should  be  removed 
twice  daily  for  the  first  few  days,  after  which  they  may  be  suffered  to 
remain  in  contact  for  three  or  four  days.  This  plan  is  to  be  continued 
till  cure  results,  unless  excoriations  show  themselves,  in  which  case  the 
cold  w*ater  applications  must  be  resumed.  In  the  dry,  scaly  form,  ec- 
zema squamosum,  preparations  of  tar  are  used  with  great  benefit,  in 
most  cases,  to  hasten  the  desired  end,  and  among  these  are  the  oleum 
cadini,  or  oil  of  cade,  and  the  oleum  fagi;  which  is  the  Russian  tanning 
oil.  These  should  be  applied,  diluted  with  alcohol,  and  laid  on  very  thin, 
for  on  the  skin  of  some  persons  they  may  of  themselves  excite  an  eczema. 
Tar,  when  applied  to  the  whole  surface  of  the  body,  often  causes  strange 
symptoms,  as  vomiting  of  black  matter,  black  urine,  and  black  diarrhoea; 
these  secretions  containing  tar  unchanged.  Relapses  may,  it  is  true, 
follow  this  treatment,  as  they  do  any  other ;  but  it  prevents  the  recurrence 
of  the  disease  as  effectuall}^,  and  works  more  rapidly,  than  all  others. 
Chronic  eczema  of  the  scalp,  for  instance,  which  so  often  baffles  the 
empirical  attempts  of  a  physician  for  months,  may  in  this  manner  be 
cured  in  as  many  days,  and  this  without  the  aid  of  internal  medicine. 


Selected  Articles^  Abstracts^  c5c.  495 

There  is  a  saying,  common  in^Germanj,  that  the  schmier  -  seife  is  for 
the  itch  what  the  comb  is  for  the  louse ;  and  all  over .  its  densly-populated 
soil,  where  the  system  of  crowded  barracks  and  wandering  journeymen 
makes  scabies  as  common  among  the  lower  classes  as  it  once  was  here, 
this  is  the  remedy  used  in  its  treatment,   both  in   hospital   and  house- 
hold.    Upon   its  ready  action  are  based  the  many  quick  cures,  which 
boast  to  kill  the  disease  in  three  or  four  hours.     These  methods,  however, 
are  not  advisable,  for  often  relapses  follow,  and  eczema  and  excoriations 
are  produced,  which  are  far  more  difficult  to  heal  than  the  original  dis- 
ease.    The  well-known   plan  adopted  by   Hebra  is  the  following:     The 
patient  takes  a  warm  bath,   rubs   thoroughly   every    part  affected   with 
a  coarse  flannel  cloth  saturated  with  schmier  -  seife,  and,  after  washing  off, 
smears  the  same  parts  with  one  of  the  following  ointments  or  tinctures. 
This  process  is  to  be  repeated  every  evening  till  itching  ceases.     Three 
baths  are  all  that  are  generally  allowed,  else  the  skin  becomes  too  much 
macerated  and  easily  inflamed.     Four  days  are  usually  sufficient  to  cure 
very  bad  cases  even,  and  the  circumscribed  ravages  of  the  animal  may  be 
stopped  at  once.     The   eczema,  papules  and  pustules,  which  the  parasites 
indirectly  cause,  are  often  not  so  easily  dealt  with,  and  require  an  after-treat- 
ment of  their  own.     The  following  is  the  "Vienna  Salve" :  Sapo  virid.,  ax- 
ungia,  each  three  parts  ;  flor.  sulph.,  pix  liquida,  each  1\  parts;  creta  alb., 
1  part.     M.  Hebra's  own  ointment  is  of  a  similar  composition:     Flowers  of 
sulphur,  oil  of  beech  or  of  cade,  each  |vi.;  schmier-seife,  fat,  each  |  xvi.  M. 
Chalk  is  added  when  necessary,  to  remove  the  epithelium  more  rapidly,  as 
with  soldiers  or  the  great  unwashed.     In  cases  where  fat  can  not  be  used, 
he  recommends  the  substitution  of  alcohol  in  the  same  amount.     Either 
of  these  preparations  may  be  used  in  connection  with  the  soap,  and  the 
result   of    such    treatment   will    be    fully  satisfactory  to   every  one  who 
may  try  it.       The  alkaline  soap,  when  applied  to  a  burrow,  produces  at 
once   an   exudation   into   the    same,  which  causes  its  immediate  recogi- 
tion.      Its    later    effects   are   to   dissolve  the  epithelium,  and   allow  the 
sulphur   to    work   directly  upon   the  animals.      The   tar,  or   beech  and 
juniper  oils,  are  added,  to  prevent  the  generation  of  excoriation  or  ecze- 
ma by  the  excess  of  alkali  and  friction. 

Whatever  may  be  said  about  the  aetiology  of  other  cutaneous  dis- 
eases in  which  vegetable  parasites  are  detected,  it  is  positively  certain 
that  pityriasis  versicolor  is  caused  by  the  fungus  called  microsporon  fur- 
fur. This  is  no  place  to  go  into  any  description  of  the  disease,  or  to 
sfate^how  it  differs  from  chloasmata,  with  which  it  is  often  confounded. 
No  two  diseases,  however,  are  more  distinct.  The  intolerable  itching 
which  betrays  the  presence  of  the  fungus,  will  cease  at  the  death  of 
the  plant,  which  is  easily  caused  in  a  short  time  by  daily  inunction 
with  schmier-seife.     Its  effect  upon  the  patches  is  wonderful. 

It   has   been   my  object  thus   to  show  how  valuable  and  general  a 
remedy  we   have  in  this   soap,  and  to    endeavor  to  introduce  it  to  the 


496  The  Peninsular  and  Independent. 

profession  as  an  instrument  both  cheap  and  cleanly,  and  of  sure  promise, 
certainly  a  long- looked- for  desideratum  in  this  class  of  diseases. 

\Boiiton  Med.  &  Surg.  Jour. 


ORIGIN"  OF  PLANTS— il  Hint  to  those  whom  it  may  concern. 

The  following  list  of  Tndigen<?s^^^65,  (everybody  has  a  right  to  coin 
words,  we  believe,  these  days),  reminds  us  of  the  student- experience  of  one 
who,  though  now  a  distinguished  Professor,  was  once,  it  appears,  often  at  a 
loss  when  questioned  as  to  the  origin  of  Medicinal  Plants.  He  finally  says, 
that  he  fell  upon  an  expedient  in  which  guessing  was  the  basis-element. 
He  found  that  most  of  the  potent  medicines  of  the  Materia  Medica,  at  that 
time,  say,  near  thirty  years  ago,  came  from  a  particular  region  ;  and  there- 
fore, whenever  asked  by  his  Professor  whether  such  or  such  is  indigenous, 
his  invariable  and  confident  answer  was,  "From  the  South  of  Europe,  Sir!'* 
He  seldom  failed  to  give  satisfaction,  nor  did  the  wisdom  of  his  Philadel- 
phia Professor  ever  even  suspect  the  ruse. 

He  is  himself  now,  as  we  have  said,  a  Professor,  and,  we  believe,  Ma- 
teria Medica  is  his  department.  "Would  it  not  be  curious  if  some  of  his 
own  pupils  should,  in  their  turn,  gain  his  commendation  by  a  similar  de- 
vice? Remember,  then,  "The  South  of  Europe,"  more  physic  comes  from 
there  "  than  is  dreamed  of  in  the  philosophy  "  of  most  students.  Verbum 
sat. 

Origin  of  Plants. — Madder  came  from  the  East.  Celery  originated 
in  Germany.  The  Chestnut  came  from  Italy.  The  Onion  originated  in 
Egypt.  Tobacco  is  a  native  of  Virginia.  The  Nettle  is  a  native  of  Europe. 
The  Citron  is  a  native  of  Greece.  The  Pine  is  a  native  of  America.  Oats 
originated  in  North  Africa.  The  Poppy  originated  in  the  East.  Rye  came, 
originally,  from  Sardinia.  Parsly  was  first  known  in  Sardinia.  The  Pear 
and  Apple  are  from  Europe.  Spinach  was  first  cultivated  in  Arabia.  The 
Sunflower  was  brought  from  Peru.  Th-e  Mulberry  Tree  originated  in  Per- 
sia. The  Gourd  is  probably  an  Eastern  plant.  The  Walnut  and  Peach 
came  from  Persia.  The  Horse  Chestnut  is  a  native  of  Thibet.  The  Cu- 
cumber came  from  the  East  Indies.  The  Quince  came  from  the  Island  of 
Crete.  The  Radish  is  a  native  of  China  and  Japan.  Peas  are  supposed  to 
be  of  an  Egyptian  origin.  The  Garden  Cress  is  from  Egypt  and  the  East. 
Horse-radish  came  from  the  South  of  Eurom. 

[Southern  Med.  and  Surg.  Journal. 

"  FIRIN"a  UP  "  WITH  MUMMIES. 

It  is  a  curious  fact  that  the  bodies  of  the  most  enlightened  nation 
of  its  time,  many  centuries  ago,  are  now  made  to  aid  in  getting  up  steam 
in  the  present  fast  age.  On  the  new  railway  in  Egypt,  the  first  locomo- 
tive run  used  mummies  for  fuel.  The  bituminous  matter  used  to  embalm 
them  and  to  seal  the  wrappings  makes  them  very  inflammable.  The  sup- 
ply of  mummies  is  said  to  be  inexhaustible,  and  they  are  used  by  the 
cord !  [Med.  and  Surg.  Reporter. 


larmautitiral  i^prtm^nt. 


••• 


Eigbth  Annual  Meeting  of  tbe  American  Pbarmaceutical  Association. 


This  meeting  was  held  in  Boston,  on  Tuesday,  Wednesday,  Thurs- 
day, and  Friday,  September  13th,  14th,  15th,  and  16th. 

The  enviable  notoriety  which  Boston  possesses,  in  regard  to  its 
social  and  intellectual  attractions,  combined  with  anticipations  of  an 
unusual  number  of  important  reports  to  be  presented  and  read  at  this 
meeting,  rendered  the  attendance  for  the  Association  at  large  very  full ; 
while,  as  might  have  been  expected,  the  craft  in  Boston  and  vicinity 
filled  the  spare  benches  at  the  Convention. 

The  first  and  second  sessions  were  opened  by  Dr.  Robert  Battey, 
of  Georgia,  who,  in  place  of  an  address  by  the  President,  delivered 
a  series   of  remarks   replete  with  pithy  suggestions. 

The  result  of  the  election  showed  the  following  to  be  the  list  of 
oflBcers  for  the  ensuing  year : 

SAMUEL  M.  COLCORD,  Boston,  President. 
AVm.  Proctor,  Jr.,  Philadelphia,  1st  Vice  President. 
Joseph  Roberts,  Baltimore,  2d  "  " 

Edwin  0.  Gale,  Chicago,  3d  "  " 

Charles  Bullock,  Philadelphia,  Recording  Secretary. 
"Wm.  Hegeman,  New  York,  Corresponding  Secretary. 
AsHAEL  BoYDEN,  Bostou,  Treasurer. 

Committee  on  tlie  Progress  of  PJiarmacy. 
Edward  Parrlsh,  Philadelphia,  A.  P.  Sharp,  Baltimore, 

E.  L.  Massot,  St.  Louis,  Jas.  W.  Cullan,  Washingtoiij 

Wm.  Hegeman,  New  York. 

Executive  Committee. 
Charles  T.  Carney,  Boston,  Chas.  A.  Tuffts,  Dover,  N.  H. 

S.  S,  Garrigurs,  Philadelphia,  Geo.  W.  Berrien,  Jr.,  New  York, 

Chas.  Bullock,  Philadelphia. 

During   the    meeting  there  were  one  hundred  and  ten  new  mem- 
VoL.  II.— 2G. 


498  The  Peninsular  and  Independent, 

bers   elected,  two   of  whom,  Samuel    P.  Duffield,    Ph.  D.,    and   Uriah 
B.    Wilson,  Esq.,  were  from  our  State. 

After  the  finishing  of  the  usual  preliminary  business,  the  first 
communication  of  interest  was  from  the  Agricultural  Department  of 
the  Patent  Office,  at  Washington,  D.  C,  through  the  special  com- 
mittee appointed  by  the  Association  to  confer  with  that  department, 
with  the  view  of  introducing  foreign  medicinal  plants.  This  was  a  let- 
ter from  A.  B.  Greenwood,  Esq.,  Commissioner  of  the  Indian  Bureau, 
who  sent,  during  the  spring,  circulars  to  the  various  Indian  Agents 
of  the  United  States,  soliciting  them  to  obtain  information  in  relation 
to  the  qualities,  habitat  and  abundance  of  indigenous  medicinal  plants 
from  the  various  tribes  of  Indians  in  the  Union.  The  first  response 
to  these  queries  was  from  the  noted  "  Kit  Cakson,"  which  was  as 
follows,    accompanied  by   a  package   of  Botanical  Specimens: 

"  Utah  Agency,  Taos,  N.  M.,  June  15,  1859. 
Sir: — Circular  from  your  office,  dated  April  30,  1859,  I  have  the 
honor  to  acknowledge.  The  only  reply  I  can  make  is  to  send  you 
roots  and  herbs,  stating  for  what  used  by  the  Indians.  The  names 
are  only  known  by  themselves.  They  are  gathered  in  the  mountains. 
The  samples  ]  send  are  used  by  the  Jichoiilla  Apaches.  I  will  send, 
from  time  to  time,  such  as  are  brought  to  me  by  the  Indians.  They 
are  found  in  latitudes  37*^,  38*^,  31)'^.  Obtained  in  small  quantities,  seven 
hundred  miles  from  navigable  streams ;  and  the  only  lacility  of  sending 
them  to  market  is  on  pack  mules. 

Have  the  honor  to  be,  very  respectfully. 
Your  obedient  servant, 
Hon.  Com.  Indian  Affairs,  C.  Cakson,  Indian  Agent. 

Washington,  D.  C." 

The  Committee  upon  the  Progress  of  Pharmacy  presented  a 
lengthy  report,  consisting,  as  usual,  of  condensed  notices  of  all  new 
improvements  and  inventions  in  Pharmacy,  and  in  the  sciences  and 
arts  accessory  to  it.  This  report  evidently,  from  its  completeness,  re- 
quired much  labor  in  its  compilation;  it  was  not  read  at  length.  We 
learn  from  it  that  Chicago  has,  through  its  Druggists,  formed  a  Col- 
lege of  Pharmacy,  with  the  expectation  of  instituting  a  course  of 
lectures. 

The  amount  of  Cod  Liver  Oil  produced  annually  by  the  New 
England  fishers,  reaches  24,000  gallons.  Castor  Beans,  (under  the 
name  of  Medicinal  seeds  to  save  duty)  are  now  largely  imported, 
and  the  oil  expressed  here,  the  cultivation  of  the  Castor  Bean  in  this 
country   appearing  to    be   on  the   decline. 

The  efforts  of  the  committee,  appointed  for  the  purpose,  to  pro- 
cure an  act  of  incorporation  from  Congress  at  its  last  session,  were 
without  avail.     A   new   committee   was  chosen. 

The  report  of  the  Treasurer  showed  that  the  expenses  of  pub- 
lishing   the    last   proceedings   were    considerably  in   excess   of    the   in- 


Pharmaceutical  Department.  499 

come,  but  that  the  new  Publishing  Committee  would  probably  have 
from  $1,000  to  $1,200  wherewith  to  publish  those  of  this  meeting. 
The  yearly  increasing  number  and  bulk  of  papers,  reports,  &c.,  pre- 
sented to  the  Association,  will  eventually,  it  is  believed,  require  the 
adoption  of  some  plan  to  increase  the  income  of  the  Association,  either 
by  increasing  the  annual  dues  to  three  or  five  dollars,  or  by  requiring 
all  who  wish  copies  of  the  proceedings  to  subscribe  a  certain  fixed 
amount  for  the  purpose.  Quite  a  large  number  of  the  proceedings  of 
1858  yet  remain  on  hand,  and  it  is  desirable  that  members  assist  in 
the   sale  and  distribution  of  them  among  the  profession  at  large. 

The  Committee  upon  Home  Adulterations,  Chas.  T.  Carney,  pre- 
sented such  a  full,  able,  and  interesting  report,  that  we  are  tempted 
to   insert   it   here   entire,    as   reported  in    The  Druggist. 

The  Committee  on  Home  Adulterations,  by  Chas.  J.  C.  Carney,  of 
Boston,  reported.  Adulteration  was  defined,  in  the  language  of  Dr.  Has- 
sell,  of  London — substitutions,  impurities,  and  accidental  contaminations 
being  excluded, — as  "the  intentional  addition  of  an  article,  for  purposes  of 
gain  or  deception,  of  any  substance  or  substances,  the  presence  of  which  is 
not  acknowledged  in  the  name  under  which  the  article  is  sold."  Great 
scientific  skill  is  shown  in  many  of  the  adulterations ;  in  other  cases  the 
most  pernicious  articles  are  substitued  for  the  genuine.  A  list  of  articles 
of  food  habitually  adulterated,  was  given  as  follows: 

Colored  Confectionary — Adulterated  with  emerald  or  scheles  green, 
arsenite  of  copper. 

Beer — with  coculus  indica  and  nux  vomica. 

Pickles  and  Bottled  Fruits — with  verdigris  and  sulphate  copper. 

Custard  Powder — with  chromate  of  lead. 

Tea  and  Snuff — with  the  same. 

Cayenne  and  Curry  Powder — with  red  oxide  of  lead. 

Sugar  Confectionary — with  gamboge,  orpiment,  or  sulphuret  of  arsenic 
and  chloride  of  copper. 

Flour  and  Bread — with  hydrated  sulphate  of  lime,  plaster  of  Paris  and 
alum. 

Vinegar — with  sulphuric  acid. 

Sugar — with  sand  and  plaster  of  Paris. 

Milk — with  chalk,  sheep's  brains,  ground  tumeric. 

Arrow  Root — with  ground  rice. 

Chocolate — with  rice  flour,  pototo  starch,  gum  tragacanth,  cinnabar, 
bals.  Peru,  red  ox,  mercury,  red  lead,  carb.  of  lime,  and  the  red  ochres,  to 
bring  up  the  color. 

Mustard — with  ground  turmeric,  to  give  it  a  brilliant  color. 

Butter — with  potato  starch,  mutton  tallow,  carb.  lead  and  sugar  of 
lead. 

While  the  committee  hesitated  to  give  the  names  of  the  parties  guilty 
of  this  practice,  it  was  recommended  that  the  Association  should  take  some 
action  in  reference  to  the  subject. 

Some  curious  instances  of  adulteration  had  come  to  the  knowledge  of 
the  committee  during  the  year. 

During  the  past  year,  in  a  wood-turner's  shop,  in  Boston,  was  seen 
more  than  a  barrel  ot  East  India  Rhubarb,  which  was  being  turned  dowa 
into   "  true  Turkey." 


500  The  Peninsular  and  Independent. 

This  rhubarb  was  sold  for  genuine  and  real  Turkey  rhubarb. 
A  druggist  was  applied  to  by  a  man  for  a  situation  as  porter  in  his 
store. 

"  What  can  you  do?  What  have  you  been  doing  at  your  last  place  V 
were  the  questions  asked. 

"Oh,"  replied  the  man,  "I  have  done  everything  about  the  store  that 
was  needed,  until  the  past  year,  I  have  worked  up  stairs  in  tlie  room  mak- 
ing Turkey  Rhubarb." 

"Making  Turkey  Rhubarb.     What  do  you  mean  by  that?" 

"Why,"  replied  the  man,  "we  used  to  take  the  East  India,  and  file 
and  "bore  it  into  true  Turkey." 

The  man  was  not  engaged. 

The  following  list  of  drugs  adulterated  was  presented: 

Acetate  of  morphia,  is  adulterated  with  acetate  and  phosphate  of  lime. 

Benzoic  acid,  with  asbestos,  carbonate  and  sulphate  of  lime,  hipponic 
acid  and  sugar. 

Citric  acid,  with  oxalic  and  tartaric  acid  and  sulplateof  lime.  It  often 
contains  sulphuric  acid  and  salts  of  lead  or  copper.  In  1850  M.  Pennes 
discovered  the  presence  of  lead  in  this  acid,  obtained  of  three  highly  respect- 
able dealers.  The  acid  was  very  white,  and  was  intended  to  prepare  the 
purgative  lemonade. 

Tartaric  acid,  with  cream  of  tartar,  acid  sulphate  of  potassa,  and  with 
lime. 

Aloes,  with  colophony,  ochre,  extract  of  licorice,  gum  arable,  and 
calcined  bones. 

Starch,  with  carbonate  and  sulphate  of  lime  or  alabaster.  The  more 
common  fraud  is,  however,  to  saturate  it  with  moisture. 

Arrow  root,  with  potato  starch,  and  i-ice  Hour. 

Assafoetida,  with  gum  resins  of  poorer  quality  with  sand,  and  other 
inert  substances. 

Balsam  Copaiva,  with  the  resinous  extract  by  decoction  of  the  bark 
and  branches  of  copaifera,  turpentine,  colophony  and  fat  oils. 

Balsam  Peru,  with  colophony,  turpentine,  benzoin  resin,  alcohol,  and 
fixed  oils. 

Balsam  Tolu,  with  turpentine,  colophony,  and  other  resins. 

Chloroform,  with  chlorhydric  ether,  hypochlorous  acid,  hydrocarbona- 
ted  oils,  compounds  of  methyle  and  aldehyde,  and  fixed  substances. 

Beeswax,  with  resin,  burgundy  pitch,  earthy  matter,  flours  of  sulphur, 
starch  and  amlyaceous  substances,  tallow,  stearic  acid,  yellow  ochre,  calcin- 
ed bones,  and  sa^ydust. 

Tart,  emetic,  with  cream  tartar,  oxide  antimony,  tartrate  of  iron,  chlor. 
calcium  and  potassium,  and  sometimes  is  contaminated  with  salts  of  copper 
and  tin. 

Essential  oils,  with  alcohol  and  fixed  oils. 

Iodide  potassium,  with  chloride  of  potassium  and  sodium,  and  calcium, 
carbonate  of  potassa  and  bromide  of  potassium.  The  latter  salt  being  some- 
times in  so  large  a  proportion,  owing  to  its  lesser  price,  as  to  replace  almost 
entirely  the  iodide. 

Manna,  with  glucose  or  starch  sugar,  and  starch.  The  large  flake 
manna  is  sometimes  made  from  a  mixture,  consisting  of  a  little  manna, 
flour,  honey,  and  a  purgative  powder;  these  are  boiled  together  to  a  syrupy 
censistence,  and  then  moulded  in  formof  "flakes."  Common  "  sorts  man- 
na" has  been  converted  into  "flake"  by  bemg  boiled  in  water,  clarified 
with  charcoal,  and  moulded  into  proper  form. 

A  number  of  specimens  were  then  presented,  and  remarked  upon  as 
follows : 


Pharmaceutical  Department.  501 

SUBSTITUTIONS. 

Specimen  No.  ],  is  Western  Alcohol.  A  barrel  of  this  was  sold  for 
"Atwood's  Alcohol."  A  very  simple  examination  proves  it  to  be  loaded 
with  grain  oils,  and  thus  exposes  the  fraud  at  once.  The  simplest  way  to 
detect  the  grain  oil  is  to  treat  the  suspected  sample  with  an  equal  volume 
of  concentrated  sulphuric  acid;  if  grain  oils  are  present,  the  mixture  be- 
comes darker  colored,  owing  to  their  carbonization.  Also  they  may  be  de- 
tected by  solution  of  nitrate  silver.  Expose  the  alcohol,  to  which  this  solu- 
tion has  been  added,  to  the  action  of  sunlight,  or  diffuse  daylight ;  if  grain 
oils  are  present,  a  black  precipitate  subsides  after  some  little  time.  This 
change  does  not  occur  if  the  alcohol  is  pure. 

Specimen  No.  2,  is  an  oil,  principally  linseed,  which  was  sold  for  true 
*' English  Oil  of  Sweet  Almonds."  The  physical  characteristics  and  the 
temperature  required  for  congealation  serve  to  detect  this  fraud.  Linseed 
oil  remains  fluid  at  zero,  while  true  oil  almonds  congeals  above  that 
temperature. 

Specimen  No.  3,  is  false  Oil  of  Bitter  Almonds.  This  was  purchased 
with  the  label  of  a  well  known  English  house  upon  it,  and  was  sold  as 
"true  essential  Oil  of  Bitter  Almonds."  It  is  the  article  known  as  "Es- 
sence de  Mirban,"  or  Nitro  Benzole,  and  may  be  detected  very  easily. 

When  a  mixture  of  one  volume  of  true  essential  oil  of  almonds  two  vol- 
umes of  alcohol,  and  one  volume  of  very  weak  solution  of  potassa,  mixed 
well  together,  is  allowed  to  stand,  it  is  converted  into  benzoic  acid  in  from 
24  to  48  hours. 

The  fictitious  oil  (nitro  benzole)  is  not  capable  of  undergoing  this 
change. 

Specimen  No.  4,  is  fictitious  Tapioca.  The  article  purports  to  be  the 
fecula  of  Jatropha  manihot,  or  cassava.  It  is  not,  however,  what  it  appears, 
and  is  proved  to  be,  by  microscopical  examination,  entirely  a  fictitious  arti- 
cle, made  from  potato  starch,  and  does  not  contain  one  particle  of  the  real 
Tapioca. 

This  article  is  made  in  Liverpool,  England,  and  imported  into  New 
York. 

Your  committee  can  not  refrain  from  recommending  the  use  of  the 
microscope  as  being  a  very  valuable  aid  to  the  Pharmaceutist.  By  this  in- 
strument he  is  enabled  to  detect  at  once  frauds  which  perhaps  might  be 
previously  unsuspected,  particularly  in  articles  of  food,  as  in  the  instance 
just  brought  to  your  notice. 

Specimen  No.  5,  is  Melambo  or  Matias  Bark.  This  bark  is  largely 
used  for  grinding  with  all  kinds  of  spices.  For  a  further  descrip- 
tion we  refer  to  Prof  Proctor's  Journal  of  Pharmacy,  Vol,  XXIX,  pp.  103 
and  215,  where  the  nature  and  characteristics  of  this  bark  are  fully  set 
forth  by  Messrs.  Edward  Parrish  and  Frank  B.  Daucy.  Your  committee 
are  not  aware  of  other  uses,  to  any  extent,  to  which  this  bark  is  put,  except 
for  adulterating  sinces. 

The  next  articles  to  be  considered  are — 

ADULTEEATIONS. 

Specimen  No.  1. — This  is  an  adulterated  article  of  cubebs,  with  the 
false  berry  used  for  the  purpose.  These  cubebs  were  purchased  as  a  select 
and  superior  article ;  the  fraud  existing  in  them  was  not  discovered  for 
sometime.  The  false  berry  is  readily  distinguished,  however,  as  it  is  hi- 
lobed,  while  the  cubeb  is  a  single  lobed  berry.  There  exists  in  the  lot  of 
cubebs  from  which  these  were  taken,  16  percent,  of  false  berries  'byweight; 
they  are  heavier  than  the  cubebs,  and  are,  on  that  account,  easily  added  in 


602  The  Peninsular  and  Independent. 

sufficient  amount  to  vitiate  the  quality  of  the  drug  without  attracting  no- 
tice. Your  Committee  have  endeavored,  without  success,  to  ascertain  the 
name  of  this  false  berry  ;  it  appears  to  be  inert  and  worthless,  not  possessed 
of  any  deleterious  property,  other  than  that  of  reducing  the  stren  gth  of  the 
powdered  cubebs,  which,  in  the  amount  present  in  sample  under  considera- 
tion, it  does  quite  perceptibly. 

Specimen  No.  2,  is  French  Lycopodiura,  which  is  adulterated  with  the 
starch  of  some  species  of  lentil,  apparently.  The  microscope  reveals  thts 
adulteration  at  once,  which  otherwise  might  not  be  suspected.  If  treated 
with  water  and  solution  of  iodine,  the  presence  of  starch  may  also  be  de- 
tected. This  drug  is  often  adulterated  with  starch,  pulv.  gypsum,  and 
even  boxwood  powder.  By  separating  with  water,  the  heavier  adulterations, 
they  can  be  examined  and  recognized ;  the  wood  powder  can  be  separated 
by  means  of  a  seive. 

The  specimen  under  examination  is  part  of  a  lot  purchased  in  one 
pound  bottles,  with  a  French  stamp  and  label  upon  it.  A  portion  of  it 
having  accidentally  been  wet  the  starch  became  "musty"  revealing  its  pre- 
sence, otherwise  unsuspected.  Subsequent  examination,  as  above,  furnish- 
ed further  proofs  of  its  existence. 

Specimen  No.  3  is  Para  Balsam  Copaiva, — This  contains  from  6  to  8 
per  cent,  of  heavy  or  fat  oil. 

Balsam  copaiva  is  very  largely  adulterated.  It  often  contains  the  re- 
sinous extract,  by  decoction,  of  the  branches  and  bark  of  the  copaifera. 

Turpentine,  colophony  and  fat  oils,  particularly  castor  oil.  The  bal- 
sam adulterated  with  turpentine  is  not  of  so  heavy  consistence  as  the  true 
balsam  ;  it  is  more  viscid  and  sticks  upon  the  sides  of  the  bottle  holding  it. 
It  maybe  very  easily  proved  whether  turpentine  is  present  or  not,  by  simply 
heating  a  drop  of  the  suspected  balsam,  upon  a  sheet  of  glazed  paper,  over  a 
spirit-lamp ;  the  oil  of  copaiva  is  first  volatalized,  and  the  odor  of  the  tur- 
pentine is  at  once  apparent. 

Castor  oil  is  the  most  dangerous  adulterative,  owing  to  the  great  simi- 
larity between  that  and  the  true  balsam, 

This  may  be  detected  by  mixing  three  parts  of  the  suspected  balsam 
with  one  part  sulphuric  acid  and  shaking  with  15  or  20  parts  of  alcohol  of 
36  deg.  If  the  mixture  separates  it  indicates  that  the  balsam  is  adulterated 
with  castor;  when  pure  there  is  no  separation.  This  test  will  detect  not 
less  than  one-ninth  part  of  adulteration. 

The  presence  of  castor  oil  may  also  be  detected  by  adding  two  parts 
ammonia  22  deg.  Beaume,  to  five  parts  suspected  balsam  and  shaking  them 
together  in  a  stopped  bottle.  The  mixture  becomes  visced  and  ''ropy," 
very  soon  clears  itself  and  becomes  transparent  if  pure. 

It  is  whitened  by  agitation,  on  the  contrary,  if  it  contains  castor  oil. 
The  only  precaution  to  be  taken,  however,  is  that  the  temperature  of  the 
mixture  should  be  from  50  to  60  deg.  Fah. ;  above  or  below  this  point  the 
result  is  inaccurate,  as,  from  68  to  76  deg,  Fah.  the  mixture  is  transparent 
whether  pure  or  adulterated,  and  at  32  to  40  deg.  Fah.,  the  pure  balsam  re- 
mains clouded. 

The  fixed  oils  may  be  discovered  by  heating  a  drop  or  two  of  the  balsam 
upon  paper.  If  the  Balsam  is  pure  the  volatile  oil  is  driven  off  leaving  the 
resin  homogeneous,  transparent,  and  brittle  ;  if  it  contains  heavy  or  fixed 
oil  the  resin  is  surrounded  by  a  greasy  aureole  and   is  less  brittle. 

Finally,  balsam  copavia  is  "made  up"  of  the  fat  oils,  as  poppy  and 
rape  seed,  with  turpentine.  These  mixtures,  however,  would  deceive  only 
the  inexperienced ;  in  all  cases  etherial  alcohol  (4  parts  alcohol  1  part 
ether,)  serve  to  recognize  this  fraud,  this  liquid  dissolving  only  the  true 
balsam,  leaving  the  foreign  matter. 


Pharmaceutical  Department,  503 

Specimen  No.  4  is  powdered  opium.  This  is  a  very  poor  specimen  of 
powdered  opium.  It  was  sold  at  a  high  price,  to  a  person  not  perfectly  fa- 
miliar with  drugs,  but  to  him  it  appeared  so  different  from  his  idea  of  the 
article,  that  he  requested  an  examination  of  it.  It  is  found  to  contain  less 
than  3  per  cent,  of  impure  morphia,  which  is  but  one-third  or  one-fourth 
the  amount  considered  to  be  the  standard  yield  by  the  United  States  Dis- 
pensatory. It  is  evident  that  this  powder  of  opium  could  scarcely  fail  to 
disappoint  the  expectations  of  the  physician.  What  article  is  used  for 
adulterating  this,  your  committee  have  not  decided.  It  is  possible  that 
the  opium  was  exhausted  in  part  before  drying  and  powdering. 

Specimen  No.  5  is  balsam  tolu,  containing  16  per  cent,  common  resin. 
Balsam  tolu  is  often  adulterated  with  turpentine  and  various  resins.  It  is 
easy  to  detect  this  fraud  by  the  peculiar  resinous  odor  which  the  adultera- 
ted article  gives  off  when  burnt.  It  may  also  be  distinguished  by  testing 
with  sulphuric  acid.  The  concentrated  acid  added  to  the  pure  balsam 
gives  a  cherry  red  liquor  without  disengagement  of  sulphurous  acid  ;  the 
same  acid  added  to  balsam  adulterated  with  resin,  gives  a  blackish- brown 
liquor  with  abundant  disengagement  of  sulphurous  acid. 

Specimen  No.  6  is  Powdered  Tartar  Emetic. — This  is  largely  contami- 
nated with  foreign  bodies,  containing  as  much  as  21  per  cent,  of  impurity. 
The  impurity  in  it  is  doubtless  owing  to  careless  manufacturing,  and  as 
this  article  in  powder  is  often  made  without  proper  and  sufficient  care  be- 
ing used  in  its  manufacture,  it  is  best  for  the  pharmaceutist  to  buy  none 
but  the  crystals,  and  being  assured  of  their  purity,  powder  them  himself 

The  impurities  most  generally  present  in  tartar  emetic  are  uncombined 
cream  of  tartar,  chloride  of  calcium  or  potassium  and  sulphate  of  potassa. 
It  also  sometimes  contains,  as  accidental  contamination,  iron  and  tin.  The 
uncombined  cream  of  tartar  may  be  detected  by  an  acid  solution  of  acetate 
of  lead  ;  the  solution  is  made  of  82  parts  distilled  water,  8  parts  cryst. 
acetate  of  lead,  and  15  parts  acetic  acid  of  9  deg.  The  presence  of  cream 
of  tartar  is  shown  by  the  white  precipitate,  produced  in  a  solution  of  tart, 
emetic,  on  adding  a  small  portion  of  the  lead  reagent. 

Chlorides  of  potassium  or  sodium,  or  chlor-hydric  acid  may  be  detect- 
ed, by  their  affording  a  white  "  curdy"  precipitate,  upon  adding  to  a  solu- 
tion of  tart,  emetic,  a  few  drops  solution  nitrate  of  silver.  This  white  pre- 
cipitate, Mcliloride  of  silver^  should  be  entirely  soluble  in  ammonia. 

This  specimen  under  examination  contains  8  per  cent,  of  chlorides. 
Sulphate  of  potassa  may  be  detected  by  the  white  precipitate,  insoluable  in 
nitric  acid,  which  is  afforded  by  solution  chloride  of  barium  or  nitrate  of 
baryta. 

The  specimen  under  examination  contains  18  per  cent,  of  sulphates. 

Specimen  No.  7  is  Cream  of  Tartar.  This  article  is  one  used  largely, 
both  as  a  medicine  and  in  the  preparation  of  food  ;  it  is,  worthy  careful  con- 
sideration, and  your  committee  have  given  considerable  attention  to  it. 

Cream  of  tartar  is  very  largely  adulterated.  Some  of  the  articles  used 
for  the  purpose  are  in  one  sense  harmless  ;  that  is  not  injurious  to  health, 
but  many  of  them  are  decidedly  pernicious,  and  all  of  them  are  to  be  con- 
demned, because  sold  to  deceive  the  community  and  enrich  the  adulterator. 

Cream  of  tartar  is  adulterated  with  tartrate  of  lime,  chalk,  finely  pow- 
dered white  marble,sulphate  of  lime,  sand,  nitrate  of  potassa,  alum,  sulphate 
of  soda,  and  potassa,  chloride  of  potassium.  It  has  been  found  to  contain, 
as  impurities,  iron,  copper,  lead  and  arsenic. 

The  addition  of  starch,  arrow  root,  and  other  amylaceous  substances  is 
well  known,  and  the  specimen  under  examination  is  only  remarkable  form 
the  fact  that  it  contains  63.83  per  cent,  of  farinaceous  substances,  as  an 
adulteration. 


504  The  Peninsular  and  Independent. 

This  was  sold  as  fure  cream  tartar.  The  easiest  way  to  detect  the 
adulteration,  with  starch  or  farinaceous  substances,  is  by  testing  a  cold  so- 
lution of  the  cream  of  tartar  with  solution  of  iodine.  The  characteristic 
blue  "  iodine  of  starch"  will  at  once  be  apparent. 

If  we  treat  the  cream  of  tartar  with  boiling  water,  we  dissolve  all  solu- 
ble substances,  leaving  behind  the  tartrate  of  lime,  quartz,  clay,  sand,  sul- 
phate of  lime,  and  other  insoluable  impurities. 

Chalk  or  white  marble  ma}'  be  discovered,  by  the  effervescence  produc- 
ed, by  the  addition  of  a  weak  acid,  as  chlorhydric  or  nitric. 

Alum, and  sulphates  of  potassaor  soda,  are  shown  to  be  present  by  the 
white  precipitate,  insoluble  in  nitric  acid,  produced  by  solution  of  chloride 
of  barium;  if  a  precipitate  is  produced  in  same  solution,  by  oxalate  of  am- 
monia, we  know  that  lime  is  also  present.  Chloride  of  potassium  is  shown, 
by  the  white  "curdy"  precipitate,  entirely  soluble  in  ammonia,  formed  by 
adding  solution  of  nitrate  of  silver  to  the  cream  of  taitar  solution. 

The  iron,  lead  and  copper  come  from  the  vessels  of  these  metals,  in 
which  the  cream  of  tartar  is  purified. 

The  solution  of  cream  of  tartar,  tested  with  tincture  of  galls,  takes  a 
hlack  color  if  iion  is  present;  with  ammonia,  a  Mue  color  if  copper  be  pre- 
sent; with  iodide  potassium,  a  yelloic^  if  lead  is  present. 

The  presence  of  arsenic  in  cream  of  tartar,  according  to  Dr.  Bley,  comes 
from  the  arsenical  sulphur  used  in  the  "mutage,"  or  process  for  arresting 
fermentation  in  the  "must"  of  grapes,  which  consists  of  burning  sulphur 
in  the  casks,  thereby  liberating  sulphurous  acid.  The  arsenic  may  be  de- 
tected by  Marsh's  apperatus. 

Specimen  No.  8  is  Acid  Sulphate  of  Soda. — This  is  the  residue  from 
nitric  acid  manufacturing.  The  nitrate  of  soda,  or  Chili  saltpeter,  is  discom- 
posed by  sulphuric  acid,  and  this  article  remains.  It  is  largely  used  to 
adulterate  cream  of  tartar  and  this. 

Specimen  No.  9 — is  one  which  contains  this  adulteration.  This  acid 
sulphate  may  be  considered  one  of  the  injurious  adulterations. 

There  is  one  drawback  to  its  use,  however,  as  a  substitute  for  cream  of 
tartar,  and  that  is  its  diliquescence,  or  property  of  taking  moisture  from  the 
atmosphere.  It  was  once  attempted  to  substitute  it  for  cream  of  tartar  in 
a  "yeast  powder,"  but  after  having  been  put  up,  the  article  was  obliged  to 
be  withdrawn  from  the  market  because  it  destroyed  the  cans.  Query — Will 
the  human  stomach  bear  it  better  than  a  tin  can  ? 

Specimen  No.  10 — is  the  "  great  adulterator."  This  article,  known 
by  the  above  name,  is  selenite  of  sulphate  of  lime.  It  is  imported  into 
New  York,  and  there  powdered  for  use. 

Specimen  No.  11 — is  the  "great  adulterator"  in  its  natural  state,  be- 
fore being  powdered. 

Specimen  No.  12 — is  cream  of  tartar  which  is  adulterated  with  the 
"great  adulterator ;"  as  this  substance  is  almost  insoluable,  any  one  can 
judge  of  the  benefit  to  health  that  might  arise  from  a  long  continued  use  of 
the  article  in  the  daily  food. 

The  specimen  of  cream  tartar  under  examination  contains  25  per  cent, 
of  the  "  great  adulterator." 

Specimen  No.  13 — is  a  fatty  residue  from  oil  of  lemon.  This  was  ob- 
tained from  a  sample  of  oil  of  lemon  of  suspected  purity  the  last  winter,  and 
amounted  to  22  per  cent,  of  the  whole  weight  of  the  oil.  In  cold  weather 
it  has  a  butyracious  consistence,  but  as  it  now  appears  is  more  fluid. 

It  is  somewhat  unusual  to  find  an  article  of  oil  lemon  adulterated  in 
this  way  ;  and  your  committee  would  call  the  attention  of  pharmaceutists 
to  the  fact,  as  being  evidence  of  a  new  practice  in  the  way  of  fraud  in  this 
article. 


Pharmaceutical  Department,  505 

Specimen  No.  14 — is  capsicum  with  adulteration  of  common  salt.  This 
can  be  detected  by  exhausting  the  pepper  with  water,  evaporating  to  dry- 
ness, and  testing  the  residue  by  nitrate  of  silver  for  clorine ;  the  soda  im- 
parts its  characteristic  color  of  yellow  to  flame  of  burning  alcohol. 

Corosive  sublimate,  sent  from  Kentucky,  was  proved  to  be  adulterated 
with  chloride  sodium  (common  salt)  by  the  usual  test.  The  sample  was 
too  small  to  estimate  amount  of  impurity  present,  and  we  can  not  show  a 
specimen  of  it,  because  it  was  all  consumed  in  examination. 

Specimen  No.  15 — Lunar  Caustic.  This  was  sent  from  Kentucky  also, 
having  been  purchesed  in  New  York  at  a  cost  of  $1  20  per  ounce,  as  2. pure 
article.  A  great  imposition  was  practiced  either  by  the  seller  or  the  manu- 
facturer. Upon  a  careful  examination,  it  yielded  only  fourteen  per  cent, 
of  chloride  of  silver,  equivalent  to  about  ten  per  cent,  of  metallic  silver. 

Had  it  been  pure  nitrate,  it  should  have  yielded  sixty-four  per  cent. 
of  metallic  silver. 

Specimen  No.  16 — Piperine.  Adulterated  with  yellow  prussiate  of 
potassa.  This  fraud  can  be  easily  detected  by  testing  a  solution  of  the  sus- 
pected piperine  with  a  per-salt  of  iron.  The  blue  reaction  is  instantly  pro- 
duced, caused  by  formation  of  ferro  cyanide  of  iron. 

This  reaction  taking  place  while  combining  a  recipe  in  which  the  pi- 
perine and  a  salt  of  iron  was  ordered,  led  to  the  detection  of  this  fraud, 
otherwise  unsuspected. 

Flowers  of  Oxide  of  Zinc.  All  specimens  examined  except  some  Ger- 
man, proved  to  be  merely  the  carbonate. 

Specimen  No.  17 — Oil  of  Eergamot.  A  lot  of  oil  of  bergamot,  pur- 
chased at  the  market  rates,  and  to  all  appearancesa  very  fine  article,  proved 
to  contain  30  per  cent,  of  alcohol,  by  the  usual  test  with  graduated  tube, 
and  treatment  with  water. 

Specimen  No.  — ,  Oil  of  Wormwood.  As  regards  smell  and  taste,  this 
oil  is  unexceptionable.  Its  specific  gravity  is  so  low  as  to  excite  suspicion, 
and  it  proves  to  be  adulterated  with  Ether  upon  a  careful  examination. 

This  fraud  can  be  easily  detected  by  the  low  boiling  point,  and  specific 
gravity. 

The  following  receipts  were  obtained  from  a  man  who  had  been  an 
employee  in  a  manufacturing  establishment  in  New  York. 

Gamboge  Powdered — Gamboge,  100  pounds ;  tartrate  of  lime  25 
pounds. 

Socotrine  Aloes — Are  pure  bonaire,  without  adulteration. 

Cream  of  Tartar  is  adulterated  with  from  10  to  65  per  cent,  of  terra 
alba,  or  tartrate  of  hme,  with  about  three  per  cent,  tartaric  acid. 

Tartaric  Acid,  Powdered — Tartaric  acid,  1000  pounds  ;  alum,  from  10 
to  35  per  cent. 

Scammony  Aleppo,  Powdered — Virgin  Scammony,  30  pounds  ;  cocoa 
beans,  80  pounds ;  biscuit,  30  pounds ;  lampblack,  q.  s.  (sufficient  quanti- 
ty) to  color. 

Bird  Pepper,  Powdered — Chilies,  1000  pounds;  rice  800  to  1,200 
pounds ;  curcuma  and  Venetian  red  to  color. 

Powdered  Fenugreek — Fenugreek  seeds,  1000  pounds;  biscuit,  1000 
pounds ;  curcuma  q.  s.  to  color. 

East  India  Rhubarb,  Powdered — East  India  rhubarb,  100  pounds ;  En- 
glish rhubarb,  60  pounds. 

English  Rhubarb,  Powdered— English  rhubarb,  100  pounds ;  biscuit, 
30  pounds;  curcuma,  to  color. 

Turkey  Rhubarb,  Powdered— East  India  rhubarb,  Turkey  rhubarb, 
equal  parts. 


506  The  Peninsular  and  Independent. 

The  tartrate  of  lime  referred,  to  is  more  properly  sulphate  of  lime  with 
a  small  portion  of  tartrate.  The  ship  biscuit  is  the  hard  and  often  worm- 
eaten  cakes  brought  in  by  ships  after  a  long  voyage. 

Powdered  Cape  Aloes — Cape  aloes  dried,  100  pounds  ;  ship  biscuit  100 
pounds ;  curcuma  q.  s.  to  color. 

Common  Ginger — African  ginger,  200  pounds ;  capsicum  hulls,  25 
pounds;  biscuit,  1000  pounds;  curuma,  q.  s.  to  color. 

Ipecac,  Powdered — Ipecac.  100  pounds;  ship  biscuit  25  to 40  pounds. 

Opium,  Powdered — Turkey  opium,  50  pounds  ;  Egyptian  opium,  25 
pounds ;  biscuit  40  pounds. 

Your  Committee  have  noticed,  in  making  a  number  of  examinations 
of  articles  furnished  by  manufacturers,  as  acetic,  nitric,  muriatic  acids, 
aqua  amonia,  oxide  of  zinc,  sub-carbonate  of  iron,  and  others,  that  but  lit- 
tle attention  is  paid  to  the  requirements  of  the  pharmacopoeia,  as  every 
pharmaceutist  can  ascertain  with  but  little  trouble. 

The  stigma  of  adulteration  does  not  belong  to  the  drug  trade  alone ;  in 
fact  very  many  articles  of  food  are  systematically  and  almost  always  adul- 
terated, so  that  to  obtain  them  in  their  absolute  purity  is  almost  the  excep- 
tion.   Of  such  are  the  ground  spices,  coffee,  etc. 

We  are  aware  this  is  a  strong  assertion,  but  proof  can  be  produced 
were  it  necessary. 

One  article  referred  to,  that  of  ground  coffee,  we  can  give  the  formula 
by  which  it  is  made. 

This  coffee,  pat  up  in  one  pound  papers,  and  labelled  "fine  old  Java," 
is  made  as  follows:  for  every  100  pounds,  there  are  60  pounds  of  peas,  20 
pounds  of  chicory  and  20  pounds  of  coffee. 

This  compound  sells  for  12^^  cents  per  pound,  and  any  person  can , 
judge  of  the  value  of  it  as  coffee,  containing  as  it  does  but  20  per  cent,  of 
that  substance. 

There  are  many  upright  and  honorable  men,  however,  who  discounte- 
nance any  such  imposition  upon  the  public,  in  all  branches  of  trade,  and 
we  feel  a  proud  satisfaction  in  referring  to  them,  whether  members  of  our 
profession  or  not;  in  our  oion  ranl's  we  know  there  are  many  upon  whom 
the  public  can  rely,  and  in  closing  we  can  only  urge  upon  the  association 
once  more,  the  importance  of  this  subject,  earnestly  soliciting  the  hearty 
co-operation  of  every  member  to  raise  the  standard  of  our  profession,  and 
as  far  as  possible  to  discourage  and  expose  fraud  and  deception. 

On  motion  of  Edward  Parrish,  of  Philadelphia,  Dr.  Chas.  T.  Jackson 
was  invited  to  take  a  seat  in  the  convention,  and  participate  in  their  dis- 
cussions. 

He  highly  complimented  the  Report  on  Adulterations,  and  added  some 
facts  in  regard  to  adulteration  in  Boston.  Ship  biscuit  is  not  used  in  Bos- 
ton in  adulteration,  but  corn-meal  and  bran  take  its  place.  Red  pepper  is 
commonly  adulterated  with  bran,  first  dried  and  then  ground  with  it.  In 
this  country  no  red  lead  is  ever  put  into  ground  pepper.  It  is  not,  there- 
fore, so  dangerous  as  the  English  compound.  In  ginger  and  mustard  In- 
dian-meal is  used,  in  the  proportion  of  one-third  part.  Dr.  J.  related  an 
anecdote  of  a  purchaser  who  submitted  to  him  for  examination  a  suspected 
article  of  mustard.  The  Dr.  informed  him  that  it  was  one-third  Indian- 
meal.  "Oh!"  said  the  buyer,  "if  it's  only  a  third,  I  don't  care;  I  sup- 
posed the  fellow  had  cheated  me  and  put  in  more  than  a  half"  Cream  of 
tartar  is  much  adulterated.  For  ten  casks  of  cream  of  tartar,  one  cask  of 
alum  and  three  of  starch,  or  ground  rice.  Thus,  when  used  as  a  laxative, 
the  drug  has  a  contrary  effect  to  that  intended.      Carelessness  in  keeping 


Pharmaceutical  Department,  501 

clean  the  mills.  Blistering  flies  are  ground  at  one  time,  and  allspice  at 
another,  making  the  latter  altogether  too  pungent.  Since  the  passage  of 
the  foolish  law  with  regard  to  examination  at  the  custom-house,  no  regular 
analyses  have  existed,  and  at  the  custom-house  they  are  impossible.  Leath- 
er is  dyed  with  Nicaragua  wood  instead  of  cochineal.  The  Nicaragua  wood 
dye  fades  with  time;  the  cochineal  does  not.  After  a  month's  unsuccess- 
ful labor,  by  one  of  his  students,  in  a  case  where  this  substitution  was  sus- 
pected, he  had  himself  undertaken  the  test,  and,  on  the  information  from 
the  owner  of  its  tendency  to  fade,  took  strips  of  the  suspected  article  and 
of  genuinely  dyed  leather,  placed  the  two  in  chlorine,  and  found  the  color 
of  the  Nicaragua  wood  to  disappear  entirely,  while  the  cochineal  only  chang- 
ed to  brown. 

Wm.  A.  Brewer,  of  Boston,  had  found  cochineal  adulterated  with 
barytes.  The  adulterated  article  may  be  distinguished  by  its  marked 
excess  of  weight,  it  occupying  little  more  than  half  the  space  of  true  coch- 
ineal. 

Mr.  Dix,  of  New  York  City,  said  that  this  cochineal  came  from  Lon- 
don. Some  years  ago  it  was  discovered  there  by  the  Messrs.  Berger,  that 
they  could  take  out  the  best  part  of  the  color  without  destroying  the  coch- 
ineal. They  sell  it  there,  immediately  to  other  firms,  and  it  is  dried,  and 
colored  with  barytes.  Mr.  Dix  urged  the  extension  of  the  association  as 
the  best  means  of  checking  adulteration. 

Among  the  incidental  remarks  upon  adulterations  made  by  mem- 
bers present,  Mr.  Hollis  mentioned  the  adulteration  of  Cassia  vrith 
Corn  meal  to  50  per  cent,  and  spoke  of  the  difficulty  of  getting  pure 
saleratus,  as  made  formerly,  an  imperfectly  carbonized  Soda  ash  being 
largely  substituted,  this  is  carbonized  by  exposure  to  the  carbonic 
acid  arising  from  beer  vats   during   fermentation. 

Mr.  Dix  said  that  he  knew  of  one  firm  in  New  York  city  that 
used  annually   one  hundred   tons   of  Soda  ash  in  making   saleratus. 

Following  this  discussion,  Mr.  Dix,  of  New  York,  and  Mr.  Ellis, 
of  Philadelphia,  presented  specimens  of  the  new  Scammony,  made  by 
Prof  Williamson's  process  in  England,  from  the  dry  scammony  root, 
which  is  imported  for  the  purpose.  We  gave  this  process  in  our 
Journal  a  few  numbers  back.  The  article  in  question  has  an  ap- 
pearance exactly  resembling  colophony,  and  a  peculiar  odor  closely 
resembling,  however,    the  virgin   scammony   of  commerce. 

The  selected  subjects,  for  scientific  reports,  were  replied  to  in 
considerable  numbers. 

Mr.  Edwin  0.  Gale  made  an  elaborate  report  upon  the  rosin 
weed  (Silphium  laciniatum),  of  the  prairies.  He  thinks  that  the  resin- 
ous exudation  of  this  plant  may  be  substituted  for  mastic,  which  it 
resembles  in  appearance  but  not  in  odor,  being  decidedly  terebin- 
thinate.  It  makes  a  good  varnish;  is  a  valued  remedy  for  heaves  in 
horses;  allays  irritation  of  the  lungs  when  chewed;  its  collection,  as 
yet,  however,  is  limited ;  and  consequently  it  is  of  no  commercial  value. 

Mr.  Joseph  Roberts,  who  made  the  deposite  in  Wine  of  Ipecac- 
uanha a  subject  for   investigation,  reports   that  said  deposit  is  not  con- 


508  The  Peninsular  and  Independent. 

fined  to  Ipecac  wine  alone,  but  is  peculiar  to  most  medicated  wines 
and  galenical  solutions,  exposed  to  atmospheric  influences.  The  deposit 
is  slight,  has  no  depreciating  effect  upon  the  wine,  as  it  contains  no 
emetia. 

Edward  Parrish,  of  Philadelphia,  reported  at  some  length  upon 
the  causes  of  the  deterioration  ^of  pharmaceutical  preparations  and  the 
means   of  preventing   the   same. 

J.  0' Gallagher,  of  St.  Louis,  presented  an  extended  historical 
notice   of  pharmacy. 

E.  R.  Squibb  offered  a  volunteer  paper  on  a  new  apparatus  for 
the  making  of  the  mechanical  preparations  of  mercury.  The  entire 
disinterestedness  of  Dr.  S.  in  making  public  the  results  of  his  skill,  in 
adapting  means  to  ends,  can  not  be  too  highly  commended,  and  we 
are  glad  to  know  that  the  Doctor's  efforts  to  establish  a^  grade  of 
pharmacopoeial  products,  which  shall  correctly  represent  the  pharmaco- 
poeia, are   meeting   with   that   pecuniary   success   which   he  deserves. 

F.  Hale,  of  New  York,  read  an  essay  upon  fitting  up  drug-stores, 
with   reference    to    convenience   and   good    taste. 

Papers  by  Ambrose  Smith,  of  Philadelphia,  upon  the  decomposition 
of  oxide  of  silver  in  pill  mass ;  by  Prof.  Procter  upon  the  obtaining 
of  Polygalic  acid  from  senega ;  by  Prof.  Grahame  upon  the  best 
means  of  preserving  the  medicinal  vegetable  extracts,  in  the  dispen- 
sing shop,  and  by  S.  S.  Garrigurs  upon  the  Cornus  florida,  were 
read. 

A  paper  from  Henry  A.  Tilden,  of  New  Lebanon^  N.  Y.,  upon 
the  relative  value  of  imported  and  indigenous  medicinal  plants,  was 
presented  and  read  by  E.  Parrish,  showing  much  research  and  ex- 
periment, though  the  conclusions  are  necessarily  deferred  till  next 
year. 

The  feasibility  of  raising  arnica  plants  in  this  country  was  dis- 
cussed. Mr.  Dix,  of  New  York,  said  they  could  be  obtained  from 
Germany  cheaper  than  the  flowers  could  be  picked  here,  if  the  fields 
were  covered  with  them.  He  could  obtain  the  seeds  for  any  person 
who  was   desirous   to   see   the   plants   growing. 

Alexander  Cushman,  of  New  York,  read  a  paper  upon  "Pepsin.' 
That  obtained  from  the  stomach  of  pigs  he  prefers ;  the  French  pre- 
fer that  from  the  stomach  of  sheep,  and  the  English  that  from  sheep 
and  calves. 

During  the  last  session,  Prof.  Procter  read  an  elaborate  paper 
upon  fluid  extracts,  it  covered  the  whole  ground,  so  long  unexplored, 
showing  the  different  kinds  of  treatment  required  by  drugs  for  their 
complete  extraction,  classifying  them  with  reference  to  this  object,  and 
presenting  an  immense  number  and  variety  of  formulae,  accompanied 
by  specimens   of  the   preparations   and  their   residues. 


Pharmaceutical  Department.  609 

This  paper  was  the  subject  of  much  commendation  and,  on  mo- 
tion, the  author  was  voted  a  presentatiop  copy  of  the  new  London 
Edition  of  Pareira's  Mat.  Medica,  as  a  testimonial  of  the  high  ap- 
preciation  of  the   Association   of  the   still   and   industry   displayed. 

Among  the  scientific  essays,  was  one  by  Dr.  Battjiy,  of  Georgia, 
upon  Sorghum  culture.  The  Doctor  presented  a  specimen  of  Rum  made 
from   sorghum  juice. 

Also  a  paper  by  Edward  Paurish,  on  liquid  preparations  of 
mustard.  One  by  Gordon  of  Cincinnati  on  Liq.  Ferri  lodidi,  two  by 
the  ZiMMERMANNS,  of  Cincinnati,  upon  Catawba  wine  and  Brandy.  All 
of  which,  with  the  preceeding  papers,  will  appear  in  the  published 
proceedings. 

The  Association  decided,  after  some  discussion,  to  hold  the  next 
meeting  at  New  York  city,  after  which,  after  passing  the  usual  re- 
solutions of  thanks,  for  attentions,  service,  entertamment,  &c.,  the 
meeting  adjourned. 

We  must  not  fail  to  mention  the  elegant  entertainment,  given  by 
the  Druggists  of  Boston  to  their  guests,  which  reflected  much  credit 
upon  the  craft,  and  where  toast  -  reading  and  speech  -  making  ruled 
the   hours  till   near   daybreak. 

All  in  all  we  think  this  year's  meeting  has  been  more  profitable 
in  results  by  far,  than  those  of  previous  years,  giving  satisfactory 
evidence  of  the  increasing  power  and  beneficial  influence  of  the  As- 
sociation. F.  S. 

»-^-« , 


PREPAEATION"  AI^D  USES  OF  IODIDE  OF  SODIUM.— By  T.  E.  Jenkins,   Phar- 

maceutiBt. 

On  account  of  the  high  terms  in  which  Iodide  of  Sodium  has 
been  sponken  of  in  the  late  periodicals  as  a  therapeutic  agent,  several, 
physicians  have  been  induced  to  try  it  in  their  practice,  and  have  called 
upon  us  to  prepare  it  for  them,  as  it  could  not  at  the  time  be  obtained 
from  the  regular  traders ;  and  from  the  superior  effects  which  this  com- 
bination of  iodine  has  manifested  in  their  hands,  it  is  thought  well  to 
give  some  account  of  the  best  mode  for  its  preparation,  and  detail  some 
of  its  principal  advantages. 

The  first  three  or  four  lots  which  we  prepared  were  made  by  first 
converting  the  iodide  into  Hydriodic  Acid  by  passing  washed  Sulphu- 
retted Hydrogen  through  water  in  which  the  iodine  was  diffused,  and 
subsequently  accurately  saturating  the  acid  with  Carbonate  of  Soda, 
and  evaporating  to  dryness.  This  process  is  a  pretty  good  one,  and 
will  furnish  a  good  product,  and  when  properly  conducted,  yield  the 
full  amount;  but  one  great  objection  in  the  way  of  its  general  adop- 
tion, by  the  physician  and  the  apothecary,  is  the  disagreeable  nature  of 
the  Sulphuretted  Hydrogen  Gas. 


510  The  Peninsular  and  Independent, 

Another   process   is   to   add   Iodine   to   a  solution  of  Caustic  Soda. 

This  procedure  will  give  a  mixture  of  Iodide  ond  lodate  of  Soda.     The 

.The   latter   salt,  however,  will   be  converted   into   the  former  when  the 

mixture   is   evaporated   to   dryness,  and   the   dry  mass   is  heated   for  a 

short  time  to  low  redness  in  a  crucible. 

We  have  not  experimented  with  the  last  mentioned  process,  and, 
consequently,  can  not  speak  advisedly  of  its  merits.  But  the  following 
is  one  which  we  have  tried  a  number  of  times,  and  are  so  much  pleased 
with  its  operation,  that  it  has  been  adopted  in  our  laboratory: 

Take  of  Iodine,  pure,         .         .         1  lb. 
"     "  Iron  wire  (piano  wire)  \  lb. 

"     "  Water,  .         .         .       32  oz. 

Put  the  ingredients  into  a  bottle  (a  mercury  flask  will  answer  best), 
and  shake  the  whole  together  until  combination  between  the  Iodine  and 
iron  is  complete,  which  may  be  known  to  be  the  case  when  the  froth 
on  the  solution  is  white.  The  resulting  solution  of  Iodide  of  Iron 
should  then  be  filtered  into  a  wide  mouthed  glass  jar,  and  diluted  with 
about  three  quarts  of  boiling  distilled  water,  and  immedirtely  a  strong 
and  hot  solution  of  carbonate  of  soda  should  be  carefully  poured  in 
until  a  bluish  white  precipitate  is  no  longer  produced,  taking  care  to 
avoid  an  excess  of  the  carbonate.  The  whole  mixture  should  then  be 
thrown  on  a  filter,  and,  after  the  liquid  (which  is  a  solution  of  Iodide  of 
Sodium)  has  drained  through,  the  remaining  precipitate  may  be  washed 
three  or  four  times  successively  with  hot  distilled  water,  and  the  wash- 
ings added  to  the  solution  first  run  through.  This  solution  should  then 
be  evaporated,  at  first  rapidly,  and  towards  the  close  more  gradually 
and  carefully,  with  constant  stirring  to  complete  dryness.  Care  should 
be  taken  as  the  salt  approaches  dryness  to  regulate  the  heat  so  as  not 
to  fuse  it,  since  it  appears  better  when  simply  dried   and   granulated. 

This  salt  is  exceedingly  deliquescent,  and  should  be  inclosed  in 
small  and  closely  stopped  bottles  while  yet  warm.  It  may  be  crys- 
tallized with  twenty  parts  water  by  very  careful  evaporation.  Its  form 
is  the  cube,  its  taste  is  saline  and  cooling,  not  unlike  a  mixture  of 
common  salt  and  nitre,  and  quite  difFerejit  from  that  of  Iodide  of  Po- 
tassium. When  left  exposed  to  the  air  it  attracts  moisture,  and  becomes 
liquid.  It  is  soluble  in  and  compatible  with  most  tinctures,  infu- 
sions, decoctions,  and  extracts.  It  should  not  be  prescribed  in  pill 
or  powder,  on  account  of  its  deliquescent  property,  but  should  be 
given  in  solution,  for  which  its  not  unpleasant  taste  especially  fits  it. 
This  is  the  salt  which  exists  in  sea  water,  and  in  the  ashes  of  sea  weed, 
and  of  the  various  plants  which  grow  on  the  sea  shore.  Iodide  of 
Sodium  exists  as  such  in  the  "burnt  sponge;"  and  we  find  that 
Iodine  is  almost  always  found  associated  with  Sodium  in  nature.  It 
appears  to  prefer,   so  to   speak,   sodium   to   potassium  in   its  combina- 


Pharmaeeutical  Department.  511 

tions,  for  it  is  proved  that  Iodine  exists  very  mnch  more  abundantly 
in  plants  whose  ashes  are  rendered  alkaline  by  soda,  than  in  those 
in  which  potassa  abounds — in  marine  plants,  than  in  land  vegeta- 
tion. It  is  also  remarkable  that  this  metalloid  is  found  in  the  oil 
of  the  salt  water  fish  termed  Gadus,  to  which  class  the  cod  belongs ; 
but  it  has  not  been  discovered  as  a  necessary  element  in  the  tis- 
sues  of   land   animals. 

The  chemical  constitution  of  Iodide  of  Sodium,  compared  with 
that   of   Iodide   of   Postassium,   is   as  follows: 

Iodide  of  Sodium  consists  of 

Iodine,         .         .         .         84,45  per  cent. 
Sodium,        .         .         .         15.55     "       " 

Iodide  of  Pottassium  consists  of 

Iodine,         .         .         .         T4.2T  per  cent. 
Potassium,  .         .         25.73  per  cent. 

Showing  that  in  every  hundred  grains  of  the  former  salt  there  are 
10.18  grains  more  of  Iodine  than  in  the  latter;  and,  although  it  con- 
tains so  much  more  Iodine,  still  it  is  perfectly  neutral,  and  the  irritant 
quality  of   the  Iodine  is  completely  counteracted  by  the  base. 

Alexander  Ure,  Esq.,  Surgeon  to  St.  Mary's  Hospital,  London,  who 
has  used  this  salt  extensively,  with  a  view  to  test  its  value,  says: 
"As  far  as  my  experience  goes,  it  is  a  blander  salt,  more  assimilable 
and  better  borne  by  the  stomach  than  Iodide  of  Potassium.  It  is, 
moreover,  much  less  prone  to  produce  symptoms  of  iodic  disturbance. 
Patients  under  my  care  have  taken  it  for  weeks  together,  without  suf- 
fering the  slightest  inconvenience,  and  with  uniform  advantage  as  re- 
garded the   morbid  condition." 

He  further  says,  that  there  has  been  no  complaint  made  of  this 
medicine  producing  sense  of  weight  or  uneasiness  referred  to  the  stom- 
ach, nausea,  impaired  appetite  and  digestion,  headache,  running  from 
the  eyes  and  nostrils,  general  nervous  depression — symptoms  which,  at 
times,  supervene  during  the  administration  of  Iodide  of  Potassium,  even 
in    moderate  doses. 

An  argument  in  favor  of  the  use  of  this  salt,  is  taken  from  "  the 
important  view  first  announced  by  M,  Dumas,  in  the  92d  volume  of 
'Annale  de  Chimie,'  which  goes  to  show  that  there  are  certain  salts 
which  leave  the  blood  the  faculty  of  becoming  arterialized,  while  others 
deprive  it  of  this  property,  and  that  the  salts  having  soda  for  their 
base,  are  more  proper  to  maintain  this  condition  of  integrity  than  those 
of  potash  or  ammonia."  If  such  be  the  case,  it  may  fairly  be  assumed 
that  the  former  are  likely  to  exercise  a  more  favorable  remedial  influ- 
ence than  the  latter,  especially  if  exhibited  continuously  for  a  length  of 
time. 

Soda  variously  combined,  is  diffused  extensively  throughout  the  or- 


512  The  Peninsular  and  Independent. 

ganism ;  fully  five-sixths  of  the  saline  constituents  of  healthy  blood  con- 
sists  of  salt  of  this  base. 

M.  Gamberini.  in  Schmidt's  Jahrbreck  for  1858,  reports  116  cases 
of  secondary  syphilis,  which  were  treated  with  the  Iodide  of  Sodium, 
and  he  has  found  ^^hat  it  acted  more  rapidly  than  the  potash  salt,  and 
often  proved  efficacious  where  the  latter  salt  had  been  of  litile  or  no 
avail.  He  recommends  it  to  be  given  by  dissolving  twenty  grains  in 
three  ounces  of  distilled  water,  and  this  to  be  taken  in  broken  doses 
throughout  the  day;  after  a  few  days  the  amount  may  be  increased  to 
twenty -six  grains,  and  so  on  until  the  patient  comes  to  take  two 
drachms  daily,  the  time  for  taking  it  being  one  hour  before  meals.  It  is 
recommended  to  associate  five  or  six  grains  of  Bicarbonate  of  Soda 
with  it  to  counteract  the  acescency  and  the  consequent  liberation  of 
Aydriodic  Acid  in  the  stomach,  which  is  sure  to  cause  headache;  and 
the  best  plan  is  to   administer   it  dissolved  in   plenty  of  water. 

[Semi -Monthly  Med.  News. 


NEWS    ITEM. 

There  are  in  Prussia  about  seventy  -  five  manufactories  of  phospho- 
rus mutches.  These  present  annually  from  thirty -five  to  forty  cases 
of  maxillary  necrosis.  Those  workmen  were  more  especially  attacked 
whose  business  it  was  to  prepare  the  phosphorus  paste  and  dip  in  the 
wood.  In  all  cases,  the  disposition  to  this  affection  manifested  itself  to 
those  persons,  both  male  and  female,  who  were  of  a  cachectic  or  scrof- 
ulous habit,  and  had  carious  teeth  before  entering  the  factory.  On  this 
account,  it  is  not  proper  to  admit  to  this  occupation  sickly  persons, 
or  those  who  have   carious   teeth.  [  Vischeic^s  Constatt. 


■  THE  - 

PENINSULAR  and  INDEPENDENT 

MEDICAL  JOUMiL. 

Vol.  IL  DETROIT,  DECEMBER,  1859.  No.  9. 

Original  €Qmmniatins . 


ART.  mil.— Cathartics  in  Peritonitis,  etc. 


By  0.  C.  GiBBs,  M.  D. 


In  the  Peninsular  and  Independent,  for  November,  1858, 
we  made  brief  mention  of  a  case  wbicb  we  denominated 
obstruction,  which  was  overcome  with  copious  injections 
It  is  known  to  many  physicians  that  obstruction  has  dif- 
ferent causes,  and  that  that  condition  of  the  intestines  called 
intussusception  is  one  of  them. 

A  person  of  ordinary  common  sense,  in  reading  that 
article,  would  at  once  see  that  obstruction  caused  by  in- 
tussusception was  meant,  though  not  in  so  many  words 
stated.  No  other  interpretation  was  possible,  that  would 
not  make  absolute  nonsense.  In  the  Peninsular  and  In- 
dependent, for  June,  1859,  Dr.  J.  A.  Brown  criticises  the 
report  of  this  case  severely,  besides  introducing  much  ir- 
relevant and  uncourteous  matter.  Because  of  misstate- 
ments  and  personal  insults,  we   replied  ;    yet,  as  mildly  as 

Vol.  II.— 2H. 


514  The  Peninsular  and  Independent. 

the  circumstances  of  tlie  case  would  permit.  This  has 
called  forth  sixteen  pages  of  irrelevant  matter,  which  the 
Dr.    says  was    "aimed   to   l:e  courteous   and   gentlemanly." 

Where  the  Dr.  learned  such  "  courteousness/'  we  will 
not  ask ;  but  from  any  such  display  of  "  gentlemanly " 
criticism  on  our  own  part,  we  pray  to  be  forever  de- 
livered. 

In  Dr.  Brown's  first  criticism,  he  denied  the  correctness 
of  our  diagnosis,  ridiculed  our  treatment,  and  exclaimed 
"  what,  we  ask,  in  the  name  of  reason,  could  it  have  been 
but  peritonitis  ?  '^  He  concludes  by  saying,  "  had  the  case 
been  clearly  understood,  and  copious  blood-letting  resorted 
to  m  the  very  out  -  set,  and  perhaps  repeated ;  then  a 
brisk,  reliable  cathartic  given,  &c."  .  .  .  "the  result,  it 
seems  to   us,    might  have  been   different." 

In  our  reply,  we  endeavored  to  show  that  our  diagnosis 
was  probably  correct,  and  that  Dr.  Brown's  proposed 
treatment  was  more  objectionable  than  that,  over  which 
he  tries  to  make  so  merry.  This  called  forth  a  re- 
petition of  misstatement,  and  the  sixteen  pages  just 
alluded  to.  We  take  occasion  to  say  thus  early  in 
our  article  that  we  do  not  propose  to  exhaust  the  vo- 
cabulary of  scurrilious  remarks  ;  this  labor  having  already 
been  performed  by  our  critic.  In  a  discussion  we  have 
never  ascended  to  the  plain  of  personal  abuse,  and  still 
hope  we  never  may ;  preferring  the  loiver  walks  of  a  can- 
did expression  of  opinion,  or  the  humble  statement  of 
an  argument.  We  gave,  in  our  first  reply,  some  reasons 
why  we  thought  Dr.  Brown's  diagnosis  was  in  error, 
and  why  his  proposed  treatment  was  injudicious.  Those 
arguments  he  has  not  condescended  to  notice,  for  the  fol- 
lowing reason  which  he  states  :  "  we  do  not  choose  to  de- 
grade ourselves  to  the  sar)ie  level; "  —  that  is,  he  does 
not  choose  to  come  down  from  the  high  vocation  of  mis- 
statement   and   abuse,    to   the   low   duties   of    vulgar  rea- 


Cathartics  in  Peritonitis,  etc,  515 


soning.  We  do  not  choose  to  go  up  to  his  "  level "  ; 
hence,  thus  far  we  are  both  content,  and  now  to  the 
subject. 

In  Dr.  Brown's  last  article,  he  leaves  his  readers  to 
suppose  that  the  case  was  one  of  obstruction  from  hard- 
ened feces  (in  which  case  any  old  woman  would  know 
that  cathartics  would  have  been  appropriate),  and  labors 
hard  to  make  his  readers  believe  that  we  were  worse 
than   foolish  in   not    thinking  so[,  too. 

This  opinion  could  never  have  been  derived,  by  any 
intelligent  physician,  from  an  attentive  reading  of  either 
of  our  former  articles.  Does  Dr.  Brown  honestly  suppose 
that  we  meant  to  report  a  case,  in  which  we  had  forced 
imparted  feces  from  the  hoivels  up  into  the  mouth,  hy  an 
injection,  thus  overcoming  an  obstruction  ?  This  foolish- 
ness is  the  only  legitimate  conclusion  that  can  be  drawn 
from  his  last  article.  We  supposed  our  injection  had 
overcome  an  obstruction,  hy  reducing  an  intussusception, 
and   so   supposed    our  readers   would   understand  us. 

It  is  with  a  statement,  made  by  Dr.  Brown  in  his* 
first  paper  and  maintained  in  his  second,  that  we  have 
more  particularly  to  do  at  present ;  it  being  a  matter  of 
practical  import,  upon  ^the  right  understanding  of  which 
we  apprehend  the  highest  interests  of  many  are  involved. 
The  Dr.  asserted  the  case  to  be  one  of  peritonitis  in  his 
first  article,  and  thorough  cathartics  a  part  of  all  judicious 
treatment,  and  in  his  last  he  expresses  his  supprise  that 
we,  who  profess  (Dr.,  we  have  made  no  such  profession), 
such  familiarity  with  authors,  should  deny  this.  Dr.  Brown 
says : 

"Let  a  case  of  peritonitis  once  be  made  out,  and  there  can  be  bat 
little  chance  for  dispute  as  to  the  appropriate  treatment,  which  is  settled 
b}'-  authorities." 

That  authoritative  treatment,  he  maintains,  is  first  and 


5  16  The  Peninsular  and  Independent, 

most  important^  thorough  cathartics.  In  acute  peritonitis,  we 
believe,  active  cathartics  should  never  he  given.  We  believe 
that  a  worse  treatment  could  not  well  be  adopted,  nor  one 
better  calculated  to  cut  off  all  hopes  of  success.  For  our- 
selves, we  had  much  rather  the  bowels  would  remain  un- 
opened for  a  week,  than  to  be  moved  by  a  cathartic  until 
the  acute  inflammation  has  abated.  In  eleven  years'  prac- 
tice, we  have  lost  but  two  cases  of  acute  peritonitis,  and 
in  both  of  those,  occurring  when  young  in  practice,  council 
was  called  by  the  friends,  our  opinions  overruled,  and 
cathartics  given.  (Dr.  Beown  will  here  see  an  occasion 
for  using  those  '^courteous''  words,  "boasting",  "vanity", 
"egotism",  &c.)  In  this  discussion,  we  do  not  propose 
to  rest  the  argument  ujDon  our  own  opinions  or  experience, 
but  to  give  the  Dr.  a  chance  to  transfer  his  '^high-toned 
criticisms  "  to  the  opinions  of  others,  and  give  him  a  chance 
to  test  his  sharp  weapons  upon  the  caput  of  a  worthier 
combattant  —  considering  ourselves  used  up  when  he  called 
our  articles  "  puerile  productions."      Dr.  Brown  says  of  us  : 

"  Certainly  he  ought  not  to  complain  that  our  understanding  hap- 
pened to  be  more  rationed  than  his  own,  and  our  views  of  the  case  more 
consistent^  as  well  as  more  in  harmony  with  the  teachings  of  standard 
authorities^ 

We  ask  the  reader's  attention  to  a  few  authorities  only, 
premising  that,  independent  of  the  controversy,  the  subject 
is  worthy  of   attentive   consideration.     Dr.    Copland   says : 

"I  have  often  seen  much  mischief  result  from  the  oflBcious 
interference  of  the  practitioner  in  these  cases;  the  irritaMlity  of 
tJie  stomach  and  the  severity  of  tJie  disease  deing  heightened  by- 
repeated  endeavors  to  operate  on  the  bowels  by  drastic  purgatives  given 
by  the  mouth.  It  is  dest^  at  an  early  stage  of  the  disease,  to  loait  the 
effects  of  the  treatment  advised  above  for  a  reasonable  period,  and  then 
to  have  recourse  to  enemeta  containing  spirits  of  turpentine,  with  castor 
or  olive  oil,  or  with  both,  in  a  thick  decoction  of  barley.  —  (See  Cop- 
land's Dictionary  Medicine^  Yol.  3,  p.  56). 

It    is    impossible    to    cite    higher   authority;    but    our 


Cathartics  in  Peritonitis^  etc.  517 

readers    will  indulge    us  in  a  few    other   quotations.      Dr. 
Bkown  says : 

"  In  ordinary  peritonitis,  Watson  says  nothing  against  the  use  of 
purgatives,  &c."  '  , 

Let  us  see.  Under  the  head  of  acute  peritonitis,  he 
says  of  purgatives  : 

"  I  do  not  think  the  good  which  they  are  calculated  to  do,  as  an- 
tiphlogistic remedies,  can  at  all  be  put  in  competition  with  the  harm 
that  I  am  persuaded  they  may  produce,  by  increasing  the  peristaltic 
action  of  the  intestines,  and  so  causing  additional  friction  and  tension 
of  the  inflamed  membrane.  I  believe  that  in  all  cases  of  well  -  marked 
and  pure  peritonitis^  when  the  inflammation  is  limited  to  the  serous 
membrane,  it  is  far  'better  and  safer  to  restrain  than  to  solicit  the  in- 
ternal movements  of  the  alimentary  tube."  —  (See  Watson^ s  Lectures^  p. 
737,  of  the  3d  American  Edition). 

It  seems  that  Dr.  Brown's  misrepresentations   are  not 
confined   to   our  opinions  only. 
Dr.   Druitt  says : 

"The  author  hopes,  that  it  is  unnecessary  to  warn  his  readers 
against  the  fatal  and  ahomnihle  custom  of  giving  purgatives  in  cases  of 
inflammation  of  the  bowels. 

We  know  that  Druitt  speaks  only  of  inflammation 
produced  by  wounds,  but  the  principle  involved  is  the 
same.  But,  as  Dr.  Brown  may  refuse  to  listen  to  the 
opinions  of  foreigners,  we  quote  from  American  authors. 
Dr.  DuNGLisoN  says  : 

"Purgatives  ought  not  to  be  exhibited  until  the  inflammation  and 
spasm  are  abated  by  the  use  of  the  bleeding  and  opium." 

(We  quote  from  his  Dictionary^  p.  284  of  the  6th  edi- 
tion,   as  his  practice  is  not  before  us.) 

We  know  that  Dr.  Wood  advises  the  bowels  to  be  opened 
with  a  onild  cathartic,  in  connection  with  opium,  early  in 
peritonitis ;  but  we  also  know  that  he  made  a  report, 
before   the   College  of   Physicians,   Philadelphia,  Feb.  7th, 


518  The  Peninsular  and  Independent. 

1855,  upon  peritonitis  in   typhoid  fever,  in  which  he  does 
not  commend   cathartics.     He   savs  : 

"The  opiate  treatment  in  the  one  best  adapted  to  peritonitis  occurr- 
ing under  these  circumstances,  whether  with  or  without  perforation  ;  as 
several  instances  of  recovery  have  taken  place  under  that  treatment, 
while  I  am  not  aware  that  one  is  on  record  effected  under  any  other 
plan."  —  (See  Medical  Examiner  Vol.  11,  p.  238). 

Dr.  Rogers  says  of  peritonitis, 

"When  resolution  takes  place,  it  is  preceded  by  action  of  the 
bowels  and  gradual  subsidence  of  the  pain,  tenderness,  sickness,  and 
fever,  about  the  fourth,  sixth,  or  even  the  eighth  day.  This  result 
can  only  le  oltained  by  most  judicious  treatment;  but  when  mistaken, 
and  treated  too  actively  hy  large  and  repeated  hleedings,  or  violent  and 
continued  purgatives,  there  is  much  danger  of  a  fatal  termination,  or 
of  a  long  and  protracted  convalescence." — (See  British  Medical  Jour- 
nal, Sep.  17th,  1857. 

Prof.  Austin  Flint,  says : 

"Prof.  Clark  has  rendered  a  great  service  to  practical  medicine, 
and  to  humanity,  by  establishing  the  merits  of  this  (the  opium)  me- 
thod of  treating  acute  peritonitis.  If  pursued  judiciously  and  boldly, 
a  large  proportion  of  the  cases  which,-  judged  by  former  experience, 
would  have  otherwise  ended  fatally,  are  brought  to  a  favorable  termi' 
nation.  The  greater  success  in  the  management,  however,  it  must  be 
confessed,  may  be  in  part  owing  to  the  discontinuence  of  measures 
which  were  injurious.  Li  this  light  loe  must  regard  Mood -letting  and 
cathartics.  As  regards  blood'- letting,  a  fair  and  ready  way  of  placing 
before  the  mind  its  theoretical  applicability  to  the  treatment  of  peri- 
tonitis, is  to  consider  the  extent  of  surface  inflamed  in  this  disease, 
and  the  loss  of  blood- constituents  involved  in  the  exuded  products  of 
inflammation.  The  condition  of  a  patient  attacked  with  peritonitis,  is 
not  unlike  that  of  a  person  after  a  scald,  or  burn,  extending  over 
a  large  portion  of  the  external  surface  of  the  body.  The  symptoms 
are  analogous  in  the  two  cases,  and  death  in  both  occurs  by  asthe- 
nia. Blood-letting  is  as  appropriate  in  the  one  case  as  in  the  other. 
Of  catharthics,  it  is  only  necessary  to  say  that  they  conflict  with  the 
first  and  great  indication  in  the  treatment  of  all  inflammations,  viz., 
to  maintain,  as  far  as  possible,  repose  of  the  parts  inflamed.  The 
value  of  opiates  in  cases  of  peritonitis  consists,  in  fact,  of  the  arrest 
of  the  peristaltic  movements  of  the  intestines.  These  remedies  have 
held  so  prominent  a  place  in  therapeutics  for   the    last   half  century, 


Cathartics  in  Peritonitis^  etc,  519 

that  it  requires  some  moral  courage,  on  the  part  of  the  practitioner^ 
to  permit  the  bowels  to  remain  constipated  for  a  fortnight  or  longer^ 
and  to  resist  the  importunities^  of  patient  and  friends  for  opening  me- 
dicine."—  (See  Neio  Yorlc  Monthly  Eeview  for  October  1859,  pp.  26T 
and  268). 

Being  in  the  regular  receipt  of  twenty  of  the  American 
Medical  Journals^  and  three  foreign^  \i  would  not  be  dif- 
ficult to  protract  similar  quotations  to  those  above  (not 
"in  Heaven"  Dr.)  but  want  of  time  and  space  will  not 
admit.  Dr.  Bkown's  article  only  came  to  hand  this  even- 
ing, and  our  other  and  more  importaniD  duties  will  not  admit 
our  giving  more  than  this  evening  to  its  consideration  ; 
hence,  we  will  not  extend  our  researches  or  protract  quo- 
tation. 

Will  the  Dr.  still  maintain  that  his  proposed  treat- 
ment in  peritonitis,  is  "more  consistent''  than  ours,  and 
"more  in  harmony  with  the  teachings  of  standard  au- 
thorities ?  "  Will  he  still  maintain,  that  in  peritonitis,  the 
propriety  of  "thorough  cathartics''  is  "settled  by  author- 
ity ? "  He  will  probably  say,  as  he  has  already,  that 
these  men  are  only  "falliablcj  and  liable  to  error,  incon- 
sistency, &c.",  "and  entitled  to  no  respect"  when  their 
teachings  do  not  commend  themselves  to  "an  enlightened 
reason,"    such  as   Dr.    Brown  brings   to   this  investigation. 

Our  readers  will  not  need  to  be  told  that  our  remarks 
upon  cathartics  in  peritonitis,  have  no  reference  to  our 
reported  case,  but  to  Dr.  Brown's  construction  and  argu- 
ment. 

Our  case  was  not  originally  a  case  of  peritonitis  at  all. 
We  supposed  it  to  be  a  case  of  obstruction^  caused  hy 
intussusception  J  and  we  supposed  the  obstruction  was  re- 
moved by  a  reduction  of  the  intussusception,  by  the  mecha- 
nical means  put  in  requisition,  and  because  we  so  thought, 
was  the  case  reported,  and  would  be  readily  so  understood 
by  any  medical  man  who  occupies  our  "  level,"  to  which  Dr. 


520  The  Peninsular  and  Independent. 

Brown  says  he  is  not  "weak  enough"  to  "  degrade '^ 
himself. 

Dr.  Brown  will  doubtless  tell  us  that  his  advice  was 
predicated  upon  the  supposition  that  the  case  was  one  of 
obstruction  from  hardened  feces  !  !  Our  article,  to  which 
we  refer  the  reader,  never  justified  any  such  inference  ; 
besides,  did  he  not  say  the  case  could  have  been  nothing 
else  hut  peritonitis  ? 

Be  the  case  what  it  might,  whether  peritonitis  or  ob- 
struction from  intussusception,  which  last  it  doubtless  was, 
we  wish  to  ask  Dr.  Brown  one  question,  and  we  hope  he 
will  give  us  a  direct  answer ;  he  can  accompany  his  an- 
swer with  sixteen  images  of  irrelevant  matter  if  he  chooses, 
—  we  are  indifferent  on  that  point.  Would  he,  in  either 
case  supposed,  where  nothing  could  be  retained  upon  the 
stomach,  persist  for  days  together  in  tormenting  the  pa- 
tient with  repeated  p)urgatives  ?  If  so,  we  hope  he  may 
never  be  called  to  administer  to  us,  or  any  of  our  friends, 
so  long  as  we  desire  to  keep  soul  and  body  a  little  longer 
together. 

We  would  gladly  stop  here,  but  there  are  one  or  two 
points  in  the  Dr's.  last  article  which  require  attention.  It 
will  be  remembered  that  Dr.  Brown's  first  article  was 
filled  with  misstatements  and  unprovoked  charges.  Among 
the  least  important  of  the  latter^  was  that  of  our  vain 
desire  to  aj)pear  in  print  with  nothing  to  say.  We 
replied,  in  effect,  that  it  was  our  study  to  use  as  few 
words  as  possible  to  express  our  idea,  and  that  the  article 
criticised  (excuse  the  misnomer),  was  not  our  maiden 
effort.  We  had  occasionly  appeared  in  print  for  the  last 
fifteen  years,  and  some  foreign  journals  had  been  foolish 
enough  to  make  extracts  from  a  few  of  our  "  puerile  j)ro- 
ductions.''  Thinking  our  captious  critic  would  fancy  he 
saw  egotism^  we  marked  this  portion  of  our  reply,  and 
suggested  that  perhaps  it  might  better  be   omitted.     With 


Cathartics  in  Peritonitis^  etc.  521 

commendable  courtesyj  our  article  was  permitted  to  appear 
as  written,  and  Dr.  Brown,  over  the  slioulders  of  a 
Chicago  friend,  virtually  charges  us  with  falsehood.  We 
are  now  compelled  to  brave  another  charge  of  egotism,  by 
referring  him  and  his  friend  to  the  British  &  Foreign 
Medico  -  Ghirurgical  Beview,  for  January  1858,  and  July 
1859,  and  Banking's  Abstract,  for  January  1858.  Other 
references  could  be  made,  but  we  hope  these  will  satisfy 
that  friend,  and   relieve   us   from   the   charge   of  falsehood. 

Dr.  Brown  charges  us  with  "malicious  misrepresen- 
tation." This  is  a  grave  charge,  and  we  now  challenge 
him  to  the  proof.  We  have  carefully  re-read  the  articles, 
and  can  find  but  one  apology  for  this  assertion,  and  that 
we  will  now  quote. 

Dr.  Brown  said  that  we  used  ^' solid  opium  for  three 
or  four  days  together,  with  little  or  nothing  else.''  (  This 
question  is  correct,  and  |the  italics  his). 

In  our  apply,  we  said  that  our  critic  said  "  that  for 
four  days  we  used  nothing  else  but  solid  opium.'' 

Thus  it  will  be  seen  that  we  omitted  the  word  "little/' 
which  omission  our  readers  will  see  did  not  materially 
change   Dr.  Brown's  meaning.     To  this  he  replies  : 

""What  quibbling!!  Are  we  to  look  upon  this  as  malicious  false- 
hood? or  are  we  to  infer  his  want  of  a  knowledge  of,  and  ability  to 
understand,   the  English  language?" 

Our  readers  will  appreciate  sucb   dignified  courtesy. 

But  let  us  see  wbo  is  guilty  of  "malicious  misrepre- 
sentation." 

In  our  first  article  we  said  the  bowels  were  "  tender 
on  pressure,"  but,  not  knowing  that  such,  a  "critic"  as 
Dr.  Brown  had  a  being,  we  did  not  specify  the  exact 
locality  of  the  tenderness.  In  our  second  we  said,  what 
was  correct,  that  "  the  bowels  were  soft  and  painless,  ex- 
cepting a  spot  that  could  he  covered  with   the  palm  of  the, 


522  The  Peninsular  and  Independent. 

hand,  in  the  region  of  the  ilio  -  coecal  valve."  If  there  is 
any  incongruity  here  we  fail  to  see  it.  Dr.  Brown,  pre- 
tending to  quote  from  our  first,  charges  us  with  saying 
the  bowels  ^'were  painful  and  tympanitic/'  and  in  our 
second,  that  "the   bowels   were  soft   and  painless." 

The  first  pretended  quotation,  is  a  fahrication,  and  the 
second  a  simple  perversion.  Is  this  a  "malicious  misre- 
presentation," or  a  dignified  and  courteous  criticism  ? 

In  our  report,  we  stated  that  calomel  and  opium  was 
given  from  the  first.  From  the  morning  of  the  third  to 
the  morning  of  the  fourth  day,  we  said  castor  oil  was  given 
in  tablespoonful  doses  every  hour  (12  ounces  in  all),  and 
that  because  the  stomach  would  retain  nothing,  we  gave 
cathartic  doses  of  infusion  of  senna  per  rectum  repeatedly. 
In   the  very  face  of  this,  Dr.  Brown   says  : 

"Little  or  nothing  but  solid  opium  was  given  for  three  or  four 
days." 

Our  first  report  states  that  on  the  fourth  day  calomel 
and  blue  pill  was  given  in  four  grains  every  two  hours, 
which  was  continued  for  sixteen  hours  (making  32  grains), 
when  calomel  was  given  in  5  grain  doses  every  three 
hours,  for  two  days  (making  80  grains  of  calomel  in  ad- 
dition). Of  this  we  reminded  our  critic  in  our  second 
article,  and  he  replies  that  nothing  but  opium  was  given 
"in  anything  like  sufficient  quantities  to  j^i'oduce  cathar- 
sis", and  then  says  of  us  : 

"  If  a  gentleman  we  shall  expect  him  to  make  the  amende  honoralle.''^ 

Could  human  impotence  farther  go  ? 

There  are  many  other  points  in  Dr.  Brown's  last  paper 
that  deserve  attention,  but  we  forbear.  We  always  court 
candid  criticism,  and  we  are  happy  to  see  our  opinions  put 
to  the  rigid  test ,-  but  we  can  not  say  that  we  particularly 
admire  that  style  of  criticism  inaugurated  by  Dr.  Brown, 


Cathartics  in  Peritonitis^  etc.  523 

and  we  regret   that  we   liave   been  compelled  to  make  ex- 
planation, and  expose  his  want  of  honor  and  veracity. 

In  conclusion  we  might  pay  a  passing  tribute  to  Dr. 
Bkown's  "courteous  and  gentlemanly"  bearing,  his  "mo- 
dest and  reserved"  department,  "common  sense  criticism" 
and  "  matter-of-fact  statements,"  which  he  boasts  as  having 
characterized  him  in  his  unprovoked  attack  —  traits  which, 
as  developed,  are  in  this  vicinity  denominated  by  other 
adjectives ;  but  we  forbear,  conscious  that  our  space 
can  be  converted  to  a  better  purpose.  We  are  will- 
ing Dr.  Brown  should  occupy  alone  and  uncontes- 
ted the  peerless  realm  of  "modest",  "courteous",  and 
"gentlemanly"  criticism.  To  contest  with  him  for  the 
palm  in  this  direction  we  have  no  hopes,  and  certainly  no 
ambition.  We  would  suggest  to  the  proprietors  of  the 
North  American  Medico-Chirurgical  Bevieio  that  they  take 
our  humble  name  from  their  list  of  collaborators,  and  sub- 
stitute that  of  J.  A.  Brown,  M.  D.,  as  he  would  doubtless 
add  new  and  increased  lustre  to  their  pages,  by  his  new 
style  of  criticism.  Such  wit  {?)  and  wisdom  will  doubtless 
shed  new  light  upon  the  dark  and  obscure  subjects  of  our 
science,  but  whether,  ignus  fatus-like,  only  to  deceive,  or 
like  the  sun  of  unmistakable  truth,  our  readers  will  each 
judge  for  himself. 

We  now  take  leave  of  Dr.  Brown,  reminding  him  that 
the  '' pump-operator y'  in  cases  of  peritonitis,  notwithstand- 
ing his  sickly  attempt  at  burlesque,  is  in  the  path  of  duty, 
acting  "in  harmony  with  the  teachings  of  standard  author- 
ities," while  the  ^physic  dispenser,  in  such  cases,  is  doing 
violation  to  authorized  treatment,  tormenting  the  patient, 
and  is  greatly  conducive  to  the  fatal  issue. 

Fkewsbury,  N.  Y. 


524  The  Peninsular  and  Independent} 


ART.  IXXIII.— Studies  for  the  Elucidation  of  tlie  Clironic  Inflam- 

mation  of  the  Uterus.* 


Translated  for  the  "Peninsular  and  Independent,"  from  the  German  of  M. 
M.  Jacobivics.     By  0.  D.  Palmer,  Zelinople,  Pa. 


The  details  of  the  differential  diagnosis  are  especially  in- 
teresting to  the  physician,  when  he  is  placed  in  a  position 
where  he  may  call  be  called  upon  to  pronounce  a  decisive 
opinion,  in  regard  to  cases  more  or  less  comj^licated,  in  prac- 
tical life. 

In  uterine  cases  the  question  arises :  which  have  we  to 
deal  with,  a  pliysiological  or  a  diseased  state,  and  with 
what  disease  ?  These  queries  are  the  more  difficult  of  solu- 
tion, the  more  scrupulousl}^  and  fundamentally  accurate  we 
may  desire  to  answer  them. 

In  the  scientific  organ  of  the  "  Doctorem  Gollegiums,'' 
27th  No.,  we  recently  indicated  the  correct  distinctions, 
necessary  to  be  observed,  in  the  developing  stage  of  chronic 
metritis  ;  that  is,  1st,  the  stage  of  congestion  ;  2d,  the 
stage  of  exudation,  and  3rd,  that  of  ulceration. 

The  symptoms  of  congestion,  and  hypersemia,  hardly 
afford  occasion  for  being  confounded. 

The  phenomena  of  ulceration  consequent  to  chronic  in- 
ffammation  of  the  uterus,  demand  a  special  and  extended 
consideration. 

We  will  permit  ourselves  here  only  to  make  an  ex- 
amination of  the  stage  of  exudation,  the  so  -  called  en- 
gorgement of  the  womb,  the  infarctus  uteri  in  the  true 
sense  of  the  phrase. 

The  pathological  symptoms  of  this  morbid  condition  are  : 

The   increased    volume   of    the    uterus,   the   fundus    of 
which  rises   from   one  to   two   inches  above   the  symphasis 
pubis,  the   vaginal  portion,    from   one   to   one   and   a    half 

*  From  the    "  0 ester reichische  Zeitschrift  fiier  PractUche  EeilTcundef 


Chronic  Inflantmation  of  the   Uterus.  525 

inches   transverse   measurement,   and   the   long  diameter  of 
the   uterine   cavity,    increased   from   one  to   two   inches. 

Altered  position,  where  the  fundus  is  found  directed  more 
forward,  and  the  lower  segment  more  towards  the  hallow 
of  the  sacrum. 

Altered  texture^  in  which  the  gestative  organ  is  much 
thicker,    more   dense,  and   more   indurated. 

Increased  weight  of  the  uterus. 

Uterine  catarrh  —  dismenorrhea,  progressing  into  ame- 
norrhsea  —  colica  spasms  of  the  uterus  —  smarting,  burning, 
and  prurities  of  the  vagina,  and  of  the  external  parts  of 
the  sexual  organs. 

The  local  -  consensulle  (ita?)  symptoms  are  Dysuric 
DysJcoelic  sensations  of  pain  and  lassitude,  in  the  upper 
part  of  the  thigh. 

As  the  effect  of  general  consent,  there  arises  at  a  later 
period  deranged  digestion,  deranged  assimilation,  and  finally 
the  train  of  symptoms  indicating  a  chlorotic  and  hysteric 
condition. 

We  have  thought  proper  to  recall  these  well  known 
details,  in  order  more  easily,  without  repetition,  to  be  able 
to   indicate   the   more   permanent  diagnostics. 

It  is  one  of  the  most  important  questions  in  practice, 
and  one  of  the  most  frequent  ones,  how  in  a  given  case, 
to  distinguish  pregnacy  from  a  diseased  state  of  the  or- 
gan of  gestation. 

My  memory  contains  instances,  in  which  a  woman  has 
been  presumed  to  be  in  a  state  of  gestation,  through  the 
regular  term  of  nine  months,  and  only  after  the  tenth  or 
eleventh,  when  no  birth  made  its  appearance,  has  she 
been  acknowleded  as  suffering  with  an  uterine  affection 
and   properly  treated  for  such. 

I    lately   recognized    a   similar   affection    in   a  woman 

who   anxiously  inquired   of    me   if    it   were   true   that   she 

was  pregnant   of   a  male,    as  informed  by  her  attendant, 

On  the  other  hand,   I  recollect  of  a  young  lady,  sever- 


526  The  Peninsular  and  Independent. 

al  years  married,  without  children,  who  had  been  treated 
for  infarctus  uteri  and  amenorrhoia,  with  hip  and  vapour 
bath,  with  buttermilk  and  mineral  water,  till  the  sup- 
posed pathological  state  was  relieved  by  the  birth  of  a 
child  at  maturity. 

In  order  to  avoid  similar  mistakes,  we  should  make 
searching  examinations  into  the  absence,  or  presence,  of  the 
symptoms  of  j^i'^gnancy.  We  should  keep  in  mind  that 
the  2^^'^^^^  vaginalis  of  the  gravid  uterus  is  always 
shorter  and  softer,  whilst  in  infarctus  uteri,  it  is  harder 
and  more  voluminous  than  in  the  natural  state.  In  these 
cases  we  should  give  a  decided  ojiinion  only  after  a  longer 
observation,  and  repeated  explorations.  We  should,  in 
such  cases,  ever  avoid  the  use  of  the  uterine  sound,  and 
prescribe  no  medicine  that  might  derange  the  normal 
course  of  gestation. 

If  it  should  be  properly  decided,  by  the  more  or  less 
regular  return  of  menstruation,  by  the  absence  of  other 
symptoms  of  graviditas,  that  no  pregnancy,  but  a  real  mor- 
bid condition  of  the  uterus,  demands  our  aid,  we  must 
still  bear  well  in  mind  that  many  of  the  appearances, 
described  as  i)athognomical  of  the  inception  of  infarctus 
uteri,  are  likewise  recognized  as  symptoms  of  anomylous 
derangement  of  position,  volume,  or  texture,  or  other  morbid 
action  of  this  organ,  and  therefore,  in  order  to  acquire  a 
correct  knowledge  of  these  states,  a  thorough  radical  ex- 
amination in  each  individual  case  is  rendered  indispen- 
sibly  necessary. 

The  inclination  forwards  of  the  unimpregnated  womb, 
is  very  well  characterized  (as  is  also  infarctus  uteri)  by 
the  dragging  sensations,  joain  in  the  sacral  region,  in  the 
epigastrium  —  by  symptoms  of  disnienoro^liea  —  by  an  ur- 
gency to  urinate,  obstinate  costiveness,  &:c.,  but  this  simple 
state  of  mal- position,  \2^q\i.  the  other  anomylous  secretions, 
and   the  farther  train  of  sympathetic  actions,  belonging  to 


Chronic  Inflammation  of  the   Uterus.  527 

chronic  metritis.  A  nice  discrimination  between  these  dif- 
ferent morbid  conditions,  can  only  be  effected  by  local  ex- 
plorations. In  the  forivard  inclination  of  the  uterus,  the 
vaginal  portion  is  found  high  up  in  the  hollow  of  the  sac^ 
rum,  the  body  of  the  womb  lying  obliquely  towards  the 
symj)hasis,  so  that  we  can  feel  through  the  distended  in- 
teguments in  front,  the  vaulted  arch  made  by  its  fundus, 
and  the  horizontal  position  can  be  determined  by  the  ex- 
ploring finger. 

In  the  engorgement  of  the  uterus,  we  can  feel  by  its 
vaulting  the  vagina,  that  the  loortio  supra  vaginalis  de- 
viates slightly  from  the  line  of  axis  of  the  pelvis,  and  the 
incre  ise  in  volume  of  the  whole  body  of  the  womb,  is 
readily  perceived. 

The  foriuard  inclination  of  the  uterus,  in  a  small  de- 
gree, simll  ites  very  much  the  symptoms  of  infarctus  uteri; 
but  an  auti -version  of  a  greater  grade,  of  this  affection, 
may  be  esteemed  a  significant  complication,  inasmuch  as 
the  displacement  of  the  os  uteri  from  its  normal  position, 
in  being  directed  backwards,  may  become  a  constant  hin- 
drance to  conception. 

The  dislocation  of  the  uterus,  the  ante  and  ret7^o  -flec- 
tions of  this  oro'an,  brin«:  with  them  a  train  of  local  and 
constitutional  disturbances,  very  similar  to  infarctus  uteri. 
Whether  the  one  or  the  other  of  these  organic  affections 
is  present  in  a  given  case,  again,  can  only  be  determined 
by  careful  and  thorough  local  investigations. 

The  points  of  union^  and  of  departure,  in  these  morbid 
states  of  the  gestative  organ,  and  the  method  of  exploring, 
necessary  to  their  being  properly  understood,  are  in  many 
respects,  practically,  of  such  weighty  import,  that  we  in- 
tend at  some  future  period  to  give  to  their  study  a  more 
extended  consideration. 

Hypei^trophy  of  the  uterus,  as  is  well  known,  consists 
in  an  increase  of  its  compass,  as  compared  to  the    normal 


528  The  Peninsular  a7id  Independent. 

proportions  of  its  structure,  in  such  an  uniform  enlargement 
of  its  histological  element,  that  epithelial,  peritoneal,  and 
muscular  coats^  are  found  increased  in  a  symetrical  proportion. 

On  the  other  hand,  in  an  enlargement  of  the  uterus, 
the  enlargement  and  thickening  of  the  peritoneal  coat  is 
predominant,  whilst  the  other  elements  of  the  parenchyma, 
particularly  the  muscular  fibres,  are  atrophied  ;  their  place 
substituted  by  the  exuberent  cellular  membrane  and  ves- 
sels, particularly  veins  and  lymphatics,  which  are  made 
impermeable. 

Whether   the   nerves  of   the   uterus,   likewise,   suffer   a 
fatty ^  colloid^  or  amyloid^  metamorphosis,  in  this  affection, 
as  happens  in  the  accumulation  of  the  cellular  membrane,  I 
have   not   as   yet   had   sufficient   grounds   to   determine. 

These  pathilogico  -  anatomical  j)eculiarities,  may  be  sig- 
nalized   also   by   indications   during   life. 

Kennedy,  of  Dublin,  remarked  twenty  years  since,  that 
in  hypertrophy  of  the  uterus,  especially  of  the  collum, 
and  of  the  labii  orificii,  the  increase  in  volume  progress- 
ed more  in  length,  whilst  in  the  remaining  diseases  of 
the  womb,  depending  on  a  pathic  mutation  of  texture, 
the  increase  was  found  to  be  more  in  the  transverse  direction. 

Hypertrophies  of  the   cervix  uteri,  have  been   described 

by  Petrikin,  equalling  a  finger's  length,  and   also  by  Lis- 

"franc,  Dupuytren,  Scanzoni,  and  particularly  by  the  two 

last,  who  by  exercising,    cured   both    this    disease  and  the 

sterility  connected  with   it. 

The   vaginal   portion  of  the   uterus,    at  times,    reaches 
five   and   six  inches  in   length,    and  this  pathological  state 
has    been,    in   modern  times,    more   perfectly   described  by 
YiRCHORR,  as  a  proboscis  -  formed^  or  polypus  -  like,  elonga- 
tion of  the   lips  of  the   os   uteri  (Scanzoni). 

From  all  these  conditions  the  chronic  infarctus  uteri 
is   distinguised,  by  its  characteristic  symptoms,  very   easily. 

The  temporary  hypertrophy,  or  more  properly  the  con- 


Chronic  Inflammation  of  the   Uterus .  529 

gestive  intumescence,  of  the  organ  of  gestation^  mentioned 
by  Newman  as  an  anomaly,  usually  appearing  in  conse- 
quence of  the  suppression  of  the  menses  in  elderly  women, 
and  which  relieves  itself  by  a  profuse  return  of  this  flux, 
is  distinguished  by  its  temporary  arrival  and  disappearance, 
from  the  more  enduring  uterine  engorgement. 

Let  us  now  consider  the  mutations  of  the  texture  in 
the  uterus,  the  confounding  of  which,  with  the  affections 
above  spoken  of,    must   be  avoided. 

From  the  violent  attacks  of  acute  inflammation  of  the 
uterus,  the  chronic  can  easily  be  distinguished,  by  the 
absence  to  the  latter  of  febrile  excesses,  and  the  inten- 
sity of  the  local  symptoms  ;  on  the  other  hand,  this  lat- 
ter is  characterized  by  its  long  enduring  course  and  by 
its  increase  in  volume. 

The  sub  acute  inflammatory  process,  occurring  as  exa- 
cerbations of  the  chronic  metritis,  are  peculiar  to  its 
decursus,  and  challenge  the  most  scrupulous  attention  in 
therapie,  since,  during  these  less  -  intense,  long  -  continued 
inflammatory  attacks,  the  magnitude  of  the  uterus,  and 
its   morbid   metamorphosis,  are   increased. 

In  relation  to  the  texture  and  the  alteration  of  the 
consistency  belonging  to  it,  we  have  to  decide  in  each 
case  that  we  see  —  whether  we  have  to  do  with  an  or- 
dinary infarctus  uteri,  or  with  a  specific  induration  of  the 
womb,  and  in  fact,  whether  with  a  healthy  or  ivell  dis- 
posed hardening,  or   one  of  a  schirrous  nature. 

Before  we  proceed  to  the  answer  of  these  queries  it 
may  be  well,  in  this  place,  to  put  into  the  scales  some 
relevant  observations  of  Prof.  Enzel,  extracted  from  his 
Compend  of  Pathological  Anatomy.  We  here  cite  his 
own  words  : 

"The  healthy  uterus  of  a  woman,  yet  young,   has  so  much  firm- 
ness and  solidity,   that  it   can  neither  be   cut    nor   torn.     An   increase, 
therefore,  of  its  firmness  and  solidity,  is  scarcely  suppossible,  since  it 
Vol.  II.  — 21. 


530  The  Peninsular  and  Independent, 

possesses  already,  near  the  greatest  hardness  that  it  is  possible  for  an 
organic  part,    not   bone,  to   have. 

"  The  cervix  ttteri^  and  vaginal  portion  of  the  uterus  surpass  in 
hardness,  if  still  possible,  the  uterine  web,  and  when  the  vaginal 
portion  seems  softer,  its  cause  is  founded  in  the  fact,  that  it  is  en- 
veloped in  a  layer  of  loose  cellular  tissue  beneath   the   mucous  coat, 

"Induration  of  the  uterus  has  then  no  determinate  meaning;  it 
effects  no  other  changes  than  those  of  form,  dimensions,  etc.,  it  is 
therefore  no  diseased  state;  should  it,  as  in  the  Idbuim  oris  uteri  be 
connected  with  an  increase  of  volume,  without  creating  an  alteration 
of  texture  itself,  it  would  then  be  well  worthy  our  observation  as  a 
well  conditioned  induration,  not  admitted  within  the  circle  of  pa- 
thology." 

Only  wlien  the  increased  hardness  of  the  uterus  is 
united  with  an  alteration  of  texture,  does  the  induration 
enter  the  precincts  of  pathology;  and  it  then  is  not  called 
a  simple  hardening;  but  a  compated  condition  of  the  viscus. 

"The  physician  then,  in  examining  a  living  person,  must  con- 
sider especially  the  size  and  form  of  the  organ  without  reference  to 
hardening." 

The  so-called  good  conditioned  hardening  of  the  uterus, 
which  the  G-ynacolleages  of  the  French  describe  under 
the  name  of  "  induration  blanche  simple/'  is  a  symmetrical 
enlarged  hardness  of  the  cervical  part,  having  an  almost 
normal  color,  and  is  often  suddenly  manifested  without 
its  causing  the  many  local  and.  general  symptoms  proper 
to  infarctios  uteri,  and  the  induration  thus  named  may 
be   esteemed   a  milder   grade   of  engorgement. 

More  important  still,  but  in  many  instances  more  dif- 
ficult, is  it  to  decide  between  simple  infarctus  of  the  os 
uteri  and  a  schirrus  induration  not  ulcerated.  The  occa- 
sional local  affections  —  the  degree  of  hardness  —  its  want 
of  symmetry,  etc.,  give  no  sufficient  standard  for  a  safe 
differential  diagnosis ;  and  we  must  ground  our  approxi- 
mate opinion  essentially  upon  the  general  symptoms : 
the  disposition,  the   age^   the   constitution   of  the   patient, 


I 


Chronic  Inflammation  of  the  Uterus.  631 

the  successive  developments^  and  tlie  progress  of  the  dis- 
ease, its  action  on  the  remaining  organism,  in  short,  on 
the  whole  elements  of  an  elaborately  detailed  history, 
with   the   most  sifting  precision  possible. 

According  to  the  opinion  of  Kokitansky  tubercular 
deposition,  and  also  uterine  tuberculosis  is  the  product  of 
inflammation;  these  assume  likewise,  at  the  commence- 
ment, so  far  as  their  local  symptoms  are  concerned,  some- 
what the  appearance  of  chronic  nutritis ;  and  in  the 
farther  effects  of  these  the  parenchyma  of  the  uterus,  that 
part  which  has  not  degenerated  into  tubercules,  is  found 
in   the   state  of  chronic  infarctits. 

The  cases  in  which  tuberculoses,  with  the  general 
system  unaffected,  selects  the  uterus  for  its  head  quarters, 
are   but   seldom,    yet   such   do   occur. 

But  should  tuberculoses  affect  primarily  the  uterus, 
we  may  avoid  confounding  it  with  infarctus  by  the  fol- 
lowing facts :  Uterine  tuburculosis  has  its  seat  generally 
in  the  mucous  membrane  of  the  body  and  fundus  of  the 
womb.  It  is  abruptly  confined  (according  to  Scanzoni's 
observations)  to  the  region  of  the  os  uteri  interiorly,  and 
when  in  the  more  severe  grades  of  this  disease,  it  spreads 
to  the  cervix  ;  this  happens  only  in  the  form  of  solitary 
tubercles,  scattered  over  the  mucous  membranes  of  the 
vagina. 

On  the  contrary,  in  the  infarctus  uteri,  the  morbid 
action  is  constantly  to  be  found  affecting  the  lower  seg- 
ments  of  the   womb. 

In  uterine  tuberculosis  there  exists  but  very  spare 
menstruation  or  absolute  amenorrh^,  but  then,  in  conse- 
quence of  an  erosion  of  the  uterine  vessels,  metorrhagia 
or  menorrhagia  supervenes.  On  the  external  surface  of 
the  vaginal  portion,  scarcely  altered  in  thickness  and  length, 
are  found  the  whitish  gray  tuberculous  granulations  re- 
ferred to. 


532  The  Peninsular  and  Independent. 

As  has  been  remarked  by  Vogel,  Wedl,  and  others,  the 
tubercular  pus,  under  the  microscope,  does  not  exhibit  the 
regular  pus  and  mucous  globules  proper  to  this  secretion, 
but  for  the  most  part  separate,  and  solitary  amorphous 
molecules,  a  mass  of  fatty  corpusculea,  granules,  and  im- 
perfect cell  formations. 

In  the  initial  developments,  considerable  fibrous  polypi 
and  small  fibroid  projecting  into  the  interior  cavity  of 
the  uterus,  beget  local  symptoms  analygous  to  those  of 
uterine   engorgement. 

Menstruation  may  serve  as  an  important  distinguishing 
trait  between  these  morbid  states.  As  before  mentioned, 
this  is  very  much  diminished  in  the  infarctus  uteri,  whilst, 
in  regard  to  mucous  polypi,  it  is  very  abundant  in  quan- 
tity,   duration,    and    repetition. 

Larger  submucous  fihroide  and  intervaginal  p)olypi 
generally  cause  a  greater  distention  of  the  cervical  cavity 
and  of  the  uterus,  thereby  shortening,  by  over -distention, 
the  vaginal  portion  of  the  uterus,  whilst,  on  the  contrary, 
in  infarctus  uteri  it  is  constantly  considerably  increased  as 
well  in   length   as   in  its   oblique  diameter. 

The  larger  subperetoneal  fihroide  is  distinguished  from 
the  engorged  fundus  uteri,  as  it  2)rojects  over  the  sym- 
phasis,  by  the  more  uneven  surface,  whilst  its  projection 
is  more  abruptly  bounded   in   shaj^e. 

We  must  finally  mention  still  a  rarity  in  pathology, 
the  symptoms  of  which  in  life,  would  be  the  a23pearance 
of  an  irritable  state  of  the  womb.  We  allude  to  para- 
sites  in  the  substance  of  the   maternal   organ. 

EoKiTANSKY,  HiSLOP,  and  Wilson,  of  England,  have 
observed  ecliinococcus  sacks  or  bladders  in  the  parenchyma 
of  the  uterus,  which  sometimes  contained  a  greater,  some- 
times a  smaller,  number  of  fraternal  bladders.  In  some 
of  these  cases,  but  very  seldomly,  these  bladders  were 
emptied  through  the  vagina ;  in  others  they  caused  rupture 


Chronic  Inflammation  of  the  Uterus.  633 

through  the  walls  of  the  uterus^  and  were  discharged  into 
the  cavity  of  the  uterus,  thereby  causing  fatal  hemorrhagus 
and   peritonitis. 

We  have  thus  indicated  the  outlihes  of  those  organic 
diseases  of  the  organ  of  maternity,  which  may  at  times  as- 
sume the   form  of  uterine  infarctus. 

Cases  may  happen  much  more  oftenly  in  which  in- 
farctus uteri  is  confounded  with  the  above  mentioned 
states  of  the  womb,  where  symptoms  of  these  affections, 
originating  in  the  general  consent  of  the  parts  in  imme- 
diate contiguity,  may  be  mistaken  for  the  primitive  essential 
disease,  and  a  treatment  may  be  prescribed  for  a  long 
time  in  opposition  to  diseases  of  the  liver,  stomach,  and 
abdomenal  organs,  all  in  vain,  or  against  rheumatism,  con- 
vulsions, and  hemorrhoids,  till  at  length  the  original  source 
of  the  chamelion  -  like  symptoms  are  better  understood, 
and  the  plan  of  treatment  is,  to  the  benefit  of  the  patient, 
essentially  re  -  considered.  Therefore,  in  order,  to  obtain  a 
correct  knowledge  of  the  evil  in  female  diseases,  and  to 
give  the  desired  clearness  to  the  diagnosis,  it  is  necessary 
to  institute  investigations,  the  most  circumstantial  possible, 
and  to  reduce  to  an  essential  postulate,  an  estimation  of 
all  the  circumstances  of  the  disease.  If  it  is  necessary 
to  make  explorations,  the  most  detailed  and  thorough  pos- 
sible to  be  effected,  in  the  diseases  in  every  morbid  form  ; 
then,  in  female  diseases,  it  can  not  be  too  strongly  im- 
pressed, that  only  by  the  most  accurate  examinations  in 
all  particulars,  can  the  probabilities  be  determined,  and 
thus  only  can  be  obtained  a  coincidence  in  judgment  of 
the  different  colleagues  consulted,  whilst  insufficiency  of 
investigation  very  easily  gives  occasion  to  difference  in 
opinion  among  physicians,  and  the  want  of  harmony  in 
the  various  diagnoses,  pronounced  by  men  of  the  same 
profession,  contribute  far  less  to  the  cure  of  either  the  one 
or  the  other,  but  abundantly  more  to  the  diminution  of 
the   general  confidence  in   science   and  the  art   we  profess* 


534  The  Peninsular  and  Independent. 


ART.  XXXIV.— What  is  the  Proper  Dose  of  Opium  in  Dysentery?* 


I  have  been  led  to  a  consideration  of  this  subject 
from  the  fact  that  authorities  differ  so  much  concerning 
it ;  some  recommending  small,  others  large  doses  ;  some 
using  it  fully,  others  but  sparingly  ;  some  employing  small 
doses  in  the  early  and  larger  ones  in  the  later  stages ; 
others  just  the  reverse,  not  a  few  though  advising  its  use 
say  nothing  as  to  the  dose  that  would  be  proj^er  ;  and  none, 
so  far  as  I  have  been  able  to  learn,  regulating  the  dose 
upon  any  recognized  general  jirinciple. 

This  subject  is  not  to  us  an  unimportant  one,  for  when 
we  reflect  upon  the  frequent  occurrence  of  dysentery  in 
this  vicinity,  its  frequently  fatal  termination,  especially 
among  children,  and  tliat  opium,  in  some  form,  is  one  of 
the  most  constant,  and  I  may  say  indispensable,  remedies 
used  in  the  treatment  of  it ;  a  consideration  of  the  proper 
dose  to  be  given,  will  seem  'worthy  our  attention.  Now 
let  us  examine  just  a  few  of  the  authorities  on  this  sub- 
ject, and  I  shall,  for  obvious  reasons,  prefer  to  examine 
those  in  very  common  use  as  works  of  reference. 

Watson  (Prac.  Physician)  mentions  a  camp  dysentery, 
where  after  bleeding  12  grs.  Dover's  powder  were  given,  and 
repeated  three  times,  at  intervals  of  an  hour.  This,  with 
other  appropriate  treatment,  was  found  quite  successful. 

CoNDiE,  in  a  note  to  the  same,  seems  averse  to  giving 
opiates.  He  says  :  the  intense  sufferings  of  the  patient 
are  apt  to  tempt  the  inexperienced  practitioner  to  resort 
at  once  to  opiates  for  relief  —  but  opium,  he  says,  is  a  de- 
ceitful remedy,  for  by  allaying  the  distress,  it  leads  the 
physician  into  a   false    security  ;    the    patient  appearing   to 


*  Read  before  the  Union  Medical  Association  of  Genesee  County.     By 
Dr.  Bullock. 


Proper  Dose  of  Opium  in  Dysentery.  535 

improve  while  fatal  miscliief  is  going  on  within.  Now, 
for  my  part,  I  can  hardly  appreciate  the  force  of  this 
remark,  for  I  do  not  think  even  an  inexperienced  prac- 
titioner would  be  likely  to  suppose  that,  because  he  had 
given  a  dose  of  opium,  and  allayed  the  sufferings  of  his 
patient,   that  he   was   therefore   secure. 

Still  after  bleeding,  either  general  or  local,  or  both, 
which  he  says  "  can  seldom  be  dispensed  with  without 
endangering  the  life  of  the  patient,''  he  gives  opiate 
moderately. 

With  regard  to  the  depletion  this  may  be  all  right 
in  Philadelphia,  for  ought  I  know,  but  I  doubt  whether 
he  would  find  a  practitioner  of  any  experience  in  this 
vicinity,  if  indeed,  in  the  whole  State,  that  would  agree 
with  him  —  indeed,  I  have  seen  in  some  very  adynamic 
cases  of  dysentery,  principally  in  cases  of  infants,  a  nota- 
ble depression  of  the  vital  powers,  occur  immediately  upon 
the   operation   of    a   not   violent    cathartic. 

Dr.  Eberle,  in  his  work  on  practice,  quotes  Dr. 
Stokes,  who  says  that  cases  occurred  to  him  during  the 
epidemic  dysentery  in  Dublin,  where  large  doses  of  opium 
were  required  —  these  cases  were  attended  with  intolerance 
of  the  slightest  pressure  on  the  abdomen,  agonizing  pain,  in- 
creasing tenesmus,  and  great  pyrexia.  In  these  cases 
copious  depletion  and  large  and  repeated  doses  of  opium 
and  calomel  produced  decided  relief —  ^^were  the  same  cases 
again  placed  under  my  care,"  says  he,  "  I  would  not  hesitate 
to  give  opium  in  doses  of  four  or  five  grains^  as  it  was  the 
opium  chiefly  which  seemed  to  arrest  the  progress  of  the 
inflammation.'' 

Still  Eberle,  himself,  thinks  that  it  should  be  given  in 
small  doses  in  the  beginning  of  the  disease,  and  the  dose 
increased  as  the  disease  advances,  and  this,  notwithstanding 
his  seeming  to  endorse,  while  treating  of  peritonitis,  the 
emphatic  remark  of  Dr.  Armstrong  that  in  this  (peritonitis) 


536  The  Peninsular  and  Independent, 

and  every  sjoecies  of  abdominal  inflammation,  the  doBt 
should  he  larcje,  for  a  small  dose  often  stimulates,  whereas 
a  large  one  is  a  direct  sedative. 

Churchill  (Dis.  Chil.)  mentions  an  epidemic  dysentery 
which  occurred  at  the  South  Dublin  Poor  House,  and  de- 
scribed by  Dr.  Mayne,  and  says  that  "  opium  in  full  doses 
aggravated  the  disease."  And  Wood  says  (just  the  re- 
verse of  Eberle)  that  in  the  early  stage  the  remedy  should 
be  given,  particularly  at  bad  turns,  in  full  doses,  and  as  the 
disease  advances,  in  regular  doses,  so  as  to  keep  up  a  con- 
stant impression. 

Now,  notwithstanding  these  conflicting  statements,  and 
others  might  be  produced,  it  seems  the  principle  that 
should  guide  us  is  very  simple.  Tlie  remark  of  Dr.  Arm- 
strong just  quoted,  will'  itself  serve  as  a  key  to  the  whole 
matter.  He  says  that  in  small  doses  it  stimulates,  whereas 
in  large  ones  it  is  a  direct  sedative.  At  any  rate  there  is 
no  doubt,  I  think,  but  that  small  and  frequent  doses  are 
more  stimulating  than  the  same  quantity  given  in  larger 
doses  at  longer  intervals. 

So  it  merely  amounts  to  this,  that  when  there  is  no 
necessity  for  a  stimulant,  full  and  infrequent  doses  should 
be  given,  but  when  the  state  of  the  patient  is  such  as 
to  require  stimulation,  small  doses  more  frequently  re- 
peated would   be   2^i'6ferable. 

I  think  morphine  to  be  preferred  when  we  wish  a 
sedative  effect.  This  might  seem  at  first  inferior  to  oj^ium, 
for  it  is  generally  believed  to  be  less  constipating,  but 
it  is  inflammation  that  we  have  chiefly  to  contend  with,  it 
is  inflammation  that  keeps  up  the  discharges,  and  our 
remedies  should  be  aimed  chiefly  at  the  subduction  of 
the  inflammation. 

Let  us  see  now  if  we  can  reconcile  some  of  these 
conflicting   statements,  according  to  this  rule. 

In  the  first  place  the  ej^idemic  mentioned  by  Dr.  Wat- 


Proper  Dose  of  Opium  in  Dysentery.  637 

SON,  where  full  doses  were  beneficial,  we  find  hleeding 
also  of  great  use,  enough  of  itself  to  establish  the  point 
that  the  disease  was  of  a  sthenic  or  inflammatory  char- 
acter. The  epidemic,  in  which  Dr.  Stokes  found  large 
doses  of  such  marked  benefit,  was  undoubtedly  of  a  very 
vigorous  or  sthenic  character  also,  for  he  says  the  cases 
were  attended  with  gy^eat  pyrexia,  a  condition  which  does 
not  obtain  in  adynamic  inflammations  of  any  part  —  and 
bleeding   was   here    indispensable. 

Now,  how  was  it  in  the  cases  of  Dr.  Mayne,  men- 
tioned by  Dr.  Churchill  ?  when  "  full  doses  of  opium 
aggravated  the  disease,"  although  he  found  small  ones  of 
service.  Why  in  the  first  place  they  occurred  in  a  Poor 
Hoiise,  and  what  is  quite  as  much  to  the  point,  many 
of  the  cases  occurred  as  a  sequellce  to  measles,  when  the 
state  of  the  system  was  lowered  by  this  disease.  So  these 
cases,  I  have  little  doubt,  were  of  an  adynamic  tendency 
and   character. 

Still,  I  presume,  that  full  doses  are  best  in  many 
asthenic  cases,  where  the  depression  is  not  too  great,  as 
in  the  early  stages  ;  on  the  other  hand  small  doses  best 
in  the  latter  stages  of  some  cases,  originally  of  a  sthenic 
form.  TJie  present  condition  of  the  patient  should  be  the 
principal  guide  as  to  the  dose  —  does  he  need  stimula- 
tion, or  can  he  bear  sedation  —  this  is  the  question  to 
be   determined. 

In  conclusion,  I  will  say  that  this  method  of  opium,  not 
only  in  dysentery  but  in  many  other  inflammations,  seems 
to  me  at  least  to  be  founded  upon  correct  therapeutic 
principles,  and  will  add  that  my  experience,  so  far  as  it 
has  gone,   is   decidedly   in  its   favor.  ^ 


538 


The  Peninsular  and  Indeinndent. 


AKT.  XXXV.  — Meteorological  Register  for  Month  of  October,  1850. 

By  L.  S.  Houton,  House  Physician  to  U.  S.  Marine  Hospital. 

Altitude  of  Barometer  above  the  level  of  the  sea,  697  feet.     Latitude,  420 24' N.-  ^nd 
Longitude.  82^58' W.  of  Greeawich. 


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Piiljli0pa5ptal  |lM0r]tr. 


♦»•- 


PROCEEDINGS  AND  DEBATES  OF  THE  THIRD  NATIONAL 
QUARANTINE  AND  SANITARY  CONVENTION,  held  in  the 
City  of  New  York,  April  27th,  28th,  29th,  and  30th,  1859.  Re- 
ported by  Chas.  Collar  and  Wm.  Anderson,  Phonographic  Re- 
porters,   New  York. 

Board  of  Councilmcn,  Sept.  19th,  1859.  Document  No.  9. 
New  York:  Edmund  Jones  &  Co.,  printers  to  Board  of  Council- 
men,    No.   20,   John   st.    1859. 

As  an  introduction  to  the  volume,  of  which  the  above 
is  the  title,  we  have  a  letter  from  Dr.  Wilson  Jevs^ell, 
of  Philadelphia,  "presenting  a  brief  history  of  the  rise 
and  progress  of  the  Quarantine  and  Sanitary  Con- 
ventions.'' From  this  letter  we  learn  that  the  Quaran- 
tine and  Sanitarj^  Convention  is  the  offspring  of  Dr. 
Jewell's  conception  and  effort.  A  long  experience  in 
the  Board  of  Health  of  a  large  city,  and  an  investiga- 
tion into  the  general  subject  of  Quarantine,  gave  him 
clearer  views  of  the  defects,  and  consequent  commercial 
embarassments,  and  also,  disease,  the  disseminating  influence 
of  prevailing  Quarantine  laws  and  practices.  In  Novem- 
ber, 1856,  the  Board  of  Health,  of  which  he  was  a 
member,  appointed  a  committee  to  correspond  with  simi- 
lar bodies  in  New  York,  Boston,  Baltimore,  and  New 
Orleans,  in  reference  to  a  convention  of  delegates  from 
the  Boards  of  health  in  the  maritime  cities  of  the  United 
States. 

The  result  of    this   effort  was  the  assembling  of  the 


640  The  Peninsular  and  Independent, 

first  Convention  in  Philadelphia  in  May,  1857.  Nine 
Atlantic  States  are  represented.  The  second  meeting  was 
held  in  Baltimure,  in  April,  1858.  At  this  meeting  "  two 
Committees,  one  on  External  Hygiene  or  Quarantine,  and 
the  other  on  Internal  Hygiene  or  the  Sanitary  Arrange- 
ments of  cities,"  were  appointed.  The  reports  of  these 
committees  were  laid  before  the  Convention  at  its  third 
and  last  meeting  in  New  York  in  May  last ;  and  are 
now    published   in   the    '^  Proceedings." 

The  Keport  of  the  Committee  on  Qaarantine  is  com- 
posed  of  four   papers  : 

I.  History   of  Quarantine.  —  Dr.  Jewell. 

II.  Have   Quarantines  Bccured   the   object  for  which   they  were   origin- 

ally   intended?      If    not,     the    reasons    of    their    failure.  —  Dr. 
Jkwkll. 

III.  What  reforms    are    required    to   make   Quarantines    more    efficient 

and  less  burdensome? — Dr.    Condie. 

IV.  Is   a  uniform   system   of  Quarantine   laws   feasible?     If  so,    to  pro- 

pose  a  plan  ,  by   which   the   object  may  be  accomplished.  —  Dr. 
Wkaog. 

The  Eeport  of  the  Committee  on  Internal  Hygiene 
or  the  Sanitary  arrangements  of  cities,  embodies  the  fol- 
lowing   j^'^^pcrs  : 

Introduction   by   Dr.    Miller. 
Report  on   Disinfectants  by  Dr.    Van   Bibber. 
Letter  of  Campbell   Moffitt,    M.  D. 

"Disinfectants''   by   Dr.    SnEUiDAX   Muspratt,    F,    R.    S.    E. 
Comparative  value   of  certain  methods   of  Disinfection,   by   M.    M. 
Tardieu  &   Cazalis. 

We  find,  also,  a  Keport  upon  Sewerage,  Water  Supply, 
and  Oftal,  By  Dr.  Griscom  ;  and  another  very  long  and 
full  report  on  the  importance  and  economy  of  Sanitary 
measures   to   cities,    by   Dr.    Bell. 

There  is  also  a  draft  of  a  Sanitary  Code  for  cities, 
by   Dr.    Clark. 

These  last   subjects  are  of  vital  importance   to  all  con- 


Bibliographical  Record,  541 

siderable  towns ;  and  should  be  studied  by  all  town 
practitioners  of  medicine.  The  reports  show^  as  a  general 
rule,  thorough  investigation.  The  next  convention  will, 
we  venture  to  '^ guess",  meet  in  Boston,  although  the 
reporters  fail  to  tell  us  the  result  of  the  vote  on  a  re- 
solution  to    that   effect. 

At  the  close  of  the  Convention  the  ISTew  York  Com- 
mon Council  entertained  the  delegates  at  the  Metropolitan 
Hotel,  Mayor  Tieman  presiding.  Our  Sanitary  friends 
seem  to  have  had  a  "time"  as  "good"  to  themselves, 
as,  we  trust,  their  labors  will  prove  profitable  to  the 
health   of  cities.  ~  G. 

THE  PHYSICTAN'S  HAND-BOOK  OF  PRACTICE,  for  1860.  By 
William  Elmer,  M.  D.,  and  Louis  Elsberg,  M.  D.  New  York:  W. 
A.   Townscnd  &   Co.,    No.   46   Walker  Street.     1860. 

As  most,  if  not  all,  of  our  readers  are  familiar  with 
this  little  book,  it  is  hardly  necessary  to  inform  them 
that  it  is  a  combination  of  a  hand-book  of  practice  and 
a  physician's  diary.  It  is  a  very  perfect  arrangement  as 
a  diary,  although  too  complicated,  for  easy  use.  We 
think  too  much  has  been  attempted.  Simplicity  of  form 
and  arrangement  should  be  the  great  object  in  getting 
up  a  blank  diary.  To  those  who  rely  upon  "pocket 
companions,"  the  hand  -  book  of  practice  will  prove  of  very 
great  service.  The  whole  is  well  and  neatly  bound  ;  and 
in  this  feature  exceeds,  by  far,  any  other  work  of  the 
kind  yet   issued. 

For   sale  by  the   Publishers   of  this   Journal. 

a. 


@Mt0rial  §ti^utmnt. 


EDITORIAL    CORRESPO>DE>CE. 


Aberdeen,  Scotland,  Sept.  23rd,  1859. 
Dear  Readers  of  the  Peninsular  and  Independent  : 

In  my  last  I  gave  some  account  of  a  portion  of  the  medi- 
cal gentlemen  connected  Avith  King's  College  Hospital,  and,  I 
think,  Middlesex  Hospital,  London.  My  design  was  to  go  on 
with  the  accounts  of  London  men  and  institutions,  until  all  I 
had  to  say  of  tlieni  Avas  completed  —  then  proceeding  to  de- 
scribe some  of  the  men  and  things  in  Paris,  Germany,  &c.,  fol- 
lowmg  the  order  m  which  my  observations  were  made — but 
after  passing  through  Wales  and  Ireland,  I  find  myself  in  this 
distant  part  of  Scotland,  in  attendance  upon  the  meeting  of 
"  The  JSritish  Association  for  the  Advanceme7it  of  Science^'' 
and  under  such  circumstances  of  interest  as  to  induce  me  to 
deviate  from  the  original  design  and  give  in  the  present  letter 
some\  account  of  aftairs  here — returning  afterwards,  perhaps,  to 
the  original  plan.  The  reasons  for  deviating  in  this  instance  is, 
that  the  Events,  as  they  are  transpiring,  will  be  more  fresh  in 
my  mind,  and  will  be  more  interesting  to  you  near  the  time 
of  their  occurrence. 

The  name  of  this  body  is  quite  exj^licit  as  to  its  great  ob. 
ject.  It  is  said  to  owe  its  commencement  to  a  discussion  which 
arose,  between  the  years  1826  and  1831,  as  to  the  low  state 
of  science  in  England,  and  the  neglect  here  of  scientific  men. 
Sir  Humphrey  Dayt,  Su-  Johx  Heeschel,  Sir  Dayid  Beew- 
STEE,  Professor  Plate  air,  and  others  of  similar  character,  had 
expressed  their  opinions  of  the  superiority  of  many  foreign,  to 
British  Scientific  Institutions,  and  their  strong  feeling  regarding 
the  want  of  encouragement  given  to  scientific  men  in  the  coun- 
try.    Sir  H.  Davy   wrote,  that   in   looking   back,  he  found  in 


Editorial  Department.  543 

previous  reigns,  Boyles,  Caveisthshes,  and  Howaeds,  who  ren- 
dered their  great  names  more  illustrious  by  their  scientific  re- 
nown. 

"  But,"  he  adds,  "  we  may  in  vain  search  the  aristocracy  now  for  philo- 
sophers, and  there  are  very  few  persons  who  pursue  science  with  true  dig- 
nity ;  it  is  followed  more  as  connected  with  objects  of  profit  than  those  of 
fame,  and  there  are  fifty  persons  who  take  out  patents  for  supposed  inven- 
tions, for  one  who  makes  a  real  discovery." 

A  Mr.  Babbage,  Sir  David  Beewstee,  and  others,  wrote  in 
a  similar  strain,  insisting  that  the  higher  departments  of 
science  had  gradually  declined  since  the  days  of  IS'ewton.  Sir 
David  concluded  an  extended  article  on  the  subject,  in  the 
Quarterly  JReview,  by  saymg : 

"An  association  of  our  nobility,  clergy,  gentry,  and  philosophers,  can 
alone  draw  the  attention  of  the  Sovereign  and  the  nation  to  this  blot  upon 
its  fame.  Our  aristocracy  will  not  decline  to  resume  their  proud  station  as 
the  patrons  of  genius,  and  our  noble  names  will  not  renounce  their  place  in 
the  scientific  annals  of  England.  The  prelates  of  our  National  Church  will 
not  refuse  to  promote  that  knowledge  which  is  the  foundation  of  pure  reli- 
gion, and  those  noble  inquiries  which  elevate  the  mind  and  prepare  it  for  its 
immortal  destination.  If  this  effort  fail,  we  must  wait  for  the  revival  of 
better  feelings,  and  deplore  our  national  misfortune  in  the  language  of  the 
wise  man :  '  I  returned,  and  saw  under  the  sun  that  there  is  neither  bread 
to  the  wise,  nor  yet  riches  to  men  of  understanding,  nor  yet  favor  to  m6n 
of  skill.' " 

By  appeals  like  these,  and  from  such  sources,  in  1831,  through 
the  instrumentality  of  Lord  Beoughaii,  the  state  of  science,  and 
its  cultivators,  was  brought  before  Lord  Geey's  Government, 
and  some  important  objects  relative  to  such  an  association,  as 
had  been  suggested  by  Sir  David  Beewstee,  were  secured. 
The  idea  of  an  association  of  this  kind,  though  urged  with 
such  effect  by  Sir  David  —  a  man  who  has  been  described  as 
"  a  philosopher  whose  investigations  have  been  extended  through 
almost  every  branch  of  i)hysical  science," — was  not  original  with 
him ;  for,  similar  associations  had  existed  in  Germany  for  some 
years  before,  and  the  advantages  to  each  other,  of  learned  men 
meeting  together,  had  long  been  understood.  The  distinguished 
La  Place  manifested  his  appreciation  of  such  meetings  when 
he  said: 

"The  chief  advantages  of  learned  societies  is  the  philosophical  S29^r- 
it  to  which  they  give  birth,  and  which  they  can  not  fail  to  diffuse  over  all 


544  The  Peninsular  and  Independent. 

the  various  pursuits  of  the  nations  among  whom  they  are  established.  The 
insulated  scholar  may,  without  dread,  abandon  himself  to  the  spirit  of  sys- 
tem ;  he  hears  the  voice  of  contradiction  from  afar ;  but  in  a  learned  society 
the  collision  of  systematic  opinions  soon  terminates  in  their  common  de- 
struction ;  while  the  desire  of  mutual  conviction  creates  among  the  mem- 
bers a  tacit  compact,  to  admit  nothing  but  the  results  of  observation,  or  the 
conclusions  of  mathematical  reasoning.  Accordingly,  experience  has  shown 
how  much  these  establishments  have  contributed  since  their  origin  to  the 
spread  of  true  philosophy." 

The  first  meeting  of  the  British  Association  for  the  Ad- 
vancement of  Science^  was  held  at  York,  in  September  of  1831, 
and  has  consequently  been  in  existence  28  years  —  tlie  present 
meeting  being  its  29tli.  The  first  meeting,  so  efficient  had 
been  the  efforts  to  call  public  attention  to  the  subject,  con- 
sisted of  353  persons.  Lord  3Iiltox,  then  President  of  the 
York  Philosophical  Society,  presided,  and  in  his  ojiening  ad- 
dress said : 

"With  regard  to  the  more  direct  advantages  which  we  have  a  right  to 
anticipate  from  these  meetings,  I  have  no  doubt  that,  if  they  shall  be  ex- 
tended to  different  parts  of  the  country,  and  held  in  well-selected  places, 
this  result  will  be  obtained  :  the  men  of  science,  now  scattered  over  the  em- 
pire, will  be  enabled  to  meet  each  other,  and  mutually  communicate  their 
ideas ;  they  will  state  the  advances  which  have  been  made  in  their  own  re- 
spective spheres  of  action,  and  also  what  the  deficiencies  may  be.  Thus 
not  only  will  an  extraordinary  impulse  be  given,  but  the  individuals  and 
the  societies,  taking  part  in  the  meetings,  will  learn  what  part  of  science 
they  can  cultivate  with  the  greatest  utility,  and  will  give  their  researches 
the  most  advantageous  direction." 

Another  object  of  the  Association  was  stated  to  be,  to  se- 
cure a  collection  of  reports,  showing  the  present  state  of 
science,  in  order  that  scientific  students  might  know  where  to 
begin  their  labors  ;  and  in  order  that  those  who  pursue  one 
branch  of  knowledge  might  know  how  to  commimicate  with 
inquirers  in  another,  for  it  was  affirmed  that  want  of  such  know- 
ledge was  constantly  found;  and  also  that  speculations  were  pub- 
lished which  showed  the  greatest  ignorance  of  what  had  been 
done  and  written  on  the  same  subjects,  by  others.  Besides  these 
general  objects,  the  originators  aimed  at  a  repeal  or  reform  of  the 
law  of  patents,  and  at  direct  national  encouragement,  by  govern- 
ment, for  science  and  its  cultivators.  From  this  beginning,  and 
with  these  aims,  an  account  of  which    I   have  thought    proper 


Editorial  Department.  545 

to  thus  somewhat  fully  present  to  you,  the  society  has  gone  on 
in  a  course  of  increasing  prosperity  and  success,  and  has  been 
a  powerful  means  of  raising  British  science  and  scientific  men 
,  to  their  present  proud  position.  At  the  first  meeting  at  York, 
as  already  stated,  353  tickets  were  issued  —  at  Oxford,  the  next 
year,  564  —  at  Cambridge,  in  1833,856 — while  at  the  next 
meeting  at  Edinburgh,  there  were  1,139;  and  still  the  next,  at 
Dublin,  there  were  1,203 ;  and  at  the  meeting  at  N^ewcastle, 
several  years  after,  2,076  were  in  attendance  —  the  largest  of 
any  until  the  present  meeting,  at  which  nearly  3,000  tickets 
have  already  been  issued,  and  many  more  would  have  been 
granted  to  applicants,  had  the  room  in  which  the  great  meet- 
ings are  held,  been  large  enough  to  accommodate  more.  Of 
the  immense  numbers  in  attendance  there  is  a  fair  sprinkling 
of  ladies  —  for  the  most  part,  the  wives,  sisters  and  daugh- 
ters of  members.  Of  those  present  between  500  and  600 
are  full  permanent  life  members,  having  paid  an  initiation 
fee  of  £10,  and  after  paying  the  annual  sum  which  entitles 
them  to  the  volume  of  Transactions,  without  further  expense ; 
the  remainder  being  Associate  members  —  paying  an  annual 
subscription  fee.  Special  tickets  are  furnished  for  ladies  at  £1 
each,  entitling  them  to  be  present  at  the  meetings  ;  but  their  names 
do  not  appear  in  the  jDrinted  lists,  as  do  the  regular  and 
Associate  members  —  the  two  latter  classes,  however,  being  in 
sef)arate  pamphlets.  There  are  26  delegates  from  difierent 
learned  societies  in  Great  Britain,  and  one  from  the  Ameri- 
can Medical  Association.  There  are  a  considerable  number 
of  gentlemen  present,  interested  in  science  from  foreign  coun- 
tries—  representing  France,  Holland,  Germany,  Austria,  Rus- 
sia,  and   the   United   States. 

Though  the  Association  is  steadily  gaining  in  favor  with 
scientific  men  and  the  country,  yet  much  of  the  edat  of  the 
present  meeting  has  been  given  by  the  fact  of  the  Peixce 
CoNSOET  acting  as  President  —  besides  the  curiosity  existing 
everywhere  of  seeing  personages  of  high  position,  there  is 
among  most  of  the  British  people  a  peculiar  admiration  for 
rank  and  title,  and  a  strong  feeling  of  loyalty  indulged  with- 
out restraint  towards  their  present  worthy  sovereign^  which 
makes  them  almost  worship  —  at  least  show  the  greatest  in- 
terest in   every   one   connected  with  the   Royal  Family.      Be- 

YOL.  II.— 2K. 


546  TJie  Peninsular  and  Independent. 

sides    all    this,   Prince    Albert    is,  from    his  unexceptionable 
character,  and    his    manifest  interest  in   science   and  improve- 
ment,  personally  popular ;    and   all  these    circumstances    have 
doubtless   contributed  to   bring  together   many  who  otherwise 
would  have  pursued  other   objects   of  interest  or  amusement. 
The    Association    convened  on  the    14th   Sept.   inst.  —  the 
Council  at  10  a.  m.,  the   General  Committee  (which  does  most 
of  the   arranging  of  affairs   and   general  business)    at   1    p.  m., 
the    General  Meetinrj  occurring   at   8  1-2   p.  m.  ;   when  the  re- 
tiring President,   Prof.   Owen,   yielded    the   chair    to   liis   suc- 
cessor in  a  brief  speech,  and  Prince  Albert  proceeded  to  deliver 
an  opening  address.     It  was  an  impretending,  but  clear  and  sen- 
sible production,  and   was   well   adapted  to  the  occasion.     He 
spoke   in  becoming  terms   of  his  inferiority  as   a  man  of   sci- 
ence,  compared  ^vith  others  around  him,  and  claimed  indulgence 
in  his  attempts  to  perform  his  duties,  especially  so,  as  he  suc- 
ceeded to   "  a  man   of   whom  the   country  was  justly  proud, 
and   whose  name   stood  among  the  foremost  of  the  naturalists 
in  Europe,  for  his  patience  in  investigation,  conscienciousness  in 
observation,  boldness  of  imagination,  and  acuteness  in  reasoning." 
In  mentioning  the  reasons  which  determined  him  to  accept 
the  office,   he  said: 

"Remembering  that  this  Association  is  a  popular  Association,  not  a 
secret  confraternity  of  men  jealously  guarding  the  mysteries  of  their  pro- 
fession, but  inviting  the  uninitiated,  the  public  at  large,  to  join  them ;  having 
as  one  of  its  objects  to  break  down  one  of  those  imaginary  and  hurtful 
barriers  which  exist  between  men  of  science  and  so-called  men  of  practice — 
I  felt  that  I  could,  from  the  peculiar  position  in  which  Providence  has 
placed  me  in  this  country,  appear  as  the  representative  of  that  large  public, 
which  profits  by  and  admires  your  exertions,  but  is  unable  actively  to  join 
in  them ;  that  my  election  was  an  act  of  humility  on  your  part  which  to 
reject  would  have  looked  like  false  humility,  that  is  like  pride,  on  mine. 
But  I  reflected  further,  and  saw  in  my  acceptance  the  means,  of  which  ne- 
cessarily so  few  are  offered  to  her  Majesty,  of  testifying  to  you,  through  the 
instrumentality  of  her  husband,  that  your  labors  are  not  unappreciated  by 
your  Sovereign,  and  that  she  wishes  her  people  to  know  this  as  well  as 
yourselves." 

He  then  spoke  of  the  objects  of  the  Association  in  very 
proper  terms,  and  proceeded  to  give  his  notions  of  science  ; 
the  following  extract  serving  as  a  specimen  of  his  style  of 
^  bought  and  expression  and  being  worthy  of  being  re2:)roduced : 


Editorial  Department,       •  547 

'*  To  me,  science,  in  its  most  general  and  comprehensive  acceptation, 
means  the  knowledge  of  what  I  know,  the  consciousness  of  human  knoW' 
ledge.  Hence,  to  know  is  the  object  of  all  science  ;  and  all  special  know-' 
ledge,  if  brought  to  our  consciousness  in  its  separate  distinctiveness  of  form, 
and  yet  in  its  recognized  relation  to  the  totality  of  our  knowledge  is,  scienti- 
fic knowledge.  "We  require,  then,  for  science — that  is  to  say,  for  the  acqui- 
sition of  scientific  knowledge — those  two  activities  of  our  minds  which  are 
necessary  for  the  acquisition  of  any  knowledge — analysis  and  synthesis ;  the 
first,  to  dissect  and  reduce  into  its  component  parts  the  object  to  be  inves- 
tigated, and  to  render  an  accurate  account  to  ourselves  of  the  nature  and 
qualities  of  these  parts  by  observation ;  the  second  to  recompose  the  oh' 
served  and  understood  parts  into  a  unity  in  our  consciousness,  exactly  axi" 
swering  to  the  object  of  our  investigation.  The  labors  of  the  man  of 
science  are  therefore  at  once  the  most  humble  and  the  loftiest  which  man 
can  undertake.  lie  only  does  what  every  little  child  does  from  its  first 
awakening  into  life,  and  must  do  every  moment  of  its  existence  ;  and  yet 
he  aims  at  the  gradual  approximation  to  divine  truth  itself.  If  then,  there 
exists  no  difference  between  the  work  of  the  man  of  science  and  that  of 
the  merest  child,  what  constitutes  the  distinction  ?  Merely  the  conscious 
self-  determination.  The  child  observes  what  accident  brings  before  it,  and 
unconsciously  forms  its  notion  of  it ;  the  so-called  practical  man  observes 
what  his  special  work  forces  upon  him,  and  he  forms  his  notions  upon  it 
with  reference  to  this  particular  work.  The  man  of  science  observes  what 
he  intends  to  observe,  and  knows  why  he  intends  it.  The  value  which  a 
peculiar  object  has  in  his  eyes  is  not  determined  by  accident,  nor  by  an  ex- 
ternal cause,  such  as  the  mere  connexion  with  work  to  be  performed,  but 
by  the  place  which  he  knows  this  object  to  hold  in  the  general  universe  of 
knowledge,  by  the  relation  which  it  bears  to  other  parts  of  that  general 
knowledge. 

"  To  arrange  and  classify  that  universe  of  knowledge  becomes  there- 
fore the  first,  and  perhaps  the  most  important,  object  and  duty  of  science. 
It  is  only  when  brought  into  a  system,  by  separating  the  incongruous,  and 
combining  those  elements  in  which  we  have  been  enabled  to  discover  the 
internal  connexion  which  the  Almighty  has  implanted  in  them  ;  that  we  can 
hope  to  grapple  with  the  boundlessness  of  His  creation,  and  with  the  laws 
which  govern  both  mind  and  matter.  The  operation  of  science  then  has 
been,  systematically  to  divide  human  knowledge,  and  raise,  as  it  were,  the 
separate  groups  of  subjects  for  scientific  consideration  into  different  and 
distinct  sciences." 

He  spoke  for  about  fifty  minutes  with  a  fairly  distinct 
and  agreeable  voice,  and  with  a  moderate  German  accent,  and 
his  efibrt  Avas  very  well  received  by  one  of  the  most  intelli- 
gent audiences  ever  assembled,  and  which  seemed  fully  to  sym- 
pathize with  Sir  Bei^jamiis^  Beodie,  who,  in  moving  a  vote  of 
thanks,  said : 


548  The  Peninsular  and  Independent. 

"  Gentlemen  of  the  British  Association  ;  His  Royal  Highness  has  per- 
formed the  task  which  he  had  undertaken,  and  I  think  we  have  a  duty  to 
perform  before  this  meeting  separates.  Of  the  address  His  Royal  highness 
has  just  delivered,  1  might  say  much  more,  if  I  were  not  prevented  by  the 
presence  of  his  Royal  highness ;  but  this  much  I  may  venture  to  say,  that 
we  may  trace  in  it  the  same  signs  of  strong  and  sound  sense,  clearness  of 
comprehension,  varied  knowledge,  and  good  intentions,  which  are  to  be  found 
in  all  the  addresses  which  His  Royal  Highness  ever  made  in  public.  [Ap- 
plause.] I  am  sure  that  we  must  all  feel  that  this  country  is  greatly  in- 
debted to  His  Royal  Highness  for  the  attention  which  he  pays,  on  all  occa- 
sions, to  the  advancement  of  knowledge  and  improvement  of  our  social  sys- 
tem, and  for  contributing  as  he  does  in  every  way  to  promote  the  happiness 
of  this,  his  adopted  country.  [Applause.]  I  am  sure  you  will  all  agree 
with  me  that  we  ought  to  express  our  cordial  thanks  to  his  Royal  Highness, 
for  the  address  which  he  has  just  delivered,  for  having  consented  not  only  to 
adorn  this  meeting  with  his  presence,  but  to  take  the  chair  and  make  such 
exertions  for  us.  [Applause.]  I  am  sure  you  will  all  join  with  me  in  hoping 
that  he  may  long  be  spared  to  be  an  honour  and  a  credit  to  this  country. 
[Great  cheering.] " 

The  scientific  work  of  the  Association,  which,  after  all,  is 
its  great  feature,  is  done  in  sections,  eight  in  number,  holding 
their  sessions  at  the  same  time  in  different  rooms,  from  11 
o'clock  to  3.  These  are  as  follows;  of  Mathematical  and 
Physical  Science — presided  over  by  the  Earl  of  Rosse,  F.R.  S.; 
of  Chemical  Science  —  President,  Dr.  Lyox  Playfair,  C.  B., 
F.  R.  S ;  of  Geology  —  President,  Sir  Charles  Ltell,  LL,  D., 
D.  C.  L.,  F.  R.  S. ;  of  Zoology  and  Botany — President,  Sir 
W.  Jardine,  Bart.,  F.  R.  S.  E. ;  of  Physiology  —  President, 
Prof.  Sharpet,  F.  R.  S.  ;  of  Geography  and  Ethnology  — 
President,  Admiral  Sir  J.  C.  Ross,  D.  C.  L.,  F.  R.  S. ;  of  Econ- 
omic Science  and  Statistics  —  President,  Col.  Stkes,  F.  R.  S., 
M.  P. ;  and  of  Mechanical  Science  —  whose  President  is  the 
Rev.  Prof.  Willis,  F.  R.  S.,  of  the  University  of  Cambridge. 

In  these  eight  sections,  during  their  six  working  days  now 
just  brought  to  a  close,  371  papers  were  read,  (generally  in 
full,  though  sometimes  by  abstracts,)  and  discussed.  This  en- 
ormous number  embraces  almost  every  variety  of  scientific  sub- 
ject, from  the  minutest  molecule  and  the  laws  which  govern 
its  being,  to  the  largest  bodies,  and  the  most  momentuous  in- 
terests in  the  universe,  and  the  great  principles  connected  with 
their  existence  and  operations.  Not  only  matters  of  physical, 
chemical,  and  vital  science  were  discussed,  but  Economics  and 


Editorial  Department,  549 

Statistics  were  brought  nnder  consideration,  and  some  of  the 
most  able  and  animated  discussions  of  the  meeting  were  held 
in  this  section.  Such  subjects  as  the  following :  statistics  of 
the  Trade  and  Progress  of  the  Colony  of  Victoria,  Australia — 
statistics  of  the  Small -Pox  and  Vaccination  in  the  United 
Kingdom  —  statistics  of  the  Free  Church  Building  in  Glasgow 

—  Trade  and  Commerce  of  India  —  the  Industrial  Feeding 
Schools  of  Aberdeen  —  the  Effect  of  the  Influx  of  the  pre- 
cious Metals  which  followed  the  Disco^/ery  of  America  —  the 
Social  and  Economical  influence  of  the  New  Gold  of  California 
and  Australia  —  statistics  of  Color  Blindness  —  Decimal  Coinage 

—  Progress  of  Public  Opinion,  with  respect  to  the  evils  pro- 
duced by  the  Trafiic  in  Intoxicating  Drinks,  as  at  present  regu- 
lated by  Law^,  <fcc.  —  were  ably  reported  upon  and  elicited  a 
large  amount  of  interest. 

The  division  in  which  I  took  most  interest,  and  which  I  at- 
tended most  constantly,  was  that  of  Physiology,  embracing  as 
it  did,  in  its  various  pajDers  and  the  discussions  upon  them, 
many  Pathological  subjects  as  well.  The  following  are  the  sub- 
jects of  the  principal  papers  produced: 

Professor  Bennett. — On  the  Structure  of  the  Nerve  Tubes. 

Dr.  Redfern. — On  the  Admixture  of  Nervous  and  Muscular  Fibres  in  the 
nerves  of  the  Leech. 

Bernard  E.  Brodhurst^  F.  R.  C.  S. — On  the  Repair  of  Tendons  after  their 
Sub-cutaneous  Division. 

Dr.  Foster. — On  the  action  of  the  Heart  of  the  Snail. 

Q.  H.  Lewes. — On  Improved  processes  of  Physiological  Investigation. 

G.  H.  Lewes. — On  the  supposed  distinction  between  Sensory  and  Motor 
Nerves. 

John  Adamson,  M.  D. — Case  of  Lactation  in  an  uninpregnated  Female  oif 
the  Canis  familiaris. 

Professor  Allman. — Eeport  on  the  Reproductive  Organs  of  the  Hydroid 
Zoophytes. 

George  Ogilme,  M.  D. — The  Genetic  Cycle  in  Organic  Nature. 

Professor  Laycoclc. — Handwriting  and  Drawings  of  the  Insane — as  illustra- 
tive of  some  modes  of  Cerebral  Functions. 

Professor  Bennett.  — On  the  Origin  of  Morbid  Growths,  with  reference  to 

the  Connective  Tissue  theory. 
John  Duguid  Milne,  jim.,  M.  A. — On  the  Homologous  Development  of  the 

Muscular  System. 
Robert  Garner,  F.  L.  S. — Reproduction  in  Gasteropoda,  and  on  some  curious 

Effects  in  Endosmosis. 


550  The  Peninsular  and  Independent. 

John  Marcel^  M.D.^  F.  R.  S. — An  Experimental  Inquiry  into  the  action  of 
Alcohol  on  the  Nervous  System. 

Professor  Bennett. — On  the  Molecular  Theory  of  Organization. 

W.  E.  C.  Nourse^  F.  R.  C.  S.  — On  the  Organs  of  the  Senses,  and  on  the 
Mental  Perceptive  Faculties. 

A.  B.  Garrod^  M.  i).,  F.  JR.  S. — On  the  Specific,  Chemical,  and  Microscopi- 
cal Phenomena  of  gouty  inflammation. 

G.  U.  Leioes. — A  Demonstration  of  the  Muscular  Sense. 

George  Eainey^  If.  JR.  C.  S. — On  the  Structure  and  Mode  of  Formation  of 
Starch  Granules,  according  to  the  principle  of  Molecular  Coalescence. 

John  Bennis  Macdonald^  JR.  iV],  F.  E.  S. — On  the  Homologies  of  the  Coats  of 
Tunicata,  with  remarks  on  the  Ph3''siology  of  the  Pallial  Sinus  System 
of  Brachiopoda. 

Professor  W.  W.  Fisher. — Illustrations  of  the  Normal  Development  of  the 
Vertebrate  System,  by  its  Abnormal  States. 

Edward  Smith,  M.D.,  LL.  B. — On  the  Sequence  observed  in  the  Phenome- 
na observed  in  Man  under  the  Influence  of  Alcohol. 

Alphonse  Gages,  JM.  JR.  SA. — On  the  comparative  action  of  Hydrocyanic 
Acid  on  Albumen  and  Caseine. 

Bichard  Foioler^  M.  D.^  F.E.S. — A  second  Physiological  attempt  to  un- 
ravel the  perplexities  of  the  Hypothesis  of  Berkley. 

William  Cami^s,  J/.  D. — On  certain  imperfectly  recognised  functions  of  the 
Optic  Thalami. 

William  Camps^  M.  D. — On  certain  Subjective  Sensations,  with  especial 
reference  to  the  Phenomena  of  Second  Sight,  Visions,  and  Appari- 
tions. 

A  brief  account  of  some  of  these  papers  and  their  authors, 
will  constitute  the  burthen  of  the  remainder  of  this  letter,  al- 
ready becoming  long. 

The  author  of  the  first  paper  on  the  list,  Prof.  Bexxett, 
of  Edinburgh,  is  the  same  who  has  recently  given  to  the 
world  a  large  work  on  "  Clinical  JMedicine^''  and  who  has 
distinguished  himself  by  so  strenuous  an  advocacy  of  absti- 
nence from  blood-letting,  and  other  depleting  measm*es  in  the 
treatment  of  Inflammations.  I  was  curious  to  see  this  gen- 
tleman, and  to  get  an  impression  of  the  character  of  his 
mind,  as  evinced  by  his  apj^earance  and  efl^orts,  otherwise 
than  upon  paper;  and  have  had  an  excellent  opportunity  in 
his  frequent  participations  in  the  discussions  of  the  section 
of  the  Association  in  which  he  takes  a  most  active  part.  He 
is  a  man  rather  less,  than  above,  50,  scarcely  looks  older 
tlian   40,   of  about  medium  size,   with   a   short  nose,    and  not 


Editorial  Department,  551 

an  expanded  brow.  He  has  an  active,  vigorous  temperament^, 
and  is  evidently  fond  of  controversy  and  disputation;  but  I 
must  say,  that  what  I  have  seen  of  him,  has  not  strongly 
impressed  me  with  the  clearness  of  his  impressions,  the  earn- 
estness and  depth  of  his  convictions,  or  the  rigor  of  his 
logic.  I  do  not  intend  to  say  that  he  is  markedly  deficient 
in  any  of  these  respects,  but,  simply,  that  in  my  judgment,  he  is 
not  eminent  in  either.  That  he  has  a  good  amount  of  talent 
— that  he  is  active  and  industrious,  his  numerous  productions 
prove.  That  he  has  the  ability  to  inspire  others  with  zeal 
and  activity  in  scientific  and  professional  pursuits,  his  student© 
testify — but  that  he  is  one  of  those  clear-headed,  unpreju- 
diced men,  whose  enlarged  views,  expanded  powers,  and. 
unquestionable  purposes,  render  them  eminent  as  authorities, 
cannot  be  fairly  claimed;  and,  although  a  useful  contributor 
to  science,  his  conclusions,  (as  should  in  fact  be  the  case 
with  every  man's),  must  by  no  means  be  received  without 
the  most  rigid  investigation.  I  feel  in  duty  bound  to  say 
at  least  this  much,  because  it  is  my  strong  conviction,  and 
because  his  works  and  opinions  are  becoming  extensively  dis- 
siminated  throughout  our  country,  and  many  of  them,  in  my 
judgment,  are  far  from  being  sustained  by  the  largest  ob- 
servation of  facts,  and  [the  most  careful  !_inductions  of  rea- 
son. These  remarks  are  not  made  with  special  reference  to 
his  papers  presented  to  the  section  of  the  Association,  with 
which  you  will  be  less  interested  than  with  the  question, — 
whether,  when  you  have  a  strong,  well  -  nourished  patient, 
with  a  full  muscular  system,  attacked  with  a  sthenic  inflam- 
mation, you  shall  not  draw  blood  as  a  powerful  means  of 
diminishing  that  action,  and  preventing  its  development  into 
all  the  consequences  which  may  follow?  It  is  to  enable  you 
to  give  Dr.  B.'s  authority  its  proper  weight  on  this  and 
other  great  practical  questions,  rather  than  those  of  a  more 
abstruse  character  respecting  the  ultimate  structure  of  the 
nerve -tube,  or  even  the  great  molecular  theory  of  organiza- 
tion,  that  I  have  made  these  remarks. 

The  chief  idea  in  the  first  paper  is  that  the  fluid  in  the 
nerve -tube  is  capable  of  being  coagulated  by  certain  manipu- 
lations and  reagents,  and  that  the  curious  structures  observed 
by  various   observers   and   authors,    do  not  exist  in  the  semi- 


662  The  Peninsular  and  Independents 

fluid  or  central  part  of  the  tube,  but  are  the  results  of  these 
chemical  changes  —  of  a  partial  coagulation.  He  thinks  the 
nerves  are  simple  tubes  containing  a  viscus  fluid,  of  unknown, 
but  in  different  parts,  various  chemical  composition  —  hence, 
being  variously  effected  by  reagents  in  the  different  parts, 
producing  the  central,  flattened,  and  waving  fibre,  and  all  the 
other  forms  observed  by  Clark,  and  others,  but  that  the 
Structure  is   uniform. 

Prof.  Allen  Thomson,  of  Glasgow,  agreed  with  Prof.  Ben- 
nett, in  much  he  had  said,  but  thought  there  was  a  differ- 
ence of  structure  as  well  as  of  chemical  composition  in  the 
interior  of  nerve  -  tubes  —  that  there  is  a  medullary  sheath  and 
a  central  body.  However,  he  thought  nothing  was  very  posi- 
tively known  on  the  subject,  and  it  was  hardly  proper  to 
come  to   conclusions  on  the   data   given. 

Prof.  Sharpey,  President  of  the  Section,  and  a  noble  spe- 
cimen of  a  clear-headed,  honest  -  hearted,  scientific  man  — 
large  and  erect  in  body  and  mind,  said :  even  Dr.  Bennett 
did  not  deny  that  there  was  at  least  a  difference  of  consis- 
tence in  the  different  portions  of  the  contents  of  the  nerve- 
tube,  and  he  thought  this  involved  something  more.  The 
central  axis  or  central  filament,  as  described,  differed  in 
structure  from  the  rest  of  the  contents  of  the  nerve  mem- 
brane, or  tube.  The  different  parts  were  more  or  less  inde- 
pendent of  each  other.  He  had  watched  the  growth  of  nerves, 
and  found  that  the  central  parts  or  Aliments  grow  first.  The 
ultimate  nerve  tapers  at  its  extremity,  when  growing.  Still 
he  admitted  that  many  of  the  changes  described  by  authors 
were  probably  mere  fibrilatiou  occurring  after  death,  or  in 
consequence   of  reagents. 

Dr.  AcLAND,  formerly  Professor  of  Anatomy,  now  of  Me- 
dine,  at  Oxford  University,  thought  it  was  dangerous  to  truth 
to  draw  conclusions  as  speedily  and  decidedly  as  some  did  on 
the  structure  of  the  nerves.  Many  of  the  apjDearances  were 
doubtless  produced  by  manipulations  and  reagents,  and  it  was 
difficult  to  say  how  far  these  differences,  when  produced,  uidi- 
ated  original  difference  of  structure.  But  there  was  a  difference 
between  the  external  and  internal  membrane  of  the  nerve  -  tube, 
and  the  central  axis  difiuered  from  the  rest  of  the  contents.  This 
difference   was   chemical   or    structural,    or  both  —  quite    likely 


Editorial  Department.  553 

both ;  but  we  should  be  careful  about  attaching  difference 
of  functions  to  these  different  parts.  Our  knowledge  was  not 
sufficiently  advanced  for  that. 

Dr.  Redfern,  Professor  of  Anatomy  and  Physiology  in 
the  University  of  Aberdeen,  said :  True  Physiologists  are  very 
cautious  in  these  respects.  They  gave  only  what  they  saw; 
and,  in  these  cases  under  discussion,  observations  were  not 
so  perfect  as  to  entitle  one  to  draw  physiological  conclusions- 
He  requested  information  as  to  the  difference  between  sym- 
pathetic and  common  nerve  -  tubes. 

Dr.   Shaepey  said  : 

This  question,  like  many  others,  was  more  easily  asked  than  an- 
swered. 

Dr.  Bekn3:tt  said : 

He  did  not  deny  there  were  differences  of  some  kind  in  differ- 
ent parts  of  the  nerve  -  tube  or  fibre.  The  central  portion,  or  as  it 
had  been  called,  band,  had  more  affinity  for  coloring  matter,  for  in- 
stance; but  the  question  was  as  to  structural  diflference.  He  could 
not  see   it  in  the  recent  state. 

Dr.  AcLAND  said: 

Dr.  Bennett,  after  all,  proved  there  was  a  difference,  (he  seemed 
to  start  with  the  position  that  there  was  none),  slight,  perhaps,  but 
yet  a  difference,  as  shown  by  the  effects  of  water  and  other  agents. 
A  slight  diflference  in  structure,  or  even  in  chemical  composition, 
may  cause  a  decided  diflference  in  function;  so  that  he  scareely  saw 
what  Dr.  Bennett's  paper  had  made  out.  Here  I  find  in  my  notes 
(these  sketches  are  from  notes  taken  at  the  time  of  the  reading  of 
the  papers,  and  the  discussions  on  them),  these  inquiries:  May  not 
chemical  differences  in  the  different  portions  of  a  nerve  modify 
the  functions  as  much  as  structural  differences  ?  Is  it  not  in- 
deed probable  that  chemical  affinity  has  much  to  do  in  conveying 
impressions  through  nerves? 

Dr.  Redfeen's  paper,  the  next  on  the  list,  merely  af- 
firmed that  he  had  seen,  some  years  ago,  movements  in  the 
nerve  of  a  leech  carefully  dissected  out  for  a  considerable 
distance  from  its  surrounding  connections.  The  inference  was 
that  nerve  substance  had  the  power  of  spontaneous  oscillatory 
movements.  He  had  made  many  inquiries  on  the  subject 
without  obtaining  light,  but  had  recently  examined  the  leech 
carefully,  and  had    found   muscular  fibres  in  the  sheath,   and 


554  The  Peninsular  and  Independent. 

combined  with  the  sympathetic  nerve.  When  nerves  are  cut 
off  from  other  connections,  but  left  with  their  ganglia,  some 
will  be  found  to  bend  in  a  rainbow  form.  Those  that  do 
so  will  be  found  to  have  muscular  fibres  attached  to 
them  within  their  sheaths,  and  on  the  side  towards  which 
the  curve  takes  place.  His  observations  have  been  made 
on  leeches,  but  he  has  no  doubt  the  same  will  be  found 
true  with  regard  to   other   of   the  lower   classes  of    animals. 

The  author  of  the  next  paper,  Mr.  Brodhurst,  is  one 
of  the  Assistant  Surgeons  to  the  Royal  Orthopoedic  Hospital, 
London,  and,  though  a  young  man,  has  had  opportunities  for 
practical  observation  Jn  the  many  cases  of  subcutaneous  divi- 
sions of  tendons  occurring  there.  His  paper  was  of  much, 
practical  interest  to  surgeons,  but  abounded  in  details  too 
lengthy  to  be  recorded  in  this  letter.  I  shall  attempt  to 
give   only   a  few   of  the    conclusions. 

When  a  tendon  has  been  divided,  its  ends  should  be  ap- 
proximated, or  union  may  not  take  place.  The  distance  va- 
ries at  which  union  may  occur  in  the  divided  ends,  but  there 
are  limits  in  all  cases,  and  in  some  the  distance  must  be 
small.  After  union  has  taken  place,  the  new  connecting  ma- 
terial may  be  extended  very  much  by  mechanical  means,  while 
it  is  new.  It  then  becomes  permanent  structure  in  the  ex- 
tended form.  Motion,  as  exertions  of  the  muscles  attached, 
will  sometimes  prevent  union  when  the  cut  ends  are  not  far 
asunder.  If  the  tendons,  after  being  cut,  are  separated  more 
than  two  inches,  union  is  not  likely  to  occur.  The  forma- 
tion process  commences  at  the  cut  ends  of  the  tendon,  and  is 
built  out  in  that  way;  but  the  sheath  of  the  tendon  is  use- 
ful in  giving  it  form.  In  the  case  of  long  ligamentous  sub- 
stance between  the  fragments  of  a  broken  patella,  it  is  pro- 
bable that  union  occurred  when  the  bones  were  approxima- 
ted, and  the  new  substance  extended  afterwards  by  the  ac- 
tion of  the  strong  muscles.  When  much  force  is  applied  to 
the  new  tendon  when  recent,  it  may  be  greatly  elongated 
—  several  inches  —  so  as  even  to  render  the  muscle  with 
which  it  is  attached  powerless.  While  the  new  tendon  is  re- 
cent, if  all  tension  is  removed  from  it,  contraction  is  apt  to 
occur.  After  a  time,  as  a  few  months,  it  becomes  fixed  and 
permanent   as  other   structures. 


Editorial  Department.  555 

Sir  Benjamin  Beodie  and  Prof.  Shaepey  asked  the  re- 
porter several  questions  wMcli  elicited  a  portion  of  tlie  facts 
above   recorded. 

Dr.  Fostee's  paper,  the  next  in  order,  tended  to  show 
that  the  heart  of  snails,  when  cut  into  small  pieces,  continued 
to  beat  for  a  considerable  time,  each  piece  beating  rythmi- 
cally — wherefrom  the  infereiice  was  drawn,  that  the  heart  of 
these  animals  had  an  inherent  power  of  rythmical  contraction 
within  itself,  independent  of  nerves.  In  a  somewhat  lengthy 
discussion  which  followed  on  this  paper,  Dr.  Bennett  agreed 
with   the   reporter   generally. 

Prof.  Huxley,  of  London,  said  these  experiments  applied 
to  the  froo:  would  have  met  with  different  results.  In  the 
higher  animals,  the  heart  is  evidently  under  the  controling  in- 
fluence  of  nerves. 

Prof.  Shaepey  suggested  that  there  might  be  small  ganglia 
in  the  heart  tissue,  causing  each  part  in  which  the  ganglia 
was  situated,  to  beat  under  proper  stimuli  independently; 
but  yet  the  different  particles  influenced  others  near  them. 
Something  of  this  kind  was  found  in  the  intestines.  He  com- 
pared this  arrangement  to  a  team  of  horses  — each  had  a  mo- 
tion from  its  own  volition,  but  one  horse  was  influenced  by 
the  others,  and  all  were  governed  by  the  driver,  with  his 
reins  and  whip.  The  latter  he  compared  to  the  nerves  which 
usually   governed  and   harmonized   all   such  motions. 

Profs.  Thomson  and  Huxley  favored  the  idea  of  the  in- 
herent motive  power  of  muscles,  independent  of  nerves,  com- 
ing back  to  the   old  views  of  Hallee. 

Sir  B.  Beodie  said: 

Spermatozoa  acted  rythmically  though  they  had  no  nerves.     Yet 
nerves  do   unquestionably  influence  the  heart. 

Dr.  Bennett  said:  The  heart  of  a  chick  beat  before  it 
had  any  deflnite  structure  —  while  there  were  nothing  but 
cells  apparent.  But  said  Dr.  Thomson:  This  is  an  incipient 
heart  with  all  its  parts  in  prospect. 

For  my  own  part,  I  cannot  confide  in  the  observations  of 
the  reporter  as  to  the  fact.  It  seemed  to  me  from  the  man- 
ner of  his  observations,  that  he  might  have  been  mistaken. 
The  movements  were  seen  several  minutes  apart,  and  it  oc- 
curred to  me  there  was  an  opportunity  for  self-deception. 


556  The  Peninsular  and  Independent* 

Mr.  G.  H.  Lewes  —  not  a  medical  man,  but  an  able  popu- 
lar writer,  sent  in  three  papers  on  physiological  subjects,  the 
titles  of  which  are  in  the  list.  He  attacked  prevaiUng  views 
with  boldness  and  vigor,  and  brought  some  out  severely 
against    him,   especially  Dr.   Be:nt^ett. 

Mr.  L.  found  fault  with  a  want  of  accurate  definitions  of 
sensation^  and  various  other  terms  used.  Announced  as  a 
trueism,  that  identity  of  structure  gives  identity  of  function, 
and  diversity  of  structure  diversity  of  function  —  declared, 
the  structure  of  what  we  called  sensory  and  motor -nerves 
to  be  identical  —  questioning  the  common  distinction  —  de- 
clared the  gray  matter  of  the  nerves  to  be  identical  with 
the  gray  matter  of  the  brain  —  inferred  identity  of  function 
— a  force  of  their  own,  like  brain  force  —  proposed  new  terms 
—  neurility  and  sensibility,  giving  each  specific  meanings,  &c., 
&c.  Dr.  Beknett's  criticisms  I  thought  very  loose  and  illogi- 
cal. Profs.  Sharpey,  Thomson,  and  Huxley,  and  Sir  B. 
Brodie,  were  more  liberal  and  fair  in  their  remarks,  admit- 
ting, as  all  must,  that  we  have  much  in  relation  to  the 
physiology  of  the  nerves  to  improve  and  learn.  The  discus- 
sion was  exceedingly  interesting,  but  took  too  broad  a  range, 
and   was  too  much  diversified  to  be  reported  here. 

For  my  own  part,  I  felt  much  interested  in  Mr.  Lewes, 
who  was  not  present,  and  in  a  subsequent  discussion  upon 
another  of  his  papers,  defended  some  of  his  positions,  which 
I  believed  to  be  correct.  I  hope  he  will  go  on  with  his 
physiological  wi'itings.  It  is  alleged  that  he  is  an  "outsider," 
but  outsiders,  in  regard  to  any  science  or  subject,  may  be 
useful  critics  nevertheless.  We  often  consult  even  children  as 
to  the  faithfulness  of  a  picture  to  nature,  and  profit  by  their 
opinions.  Improvements  in  medical  science  have  sometimes 
come  from  non  -  professional  persons  —  political  improvements 
from  those  who  have  not  been  educated  in  politics.  But  Mr. 
Lewes,  though  not  a  professional  man,  has  studied,  it  was 
stated,  physiology  thoroughly  —  was  well  informed  of  its  liter- 
ature —  perhaps  much  better  than  some  who  might  criticise  him. 
While  I  would  not  receive  such  a  man  as  an  authority,  I 
would  listen  to  him  as  a  witness,  and  would  receive  his  sug- 
gestions for  what  they  were  worth. 

I   have   thus   given   you   a  brief  and  exceedingly  imperfect 


Editorial  Department.  55 Y 

report  of  a  single  day's  proceedings,  in  one  of    the  eight    sec- 
tions of  the    British   Association  for  the   Advancement  of  Sci- 
ence, and    this,  with  other  matters  mentioned,  will  enable  you, 
I  hope,  to  form  some  notion  of  its  character.      I  should,  how- 
ever, further  say  that  two  of  the  evenings    since  the  body  has 
been  in  session,  besides   the  opening,  have  been  occupied  with 
lectures  in  the  large  Musical  Hall,  before  the  whole  body.  One 
by  Sir  R.  J.  Muechisoi^,    Director   General  of  the  Geological 
Survey    of    the    United    Kingdom,    "  On   the    Geology  of  the 
Northern   Highlands   of    Scotland,"    another    by  the   Rev.  Dr. 
Robinson,   Director  of    the    Armagh  Observatory,    "  On  Elec- 
trical   Discharges   in    highly  Rarified  Media;"    and   two  other 
evenings  were  spent  in  general  conversaziones  in  the  Music  Hall 
and    rooms    adjoining,  where    a    large    number    of    objects    of 
scientific  and  historic  interest  were  exhibited,  and  where  prome- 
nades and  refreshments  were  enjoyed — coffee,  tea,  &c.,  but  no 
wines   were    provided.      Large  numbers  of  ladies  were  present 
on  these  occasions.     The   Geological  lecture  was  illustrated  by 
large  drawings,  and  the  the  Electrical  by  the  most  brilliant  ex- 
periments   of   the  kind   I   have  ever   witnessed.      During   the 
electrical    discharges    into    these  Rarified  Media,    the  Hall  was 
darkened,  and   the  most  beautiful  colored   lights  produced    of 
which  it  is  possible  to  conceive. 

The  concluding  meeting  —  a  general  one — took  place  on 
Wednesday  the  21st.,  at  3  o'clock  p.  m.,  when  a  report  was 
made  of  the  proceedings  of  the  General  Committee,  showing 
an  appropriation  of  £930  for  the  coming  year ;  for  various 
scientific  enquiries,  &c.,  and  various  congratulatory  and  lauda- 
tory speeches  were  made. 

During  the  Session  of  the  Association,  a  note  was  received 
by  the  Secretary  from  the  Prince  Consort^  inviting,  in  the  name 
of  Her  Majesty,  the  members  of  the  General  Committee,  in- 
cluding foreigners  in  attendance,  to  a  breakfast  on  Thursday  at 
Balmoral,  her  Scottish  residence,  about  fifty  miles  from  Aber- 
deen, among  the  Highlands.  It  was  of  course  accepted,  and  at 
6  o'clock  in  the  morning  of  that  day,  200  persons,  including 
most  of  the  distinguished  men  of  the  Association,  were  on 
their  way ;  seventeen  miles  being  of  railway  and  the  remain- 
ing thirty  -  three  by  omnibusses.  This  route  was  a  most  beauti- 
ful one,  up  the  river  Dee,  presenting  many  characteristic  scenes 
of  the  Highlands,  bringing  us  to  the  Palace  about  2  o'clock. 


558  The  Peninsular  and  Independent, 

This  letter  is  already  too  long,  and  I  shall  attempt  no  de- 
tailed description  of  our  entertainment.  A  good  deal  of  pre- 
paration had  evidently  been  made  for  our  reception  and  enjoy- 
ment. There  was  a  large  collection  of  people  within  the 
grounds,  tents  were  pitched  about,  bands  of  music,  companies 
of  Highlanders  in  their  national  costumes,  were  present,  and 
during  the  afternoon  a  large  number  of  the  Scottish  national 
games,  such  as  throwing  a  huge  sledge,  carrying  and  throwing 
over  an  immense  pole,  foot  racing,  and  dancing  the  "  Highland 
Fling,"  were  performed ;  the  Queen  giving  prizes  to  those  Avho 
excelled  in  tliese  muscular  feats.  The  Queen,  and  her  husband 
and  family  were  dressed  in  Scottish  costume,  and  entirely 
unattended  by  any  guards — not  a  musket  was  in  sight  — 
was  surrounded  by  her  guests  and  almost  literally  mingling 
with  the  people  around.  She  is  a  bright,  energetic,  kind  look- 
ing little  woman,  and  the  Prince  of  AVales  and  the  rest  of  the 
family  are  very  pleasant,  good  looking  children.  They  aU  seem- 
ed in  excellent  health,  and  under  excellent  physical,  mental, 
and  moral  discipline.  Both  the  Queen  and  her  husband  appear 
remarkably  young  for  persons  of  their  age,  and  in  no  way  ap- 
pear to  difler  from  other  well  dressed,  well  behaved,  respecta- 
ble people.  Looking  with  purely  republican  eyes,  it  seems 
strange  that  so  much  interest  is  concentrated  upon  one  little 
woman;  innocent,  sensible  and  amiable  though  she  be  —  but 
the  sentiment  of  loyalty  is  strongly  rooted  in  the  English,  and 
indeed,  in  the  Scottish  heart,  and  in  the  present  state  of  the 
world  it  may  be  weU  that  it  is  so.  There  could,  certainly,  be 
no  more  unexceptionable  RoyaUey  than  that  which  now  amuses 
and  interests  the  British  nation;  and  as  I  left  the  royal  pres- 
ence and  mansion,  with  the  effects  of  royal  good  -  cheer  upon 
me,  I  could  but  join  in  the  general  wish  for  the  good  health 
and  long  life  of  Her  Majesty,  and  as  the  bauds  played  "  God 
save  the  Queen,"  a  fervent  heart -felt  response  could  but  arise. 

^''^LM^i  Yours  truly,  A.  B.  P. 


The  Ifew  York  Medical  Press 

Very  justly  complains  of  us  for  quoting  fi'om  its 
pages  without  due  credit.  We  thank  him  for  calling 
our  attention   to   the   fact   and   hasten   to   make  due   apo- 


Editorial  DexMrtment.  559 

logy.  The  error  originated  with  the  compositor,  and  was 
inadvertantly  allowed  to  pass  the  proof  reader.  We  as- 
sure our  Metropolitan  brother  that  no  injustice  was  in- 
tended. The  charge,  however,  that  we  attempted  to 
"deprive  us  (them)  of  our  (their)  distinguished  fellow 
citizen.  Dr.  Cammah,  of  Fourteenth  st.,  whom  they  (we), 
would  fain  locate  in  the  pleasant  little  village  of  Detroit," 
is  quite  as  "ludricous"  as  any  of  our  own  "bunders." 
The  self-  complacency,  too,  which  our  friend  of  the  '^ Press" 
displays  in  advancing  such  an  idea,  and  also  in  alluding 
to  our  pleasant  little  village  is  highly  amusing.  Don't 
be  alarmed,  brother,  we  won't  steal  amj  of  you.  By  no 
act   of  ours  will  you  be   compelled  to  ruralize  in  Detroit. 

a. 

The  Cleveland  Medical  Gazette 

Asks  us  if  we  have  forgotten  him.  By  no  means, 
dear  brother ;  we  thought  we  had  given  you  due  notice  ; 
and  if  we  have  not,  we  have  reproduced  from  your  pages 
a  capital  article  of  your  own ;  and  we  now  bear  testimony 
that  you  are  born,  christened,  and  are  crowing  lustily. 
Seriously,  we  highly  prize  the  exchange  and  wish  it  all 
success.  Gr, 


thtttli  ^xixths,  gibstracts,  ^t. 


•♦• 


ABSTRACTS  AND  SELECTIOXS  for  tbe  PEMNSULAR  AND  LNDEPEXDEMT. 


By  M.  A.  Pattbbson,  M   D.,  Tecumsoh. 


DESCRIPTION  OF  A  FRACTURE -BOX  ADAPTED  TO  THE  APPLICATION  OF 
EXTENDING  AND  COUNTER -EXTENDING  ADHESIVE  BANDS. 

In  the  August  number  of  the  Peninsular  and  InchpeTident^  we 
gave  an  abstract  of  Dr.  Gilbert's  method  of  effecting  counter  -  exten- 
sion in  oblique  fractures  of  the  lower  extremity.  Since  then  we  have 
tested  the  value  of  his  suggestions  in  two  cases  of  fracture  of  the 
thigh-bone,  one  of  which  was  very  oblique,  and  we  must  say  that  we 
have  never  known  fractures  of  this  description  treated  with  so  little 
trouble  to  all  concerned  or  with  better  results.  In  place  of  the  splints 
recommended  by  Dr.  Gilbert,  we  used  an  old  fashioned  straight  frac- 
ture-box, modified  for  the  proper  attachment  of  the  adhesive  bands. 
Originally,  this  box  was  constructed  of  three  narrow  boards,  the  side 
pieces  being  of  the  length  of  a  line  drawn  from  the  patient's  groin  to 
about  six  inches  beyond  his  foot.  The  bottom  board  reached  the  same 
distance  above,  but  extended  no  lower  than  just  above  the  malleoli ; 
thus  allowing  the  heel  to  clear  the  bottom  board.  Mortice  holes  were 
cut  near  the  lower  end  of  each  side  piece,  for  the  reception  of  a  cross- 
piece,  to  which  the  now  —  we  trust  —  obsolete  gaiter  or  folded  handker- 
chief was  formerly  tied  for  the  purpose  of  maintaining  extension.  In 
the  place  of  this  cross-piece  we  substitute  a  wooden  roller,  an  inch  in 
diameter,  with  a  ratchet-wheel  on  the  end  that  passes  through  the 
outer  side -piece.  The  centre  of  the  roller  is  perforated  with  two  gim- 
let -  holes,  through  which  the  strings  of  the  adhesive  extension  band  are 
passed,  in  order  to  fasten  them  conveniently  to  the  roller.  The  ratchet- 
wheel  enables  us  to  reguluate  and  maintain  the  required  extension  very 
perfectly.  Instead  of  terminating  the  outside  piece  opposite  the  groin,  as 
in  the  old  box,  we  have  it  made  to  extend,  in  a  direction  somewhat 
obliquely  above  the  plane  of  the  box,  to  a  point  opposite  the  nipple  or 
rather  above  it.  The  object  of  this  departure  from  a  straight  line  is  to 
give  the  box,  and  consequently  the  injured  limb,  any  desired  inclination 
from  below  upward  without  resistance  from  the  under  edge  of  the  upper 


Selected  Articles^  Abstracts^  c&c.  561 

splint -like  extremity  of  the  box.  The  object  of  extending  the  side- 
piece  so  high  toward  the  axilla  is  to  form  a  point  for  the  attachment 
of  the  adhesive  counter  -  extending  bands,  after  adjustment,  precisely  in 
the  manner  directed  by  Dr.  Gilbert;  whereby  we  secure  the  principal 
object  of  Piiysick's  modification  of  Desault's  splint.  In  this  position, 
in  the  language  of  Dorsey,  "The  band  for  counter  -  extension  acts  upon 
the  pelvis  in  a  line  nearly  parallel  with  the  natural  direction  of  the 
limb  and  has  no  tendency  to  any  lateral  displacement  of  either  fragment." 

The  extending  and  counter  -  extending  strips  should  be  neatly  ap- 
plied, and  made  to  adhere  firmly  to  the  skin  before  the  limb  is  placed 
in  the  box.  In  compound  fractures,  lids,  to  open  on  hinges,  must  be  in- 
serted, at  points  convenient  for  dressing  the  lacerated  soft  parts.  We 
need  scarcely  say  that  the  inside  of  the  box  should  be  padded  to  suit 
the  requirements  of  the  case. 

We  have  thus  rudely  described  a  modification  of  an  almost  obsolete 
fracture  box,  which,  with  its  appendages,  adhesive  strips,  bandages,  etc., 
seem  to  combine  all  the  essentials  of  a  good  fracture  apparatus  —  at 
once  simple,  cheap  and  efficient.  The  injured  limb  rests  on  a  smooth, 
firm,  extended  plane ;  precisely  where  it  should  lie  when  fractured.  The 
side  -  pieces  have  all  the  advantages  of  ordinary  splints  without  their 
constant  tendency  to  displacement.  The  box,  as  modified,  together  with 
the  fracture  bed  described  in  the  August  number  of  this  Journal,  page 
307,  can  be  made  in  a  few  hours,  by  any  ordinary  mechanic,  at  the 
cost  of  a  few  shillings. 

Apply  the  adhesive  bands  as  directed  by  Dr.  Gilbert;  place  the 
box  on  the  fracture  bed;  lay  the  limb  into  it  and  adjust  the  whole  ap- 
paratus carefully,  applying  merely  sufficient  extension  to  retain  the  frac- 
tured extremities  nicely  in  apposition  —  a  thing  by  no  means  diflScult, 
if  the  muscles,  during  the  first  few  days  are  not  outrageously  irritated 
by  repeated  officious  efforts  to  "  pull  the  limb  into  shape  "  —  and,  we 
shall  be  greatly  mistaken  if  the  limb  in  due  time,  does  not  come  out 
of  the  box  of  the  right  length  and  form. 


FRACTURE  OF  BOTH  CLAVICLES. 

Dr.  A.  Metz,  of  Massilon,  0.,  reports  for  the  Ohio  Medical  and 
Surgical  Journal,  a  case  of  fracture  of  both  clavicles — certainly  a  rare 
accident,  and  for  the  remedying  of  which  we  are  not  aware  that  European 
Surgery  has  any  reliable  apparatus.  Speaking  of  the  case,  Dr.  Metz 
remarks:  "Never  having  given  the  management  of  such  an  unexpected 
contingency  a  thought,  I  was  taken  by  surprise  by  the  complete  inap- 
plicability of  all  the  fixtures  I  had  been  in  the  habit  of  using  for  frac- 
tures of  the  clavicle.  Fox's  excellent  apparatus  I  found  useless  —  or  at 
least  quite  inconvenient,  for  want  of  a  point  of  attachment  for  the 
tapes.     *    *    *     J  ^jjgjj  applied  to  my  friend  Dr.  F.  T.  Huxthal  for  a 

Vol.  IL— 2L. 


562  The  Peninsular  and  Independent, 

pattern  of  his  yoV,e^  with  which  he  has  quite  successfully  treated  frac- 
tures of  the  clavicle.  1  believe  he  is  the  originator  of  it.  I  had  the 
yoke  project  a  few  inches  beyond  the  shoulders  with  holes  in  the  ends 
for  attaching  tapes.  I  used  the  elbow -pokes  and  axillary  pads  of  Fox 
and  the  yoke  presented  excellent  points  of  attachment  for  the  tapes. 
The  cure  was  completed  with  but  little  trouble  and  no  deformity." 


ISTASAL  POLYPUS  CURED  BY  TINCT  MURIATE  OF  IRON. 

Dr.  J.  II.  Reeder,  of  Lacon,  111.,  has  an  article  in  the  Chicago 
Medical  Journal  describing  the  cure  of  two  cases  of  nasal  polypus  by 
the  application  of  diluted  muriate  tinct.  of  iron.  He  injected  the  tinct. 
in  the  first  case,  to  arrest  the  hemorrhage  arising  from  an  unsuccessful 
effort  to  extract  the  polypus  by  means  of  the  forceps.  After  the  injec- 
tion a  piece  of  moistened  sponge  was  forced  into  the  nostril  "  with  the 
view  of  dilating  it."  On  the  following  morning  the  patient  —  a  little 
girl — informed  him  "that  soon  after  she  arose  from  her  bed  the  whole 
mass  had  escaped  from  the  nostril  posteriorly  and  had  been  thrown  out 
on  the  floor  a  semi-fluid  mass."  The  second  person  treated  was  a  gen- 
tleman, "who  has  had  polypus  in  both  nostrils  for  more  than  ten 
years."  In  this  case  the  tincture,  but  slightly  diluted,'  was  applied  by 
saturating  the  sponge  of  a  small  probang,  and  forcing  it  as  fir  up  the 
nostril  as  practicable,  repeating  the  operation  every  alternate  day.  In 
about  a  week  both  nasal  cavities  were  free  from  all  obstructions." 


MODE  OF  APPLYING  ARBENIC  TO  DESTROY  THE  NERVE  OF  A  TOOTH. 

The  editor  of  the  American  Journal  of  Dental  Science^  alluding  to 
the  newspaper  statement  that  "  Lieut.  Stamford  was  supposed  to  have 
lost  his  life  from  the  effects  of  arsenic  applied  to  a  tooth  for  the  pur- 
pose of  destroying  the  nerve,"  remarks,  "If  this  be  true,  four  times 
as  much  arsenic  must  have  been  used  as  is  required  to  destroy  the 
vitality  of  the  pulp  of  a  tooth,  and  it  must  have  been  applied  very 
carelessly."  In  the  use  of  this  agent  medicinally,  the  tenth  part  of  a 
grain  is  often  administered  at  a  time,  and  the  fortieth  or  fiftieth  part 
of  a  grain  is  suflScient  to  destroy  the  nerve  of  a  tooth.  After  being 
placed  upon  the  exposed  nerve,  the  cavity  in  the  tooth  should  be  se- 
curely filled  with  softened  wax,  to  prevent  the  possibility  of  the  escape 
of  the  assent  into  the  mouth. 

The  manner  in  which  we  have  it  prepared  for  use  is,  to  mix  gr. 
1  of  arseniojis  acid  with  the  same  quantity  of  sulp.  morphia.  The  two 
are  thoroughly  incorporated  and  then  divided  into  thirty  parts.  Each 
of  these  powders  is  put  into  a  paper  by  itself  In  applying  it  to  a 
tooth,  a  small  dossel  of  raw  cotton  is  moistened  in  creosote,  and  then 
placed  on  the  arsenical   powder  which  it   readily  absorbs.      This    done, 


Selected  Articles^  Abstracts^  c&c.  563 

the  cotton  is  placed  carefully  over  the  exposed  pulp,  and  the  cavity 
sealed  in  the  manner  as  stated  above  It  is  permitted  to  remain  in  the 
tooth  from  seven  to  ten  hours;  it  is  then  removed,  and  the  pulp  com- 
pletely extirpated  to  the  extremity  of  the  root.  In  removing  the  pow- 
der, about  one -tenth  of  it  remains  adhering  to  the  paper,  so  that  not 
more  than  the  fortieth  part  of  a  grain  is  actually  applied  to  the  tooth. 
This  quantity  is  as  effective  in  the  destruction  of  the  vitality  of  the 
pulp  of  a  tooth  as  half  a  grain  would  be." 


REPLACEMENT  OF  AN  EXTRACTED  TOOTH. 

We  notice  in  the  Lancet^  that  Thos.  H.  Harding,  an  experienced 
Dentist  of  London,  insists  that  when  a  sound  tooth  is  removed  it  may 
be  immediately  returned  to  the  alveolus,  with  a  reasonable  prospect  that 
it  will  resume  its  vitality! 


COMPOUND  SYR.  OF   THE  HYPOPHOSPHATES  OF  IRON,  SODA,  LIME  AND 
POTASSA  IN  TYPHOID  FEVER. 

Prof.  J.  B.  Read,  of  the  Savannah  Medical  College,  reports  in   the 
Savannah   Medical   Journal^    a   severe   case   of  enteric  fever,  which   for 
thirty  days  resisted  all  ordinary  treatment,  tereblnthinates  included,  and 
during  its  progress  assumed  a  more  alarming  form.     He  says :    "  On  the 
thirtieth  day  of  his    illness   his   case  seemed  to  be  desperate,  and  I  de- 
termined,  as    all  the  ordinary  methods  of  treatment  had  failed,  to  have 
recourse   to   some   powerful   nervous    stimulant  —  to   try  and  excite  the 
torpid  nervous  system.     Some  preparation  of  phosphorus  seemed  best  to 
suit  the  /indications  of  the  case,  and  I  determined  to  give  the  Syrup  of 
Hypophosphites,  for  it  contained  not  only  phosphorus  in  its  most  easily 
assimilated  form,  but  likewise  in  the  iron,  lime,  soda  and  potassa,  reme- 
dies  which   might   be   useful  in  the  weakened  state  of  the  assimilating 
organs,  recollecting  also  that  Stevens,  in  his   examination  of  the   blood 
in  this  disease,  found  it  wanting  in  its  alkaline  constituents.     I  discoti' 
tinued  all  previous  treatment  and  directed   20  drops  of  the  comp.  syrup 
to  be  given  every  two  hours,  with  a  teaspoonful  of  brandy  in  a   table- 
spoonful  of  iced  milk.     Visiting  the   patient   after   the   third  dose   had 
been  administered,  I  was  agreeably  surprised  to  find   his   condition  im- 
proved.    There  had  been  no  more  action  from  the  bowels,  the  pulse  was 
not  so  rapid,  the  skin  was  warmer  and  the  tongue  had   a  little   less  of 
the  hard    dry,  red  appearance,  the  abdomen  was  not  so  much  swollen." 
The  dose  of  the  syrup  was  now  increased  to  30  drops,  and  repeated  as 
before,  which,  with  an  occasional  enema  of  flaxseed  tea,  was  all  the  medi- 
cation required  until  the  patient  was  restored  to  health.     From  the  Pro- 
fessor's description  we  conclude  that  his  patient  had  all  the  dangerous 


564  The  Peninsular  and  Independent. 

symptoms  characteristic  of  the  worst  forms  of  the  disease,  except  hemorr- 
hage of  the  bowels,  which  is  not  alluded  to. 


ANESTHESIA  DURING  SLEEP. 

We  notice  in  the  report  of  proceedings,  for  September,  of  the 
Buffalo  Medical  Association,  published  in  the  October  number  of  the 
New  York  monthly,  that  "Dr.  Hamilton  is  of  the  opinion  that  a 
person  during  sleep  could  not  be  anassthetized  by  chloroform.  He  re- 
cently tried  the  experiment,  placing  chloroform  to  the  nostrils  of  a  child. 
It  at  once  turned  away  its  head;  again  applying  it,  the  child  again 
turned  away;  the  third  trial,  the  child  lifted  up  its 'head,  pressed 
away  the  handkerchief  and  awoke.  This  question  is  important  in  a 
medico -legal  point.  He  hopes  that  experiments  will  be  made,  and 
that  others  will  pursue  the  mquiry;  but  is  thoroughly  convinced  the 
effect  can  not  be  produced,  unless  the  person  be  drugged,  or  is  in 
an  unnatural  sleep."  Dr.  Wycoff  held  different  views,  but  most  of 
the  members  were  evidently  in  a  quandary  on  the  subject. 


METALLIC  WIRE  IN  THE  TREATMENT.OF  HYDROCELE. 

The  Medical  and  Surgical  Rej^orter,  Philadelphia,  says,  that  this 
method  of  treating  Hydrocele  "is  reported  upon  unfavorably  by  Dr. 
Gillespie,  in  the  Medical  Times  and  Gazette.  The  results  in  the  cases 
operated  on  by  him  were  unsuccessful,  or  the  treatment  prolonged  and 
painful. 

A  Neio  Diuretic.  — The  same  Journal  for  October  15,  states,  that 
"Dr.  Byerly,  of  Cheshire,  Eng.,  attributes  powerful  diuretic  properties 
to  the  erodium  cicutarium  or  '  Storks'  bill.' "  He  gives  in  the  Medical 
Times  and  Gazette^  the  following  directions  for  its  use.  "  Infuse  an 
ounce  of  the  dried  plant  (every  part  of  it)  in  three  pints  of  water, 
stewing  it  in  an  oven  until  two  pints  remain.  The  dose  for  an  adult 
is  four  or  five  fluid  ounces,  three  times  a  day  ;  probably  more  may  be 
needed  in  some  cases." 

The  Storks'  bill  is  indigenous  in  England  where  it  grows  abun- 
dantly on  sand  hills  near  the  coast,  but  it  has  been  introduced  into 
this  country  and  is  to  be  found  on  the  shores  of  Oneida  lake,  in  the 
State  of  New  York." 


REMEDY  FOR  THE  BITE  QF  MAD  DOGS 

In  the  absence  of  all  reliable  remedies,  the  following,  from  the 
London  Medical  Circular^  although  originally  derived  from  rather  ques- 
tionable authority  may  be  worth  remembering:  "  A  Saxon  forester,  named 
Gastell,  now  of  the  venerable  age  of  82,  unwilling  to  take  to  the  grave 


Select  Articles^  Abstracts^  <&c.  565 

with  him  a  secret  of  so  much  importance,  has  made  public  in  the  Leip- 
sic  Journal  the  means  which  he  has  used  for  fifty  years,  and  where- 
with he  affirms  he  has  rescued  many  human  beings  and  cattle  from  the 
fearful  death  of  hydrophobia.  Take  immediately  warm  vinegar  or  tepid 
water,  wash  the  wound  clean  therewith,  and  then  dry  it :  then  pour 
upon  the  wound  a  few  drops  of  hydrochloric  acid,  because  mineral 
acids  destroy  the  poison  of  the  saliva. 


OVARIAN"  DISEASE. 

Dr.  Channing,  in  a  somewhat  humorous  communication,  published 
in  the  '■''Boston  Medical  and  Surgical  Journal,''''  entitled  "Never  too 
late  to  mend,"  among  other  reminiscences  describes  two  cases  of  Ovarian 
tumor  of  great  size,  which  yielded  to  "the  external  and  internal  use  of 
iodine,  with  occasional  substitutes  of  the  liquor  calcis  muriatis,  for  the 
internal  use  of  iodine"  —  or,  to  time  —  after  treatment  "for  months  or 
years."  The  doctor  says,  "the  fir^c  noticed  effect  was  the  arrest  of 
growth. " 


ACONITUM  NAPELLUS. 

Dr.  John  R.  Gushing,  of  Alabama,  speaking  of  this  article — At- 
lanta Medical  and  Surgical  Journal  —  not  only  confirms  the  views  of 
Dr.  Ames  respecting  the  sedative  influence  of  this  agent  over  the  heart's 
action,  thereby  controlling  inflammatory  affections,  but  says,  "aconite 
comes  nearer  to  my  notion  of  being  a  specific  than  any  other  agenf  I 
have  ever  used.  *  *  *  Many  times  it  supersedes  mercury  in  its  con- 
trolling influence  over  diseased  action,  when  the  mercurial  is  contra- 
indicated,  or  the  system  will  not  bear  it."  The  therapeutical  properties 
of  aconite  have  been  greatly  overrated  by  a  class  of  irregular  practi- 
tioners. It  is  probable  that  it  will  never  be  a  favorite  remedy  with  the 
generality  of  the  profession  or  supersede  the  veratrum  vivide  as  an  arte- 
rial sedative, 


TETANUS  CURED. 

Dr.  Fisher,  resident  Surgeon  of  the  N.  Y.  Hospital,  reports  the 
following  case  for  the  Iffew  Yor'k  Medical  Press,  "A.  B.,  aged  15,  a  deli- 
cate looking  boy,  was  admitted  August  22,  with  a  severe  laceration  and 
contusion  of  the  toes  of  left  foot,  caused  by  their  being  ran  over  by  a 
car.  *  *  ^  On  the  8th  September  symptoms  of  tetanus  began  to 
show  themselves.  The  corners  of  the  mouth  were  drawn  up,  the  jaws 
firmly  closed  and  the  sterno  -  mastoid  muscles  rigidly  contracted.  As 
soon  as  these  symptoms  showed  themselves,  the  attending  surgeon 
(Dr.    John   Watson;    ordered   the  patient  to  be   fed   with   milk  punch 


566  The  Peninsular  and  Independent. 

and  beef  tea,  in  as  large  quantities  as  could  be  taken,  also  injections 
of  Emulsion  Assafoetida  3  ^  every  three  hours  was  ordered,  and  di- 
rections given  that  the  patient  be  sedulously  protected  from  drafts  of 
air.  This  treatment  Dr.  Watson  prescribes  with  much  confidence  in  its 
good  results,  as  he  has  had  large  experience  in  treating  this  fearful 
malady.  *  ''=  *  The  remedies  were  persevered  in,  the  injections  being 
given  as  directed,  day  and  night,  till  October  4.  Patient  could  now  set 
up  in  bed  and  enjoyed  good  health." 

In  the  June  number  of  the  Peninsular  and  Independent  will  be 
found  an  abstract  of  an  interesting  case  of  Tetanus  treated  by  Atropia — 
we  say  treated,  because,  although  the  patient  recovered,  we  believe  that 
Dr.  AVatson,  and  all  other  physicians,  intelligent  on  this  subject,  agree 
in  the  opinion  that  Tetanus  can  not  be  cured  in  the  ordinary  sense  of 
the  term.  The  disease  either  destroys  its  victim,  or,  in  time,  literally 
"wears  itself  out."  If  we  can  keep  the  patient  alive  by  the  administra- 
tion of  stimulants  and  anti-spasmodics  until  the  violenence  of  the  malady 
has  subsided,  we  shall  accomplish  all  that  our  art  is  capable  of  effect- 
ing.    In  this  view  all  treatment  must  be  regarded  as  palliative. 


DEATH  FROM  CHLOROFORM. 

Our  object  is  not  to  add  another  name  to  the  list  of  victims  who  have 
suddenly  died  in  consequence  of  inhaling  chloroform.  But  to  call  at- 
tention to  the  foct  that  these  melancholy  announcements  are  of  start- 
ling frequency,  and  admonish  the  prudent  practitioner  to  inquire  whether 
ether  can  not  be  generally  substituted  to  produce  anaesthesia  in  place 
of  an  agent  that  has  frequently  extinguished  life,  when  a  few  minutes 
before  the  sad  occurrence,    not   the  slightest  danger  was    apprehended. 

It  is  in  vain  to  repeat  the  more  than  "thrice  told  tale,"  that  most 
of  the  numerous  recorded  and  unrecorded  instances  of  "Death  from 
Chloroform,"  were  produced  by  ignorance  or  carelessness.  This  agent 
has  destroyed  life  at  times  when  its  administration  has  been  sedulously 
watched  by   the  most  experienced  and  intelligent  operators. 

"We  believe  that  a  majority  of  the  Surgeons  of  the  United  States 
prefer  ether  on  account  of  its  superior  safety,  but  many  still  use  chlor- 
oform in  cases  where  ether  would  answer  their  purpose  equall}'  as  well 
and  be  far  less  hazardous  to  their  patients. 

The  Editors  of  the  Boston  Medical  and  Surgical  Journal,  in  the 
September  15  No.,  advance  the  opinion  that  Chloroform  "  is  unsafe 
in  the  most  careful  and  most  experienced  hands;"  also,  that  "the 
merits  of  ether  in  preference  to  Chloroform  as  an  anaesthetic  agent, 
are  slowly  gaining  ground  in  the  estimation  of  the  medical  public, 
and  the  time  will  surely  come  when  the  latter  drug  will  be  almost 
wholly   abandoned,"     The   same  journal    publishes  a   translation   of  an 


Selected  Articles^  Abstracts^  Sc.  567 

article  from  the  Gazette  Medicale,  of  Lyons  —  the  second  largest  city 
of  France  —  containing  a  discussion  before  the  Imperial  Society  of 
Lyons,  of  the  following  propositions,  which,  after  full  and  free  dis- 
cussion, were  unanimously  adopted,  as  the  deliberate  conclusion  of 
the  Society. 

The   Imperial   Society   of  the  city  of  Lyons,    is  of  the   opinion: 

That  ether  employed  to  produce  anaesthesia  in  surgery,  is  less 
dangerous   than   Chloroform: 

That  ana3sthesia  is  obtained  as  constantly  and  as  completely  by^ 
ether   as   by  Chloroform : 

That  if  ether  presents  the  inconveniences,  which  Chloroform  offers 
to  a  less  degree,  these  inconveniences  are  of  slight  importance,  and 
do  not  compensate  for  the  danger  inherent  to  the  employment  of  the- 
latter : 

That,  consequently,  ether  ought,  in  general,  to  be  preferred  to 
Chloroform. 

TREATMENT  OF  SPINA  BIFIDA  BY  INJECTIONS  OF  IODINE. 

"We  can  scarcely  imagine  more  unpromising  subjects,  for  hopeful 
medical  or  surgical  treatment,  than  the  victims  of  Spina  Bifida  which 
have  fallen  under  our  observation  during  a  somewhat  active  practice 
of  more  than  thirty  years.  Having  but  little  confidence  in  the  reme- 
dies usually  proposed  for  the  removal  of  this  strange  malady,  we 
merely  allude  to  the  subject  in  order  to  inform  our  readers  that  in 
the  September  number  of  the  Chicago  Medical  Journal^  Prof  Brai- 
NARD  reports  the  cure  of  five  out  of  seven  cases  of  Spina  Bifida,  by 
means  of  iodine  injections.  Five  of  these  w'ere  operated  on  by  him- 
self, and  two  by  Dr.  Crawford,  under  his  direction.  Two  of  the 
cases  described  as  follows,  by  Dr.  Brainard,^;  will  serve  to  illustrate 
his  practice: 

Case  I. —  "  The  subject  was  a  girl  thirteen  years  of  age.  The 
tumor,  situated  at  the  top  of  the  sacrum,  was  nine  inches  in  circumference 
and  three  inches  in  height.  Its  surface,  and  the  skin  adjoining,  presented 
numerous  cicatrices,  marks  apparently  of  former  ulcerations.  The  child 
was  partially  paralytic  in  the  lower  extremities,  idiotic,  and  passed  the 
urine  and  foec.es  involuntarily.  The  head  was  small  and  the  bones  per- 
fectly formed. 

The  first  injection  was  performed  on  the  2nd  December,  184:7.  A 
puncture  was  made  with  the  point  of  the  lancet,  half  an  inch  distant  from 
the  point  of  the  base  of  the  tumor,  and  a  small  -  sized  exploring  trochar 
carried  thence  into  the  sac.  Through  the  canula,  a  solution  of  half  a  grain 
of  iodine,  with  one  grain  of  iodide  of  potassium,  in  one  ounce  of  distilled 
water,  was  injected.  The  canula  was  immediately  withdrawn,  and  a 
compress  and  bandage  applied  so  as  to  prevent  the  escape  of  the  liquid. 

The  injection  produced  a  sharp  pain  which  soon  subsided.  Redness, 
heat,  and  tenderness  of  the  tumor  followed,  for  which  a  cathartic  was  ad- 
ministered, and  evaporating  lotions  applied  to  the  part.     Compresssion  was 


568  The  Peninsular  and  ladipendait. 

resorted  to  as  the  heat  and  tension  sulj.^idcMl,  find,  December  27tli,  the  tu- 
mor was  about  half  its  former  size. 

At  this  time,  a  second  injection  was  ic-jru'i  lo,  of  half  the  strength  of 
the  first.  Thisi)rodiiced  little  inllaniination.  The  compression  was  contin- 
ued. January  15,  1848,  the  fluid  was  so  far  absf>rbed  as  to  render  it  easy 
to  press  most  of  it  within  the  spine,  and  a  common  spring  truss  for  hernia 
was  applied,  the  pad  upon  the  opening. 

The  case  then  piissed  from  under  my  observation,  but  full  under  the 
care  of  Dr.  Iluber,  who  had  at  that  titne  charge  of  the  county  poor  at  Chi- 
cago.    The  following  is  his  account  of  the  case  and  his  treatment: 

'I  injected  the  tumor  thirteen  times,  viz.:  May  3,  10,  20,  June  15,  22, 
July  14,  August  10,  lo,  25,  Sej>tember  5,  10,  2»;,  and  October  20,  1848. 
The  injection  for  the  first  four  times  was  of  the  strength  of  four  grains  of 
iodine  and  sixteen  grains  of  iodide  of  potassium  to  the  ounce  of  distilled 
water,  beginning  with  one  and  a-half,  and  increa.sing  to  three  ounces  at 
the  fourth  injection. 

'The  sac  was  then  much  contracted,  and  I  therefore  doubled  the 
strength  of  the  solution,  and  injected  but  half  an  ounce.  After  the  first 
two  operations,  the  child  had  some  slight  febrile  symptoms,  but  not  since. 
I  consider  the  cure  comj)lele.  She  has  improved  in  the  use  of  her  lower 
extremities,  being  now  able  to  walk  across  the  room,' 

Two  years  after  the  operation  the  child  remained  cured,  and  much  im- 
proved in  every  respect." 

"Case  II. —  This  case  occurred  to  me,  April  12,  184!i.  The  tumor 
was  of  the  size  of  a  closed  fist,  and  had  been  ruptured  during  labor. 

By  the  application  of  artificial  heat,  the  first  ill  effects  of  the  rupture 
were  dissipated.  A  reddish  serum  was  discharged  from  the  .sac  and  canal, 
which,  on  the  17lh,  became  copious  and  oll'ensive.  Injected  a  solution  of 
iodine,  4  grains,  iodide  of  potassium  12  grains  to  the  ounce  of  distilled  wa- 
ter.    The  solution  escaped  as  fast  as  injected. 

30^/i.  Kcpeated  injection ;  discharge  purulent. 

May  2'/.  Injecteil  with  solution  of  sulphate  of  copper,  and  applied 
compression  over  the  opening.  The  sac  was  contracted  down  to  a  hard  tu- 
bercle, with  a  small  opening  in  the  centre. 

The  injection  was  repeated  on  the  4th  and  Cth,  and  the  child  seemed 
well  in  every  respect. 

May  \1tli.  Opening  quite  closed;  liead  noticed  to  he  enlarging ;  hones 
seperated.  This  continued  till  June  1,  when  the  child  died  in  a  paroxysm 
of  convulsion. 

This  case  resulted  fiitally  from  closing  the  fistulous  opening  in  the  skin 
too  soon,  but  it  illustrates  in  a  striking  manner,  the  beneficial  effect  of  in- 
jections into  the  spinal  canal,  and  the  little  danger  to  be  apprehended  from 
their  use.     The  child  lived  over  six  weeks. 

I  was  not  aware,  at  the  time,  of  the  danger  of  making  compression  over 
such  an  opening,  but  held,  in  common  with  the  whole  profession,  the  erro- 
neous opinion,  that  the  danger  in  cases  of  inflammation  of  the  meninges  of 
the  cord  and  brain  was  greatest  when  an  opening  existed. 

This  is  an  error  which  has  recently  been  pointed  out  by  Dr.  Thompson, 
of  Columbus,  Ohio.  Far  from  closing  such  an  opening,  the  sac  should  be 
punctured  if  acute  inflammation  results  from  treatment,  and  the  liquid 
drawn  off." 

As  Dr.  Brainard's  successful  cases  date  back  several  years,  it  would 

be  interesting  to  know  the'present  physical  and  intellectual  state  of  the  sub- 

ects  thus  rescued,  apparently,  from  a  most  pitiable  condition. 


Selected  Articles^  Abstracts^  dec.  569 

RECTAL  ALIMENTATION  QUESTIONED. 

The  leading  article  in  the  American  'Journal  of  Insanity  for  July, 
is  an  able  essay  on  the  subject  of  "  Sitomania,^^  which  was  read  be- 
fore the  American  Association  of  Medical  Superintendents  of  American 
Institutions  for  the  Insane.  The  writer  had  been  appointed,  by  the  Pre- 
sident of  the  Association,  to  prepare  a  paper  on  "the  various  compulsory 
methods  of  administering  food."  Without  attempting  to  condense  the 
topics  embraced  in  the  entire  range  of  this  elaborate  paper,  we  shall 
merely  give  the  conclusion  of  the  author  on  two  points  of  impor- 
tant practical  utility. 

The  first  relates  to  the  best  mode  of  conveying  nutriment  into  the 
stomach  of  an  insane  person,  who  obstinately  persists  in  refusing  food. 

The  second  embodies  the  author's  views  on  the  vexed  subject  of 
Rectal  Alimentation.  In  regard  to  the  first  point,  after  describing  the 
instruments  invented  to  aid  in  accomplishing  the  process  of  forced  Ali- 
mentation, D.  Chipley  concludes  as  follows: 

"Of  all  these  instruments,  I  do  not  hesitate  to  give  the  preference 
to  the  wooden  spoon,  or  to  the  simple  process  of  projecting  the  food 
deep  in  the  pharynx,  while  the  dental  arches  are  held  apart  by 
means  of  a  wooden  wedge,  without  sharp  edges,  pressed  somewhat 
upon  the  tongue.  Without  entering  upon  any  elaborate  defense  of 
this  method,  I  may  say  that,  while  it  is  more  easily  accomplished 
than  most  others,  it  is  free  from  danger,  occupies  less  time,  and,  I 
am  yet  to  be  convinced,  that  it  may  not  be  practiced  in  any  case 
requiring  a  resort  to  force.  But  it  is  a  method  requiring  tact,  to 
be  acquired  only  by  experience.  This  tact  is  acquired  by  some  per- 
son with  wonderful  facility,  and  they  will  succeed  where  scores  of 
very   clever   practitioners  would   utterly   fail." 

His  conclusions  on  the  second  point,  are  contained  in  the  sub- 
joined extract: 

Nutritive  injections,  as  they  are  termed,  have  been  proposed  to 
meet  the  exigences  of  certain  cases.  I  know  that  this  process  is  approved 
by  high  authority,  and  I  know  not  where  to  find  authority  of  equal  weio-ht 
for  the  opinion  I  entertain ;  but  my  conviction  is  so  thorough  that  I  shall 
not  hesitate  to  avow  it.  I  do  not  believe  that  one  particle  of  real  nourish- 
ment can  enter  the  system  in  an  available  form  through  the  rectum.  And 
I  think  it  is  hazaidous  to  entertain  a  different  opinion.  In  many  cases  it 
is  so  much  easier  to  throw  fluids  into  the  rectum  than  into  the  stomach 
that  we  may  be  induced  to  rely  on  this  method  until  it  is  too  late  to  save 
the  patient  by  any  other  means.  This,  then,  is  a  practical  question  and 
one  of  great  importance.  The  view  we  take  of  it  may  involve  even  life 
itself. 

No  one  will  contend  that  this  process  finds  any  support  in  theory  con- 
structed in  the  light  of  modern  physiological  science.  How  can  the  rectum 
convert  any  species  of  aliment  into  chyle  ?  And  where  are  the  lacteals  to 
introduce  it  if  it  really  existed?    The  idea  of  rectal  alimentation,  ignores 


5V0  The  Perdnsular  and  Independent. 

the  wisdom  which  has  constructed  a  complicated  set  of  organs,  the  concur- 
rent action  of  which  is  absolutely  necessary  to  such  an  elaboration  of  food 
as  is  required  to  fit  it  to  become  incorporated  with  the  body,  and  thus  to 
sustain  its  vitality.  Follow  the  food  from  the  time  it  enters  the  stomach 
until  it  is  in  part  poured  into  the  circulation  to  supply  the  wastes  of  the 
system,  and  at  every  step  you  will  find  changes,  no  one  of  which  can  pos- 
sibly take  place  in  the  rectum.  Is  there  any  reason  to  suppose  that  the 
chana;es  wrouijht  by  the  action  of  the  gastric  and  pancreatic  j^if•r•^  and 
bile  are  not  essential  to  the  preparation  of  food  for  assimilation,  and  lor  the 
nourishment  and  support  of  the  body  V  Where  in  the  rectal  region  will 
you  find  an}"-  organ  capable  of  producing  that  ch^mge  which  is  effected  in 
the  r-hyle  as  it  passes  through  the  lacteal  glands?  How  different  are  the 
qualities  of  this  liui<l  when  it  issues  from  these  glands  from  those  which  it 
presents  when  it  enters  them  ! 

I  shall  be  told  that  poisons  are  taken  up  from  the  rectum  and  carried 
into  the  circulation,  and  why  not  nutritious  food?  T  am  aware  that  venous 
absorption  goes  on  there,  and  a  person  may  be  destro3'ed  by  throwing  poi- 
son into  the  rectum,  liut  that  is  a  perturbing  agent,  and  requires  no 
change  or  elaboration  to  render  it  capable  of  producing  certain  efTccts. 
Food  requires  to  undergo  material  alterations  before  it  is  fitted  to  sustain 
the  body.  If  it  may  be  taken  up  from  the  rectum  without  change,  and 
nourish  the  body,  why  not  inject  it  into  the  veins  at  once,  and  thus  effect 
directly  what  we  seek  to  do  through  the  rectum? 

There  are  no  lacteals  provided  to  perform  the  important  function  of 
absorbing  nutritive  matters  from  the  lower  bowels.  It  cannot  be  that  the 
lymphatics  fulfill  this  oflice,  as  is  readily  demonstrated  by  a  comparative 
analysis  of  the  contents  of  the  two  sets  of  vessels.  The  fluid  contained  in 
the  lymphatic,  is  composed  of  a  much  larger  proportion  of  water  than 
that  in  the  lacteals,  while  the  proportion  of  albumen,  fibrin,  and 
especially  fatt^'^  matter  predominate  in  the  latter.  This  material  dif- 
ference in  the  constitution  of  lymph  and  chyle  is  fatal  to  the  idea  of  its  af- 
fording any  support  to  the  body.  Although  the  function  of  the  l3''mphatics 
is  not  definitely  determined,  it  is  certain  that  they  form  no  channels  for 
conveying  new  material  to  the  system. 

''  The  corpuscles  of  the  chyle  are  the  same  as  those  of  the  lymph.  In 
addition,  however,  we  have  in  most  instances  the  molecular  I.  %  which  is 
present  in  the  lacteals  from  the  very  commencement,  even  from  the  villi 
of  the  intestines.  It  seems  to  consist  of  almost  infinitely  small  particles  of 
oleaginous  or  fatty  matter,  thrown  into  this  form  by  contact  with  the  pan- 
creatic secretion,  as  so  well  proved  by  Bernard.'"  But  in  the  rectum  we 
have  no  pancreatic  juice  to  perform  this  important  office,  and  we  know  of 
no  substitute  for  it. 

But  the  main  support  of  the  idea  of  rectal  alimentation,  is  to  be  found 
in  the  reports  of  cases  said  to  have  been  sustained  for  considerable  periods 
of  time  by  this  means  alone.  But  these  cases  prove  nothing,  unless  it  can 
be  shown  that  man  is  incapable  of  living  for  a  like  period  in  the  absence  of 
this  or  any  source  of  nourishment.  Now,  if  we  can  show  that  persons 
have  survived  longer  periods  of  abstinence  without  these  injections,  then 
the  conclusion  attempted  to  be  drawn  from  these  cases  is  absolutely  unau- 
thorized. 

How  long  it  is  possible  for  man  to  survive  without  food  is  an  unsolved 
problem.  We  have  a  general  approximative  rule,  but  numerous  remarka- 
ble exceptions  are  scattered  in  the  records  of  medicine.  I  might  appeal  to 
that  wonderful  case  related  by  Hildanus,  of  sixteen  years  abstinence  from 
food,  or  that  reported  by  Prof.  Ricci,  of  Turin,  covering  a  period  of  two 
years  and  a  half,  and  many  others  of  a  similar  character,  but  I  will  not,  al- 


Selected  Articles^  Abstracts^  dbc.  671 

though  of  the  last  case  I  might  speak  with  some  confidence,  as  the  bowels 
showed  at  the  post-mortem  a  condition  that  precluded  the  possibility  of 
anything  passing  through  them.  But  I  set  these  remarkable  cases  aside 
for  others  that  cannot  be  questioned,  and  they  will  show  as  great  endu- 
rance without  nutritive  injections  as  can  be  found  with  them. 

I  have  quoted  from  Dr.  Burrows  a  case  of  forty-five  days'  abstinence, 
and  the  patient  recovered.  Dr.  Currie,  on  the  authority  of  Ramazzini, 
gives  an  account  of  a  man  who  abstained  from  food  sixty -four  days,  and 
ultimately  recovered.  A  prisoner  at  Toulouse  perished  of  inanition  on  the 
sixty -third  day.  Many  are  reported  on  undoubted  authority,  to  have  fasted 
forty,  fifty,  and  sixty  days.  Now,  if  in  these  caess  rectal  feeding  had  been 
practised,  they  would  have  been,  it  is  probable,  published  as  indubitable 
evidence  of  the  practicability  of  nourishing  the  system  through  the  rectum. 
I  do  not  doubt  the  cases  reported  by  Guislam,  as  sustained  for  two  or  three 
months  by  rectal  alimentation,  would  have  lived  just  two  or  three  months 
without  such  aid. 


ANESTHESIA  BY  CHLOROFORM. 

The  immunity  from  pain  is  a  privilege  so  precious,  that  life  itself  is 
sometimes  thought  hardly  too  great  a  stake  to  play  when  enduring  agony 
is  risked  on  the  other  side.  But  it  can  never  be  the  duty  of  the  surgeon 
to  endanger  life  for  any  other  prospective  gain  to  his  patient ;  this  must 
always  be  the  highest  consideration  for  him,  and  all  else  is  lessened  by 
comparison  with  its  all  importance.  If,  then,  it  can  be  shown  that  the  dan- 
ger to  life,  from  the  use  of  chloroform,  exceeds  the  saving  of  life  which  it 
can  effect ;  if  it  can  be  shown  that  so  many  lives  have  been  sacrificed  by 
the  employment  of  this  anaesthetic,  while  there  has  been  no  corresponding 
gain  in  decreased  mortality  after  operations  arising  from  the  earlier  applica- 
tion of  surgical  procedure,  due  to  a  diminished  repugnance  to  submit  to 
such  treatment,  from  the  increased  security  and  perfection  which  delibera- 
tion and  immobility  have  brought  to  our  modern  operations,  from  the  les- 
sened shock,  from  the  abstraction  of  pain,  from  the  absence  of  the  agonized 
anticipation,  that  broke  the  mental  power  and  destroyed  tranquility  ;  if  it 
could  not  be  shown  that  from  all  these  causes  chloroform  has  been  success- 
ful in  diminishing  mortality  to  a  larger  extent  than  it  has  caused  deaths, 
then  we  think  that  surgeons  would  not  be  justified  in  recommending  its 
inhalation  to  their  patients.  But  we  believe  that  the  evidence  on  this 
score  is  sufficiently  strong  to  justify  operators  in  thus  mercifully  annihilat- 
ing the  agony,  and  with  it,  the  terrors  of  the  knife.  It  is  to  this  end  that 
the  controversy  has  tended,  which  has  been  so  ably  supported  by  Mr.  T. 
Holmes  and  Dr.  Fenwick  against  Dr.  Aunott  ;  and  that  this  conviction  is 
entertained  by  all  those  best  qualified,  by  their  great  experience,  to  judge, 
is  best  shown  by  the  daily  practice  of  hospital  surgeons.  There  remains 
the  great  problem  for  study — how  best  to  avert  the  danger  which  attends 
the  inhalation  of  chloroform.  We  have  repeatedly  urged,  in  these  columns, 
the  duty  of  taking  such  precautions  as  the  latest  results  of  the  experience 
of  practised  chloroformists  can  suggest.  We  have  especially  urged  the 
importance  of  carefully  regulating  the  proportion  of  chloroform  to  that  of 
atmospheric  air  inhaled ;  and  this  not  by  any  rule  of  thumb,  such  as  the 
approximation  or  removal  of  a  cloth  damped  with  chloroform,  but  by  the 
most  accurate  instrument  which  mechanical  skill  can  supply.  Other  pre- 
cautions are — the  regulation  of  the  quantity  (one  drachm  at  a  time),  the 
prescription  of  slight  preliminary  abstinence,  and  so  forth.  We  need  not 
repeat  these  rules;  they  have  been  more  than  once  laid  down  in  these 


572  The  Peninsular  and  Independent. 

columns.  They  arc  followed  and  approved  by  those  most  accustomed  to 
the  administration  of  chloroform.  They  were  indorsed  by  Mr.  Pottek,  the 
chloroformist  of  St.  George's  Hospital.  Thc}^  received  last  week  the  in- 
dorsement of  Dr.  Anstie,  of  King's  College  Hospital,  who  emphatically  re- 
peated our  cautions  almost  tot  idem  xcrMs^  as  borne  out  by  his  own  expe- 
rience. They  accord  with  the  opinions  of  Dr.  Ricitakdsox,  the  friend  and 
biographer  of  the  late  Dr.  Snow;  and  we  arc  glad  to  iind  that  they  receive 
the  support  of  Dr.  Martin,  of  St.  Bartholomew's  Hospital.  In  a  Cambridge 
thesis  on  this  subject,  Dr.  Martin  reviews  the  dangers  attendant  upon  the 
inhalation  of  chloroform.  He  considers  them  to  arise  from  the  influence  of 
chloroform  upon  the  medulla  oblongata  and  sympathetic  S3'stem,  from  "  pe- 
culiar susceptibility  "  of  the  vital  organs  and  nervous  centres,  and  perhaps 
sometimes  from  shock.  The  latter  cause  may  fairly  be  expunged,  since  it 
is,  in  a  greater  degree,  characteristic  of  operations  performed  without  anaes- 
thesia. There  remains  a  theory  which  is  niore  comprehensive  than  satis- 
factory, and  is,  perhaps,  rather  an  apology  than  an  explanation.  Be  this 
as  it  may,  Dr.  Martin  concurs  in  the  opinion  that  "  the  best  guarantee  of 
safety  is  to  be  obtained  by  such  cautious  administration  of  the  chloroform 
as  may  prevent  the  air  and  the  blood  in  the  lungs  from  being  surcharged 
with  tlic  vapour,  and  by  a  jealous  watching  of  the  patient  while  he  is  being 
subjected  to  its  influence."  We  trust  that  this  accumulation  of  authorities 
will  make  surgeons  more  than  ever  loth  to  have  recourse  to  the  use  of  so 
loose  and  irregular  a  proceeding  as  the  administration  of  chloroform  on  a 
handkerchief  or  napkin,  or  in  any  other  way  than  through  the  most  scien- 
tifically devised  inhaler.  {^Lancct^  July  20,  1859. 


TREATMENT  OF   NERVOUS   HEADACHE  BY  THE    HYDROCIILORATE  OF 
AMMONIA.— Bv  Dr.  A.  Barraliek. 

The  author  recommends  the  hydrochlorate  of  ammonia  as  the  best 
therapeutic  agent  in  cases  of  nervous  headache,  and  especially  in  idiopathic 
cephalalgia  and  nn'graine.  For  upwards  of  three  years  he  has  employed  it 
with  success  202  times  out  of  250.  The  salt  is  administered  in  the  form  of 
potion :  distilled  or  mint  water,  GO  grammes ;  hydrochlorate  of  ammonia, 
8  grammes  ;  syrup  of  orange  peel,  25  grammes;  taken  in  three  doses  at 
half  an  hour's  interval.  These  doses  do  not  produce  any  evident  physiolo- 
gical eflects  in  the  healthy  condition;  but,  when  administered  during  a 
paroxysm  of  nervous  cephalalgia,  their  effect  is  manifested  with  great 
promptitude.  Gcncralh^,  after  the  first  dose,  the  pain  abates  and  the  pulse 
rises,  and  a  gentle  perspiration  relieves  the  dryness  of  the  skin.  The  influ- 
ence on  the  circulation  is  so  great  that  the  pulsations,  which  were  under  50 
during  the  paroxysm,  rise  above  70  after  the  first  dose.  The  headache, 
which  is  calmed  by  the  first  dose,  diminishes  and  entirely  disappears  dur- 
ing the  second  and  third.  An  important  circumstance  is,  that  the  sal-am- 
moniac does  not  develop  its  curative  action  except  when  the  pain  is  at  its 
height ;  at  the  commencement  of  an  attack,  the  potion  has  only  a  slight 
efiect,  but  when  the  sufferings  of  the  patient  are  very  intense,  the  medicine 
acts  with  wonderful  promptitude.  Besides  the  temporary  relief,  it  was  ob- 
served that,  in  cases  of  headache  returning  in  periodical  paroxysm  several 
times  a  month,  the  intervals  gradually  became  longer,  the  attacks  diminished 
in  intensity,  and  ended  by  disappearing  completely  after  having  been  seve- 
ral times  arrested  by  the  ammoniacal  potion.  To  obtain  success,  however, 
it  must  be  administered  in  certain  cases,  and  according  to  precise  indica- 
tions. The  results  of  the  author's  observations  are  that  the  potion  of  hy- 
drochlorate of  ammonia  has  almost  constantly  dispelled  attacks  idiopathic 


Selected  Articles^  Abstracts,  c§c.  573 

hemicrania  or  migraine,  and  of  migraine  succeeding  menstuation  more 
abundant  than  usual.  It  has  no  effect  in  relieving  attacks  of  hemicrania 
depending  on  irregular  or  suppressed  menstuation;  it  has  given  pretty  good 
results  in  cranial  pains,  depending  on  functional  disorder  of  the  stomach, 
and  in  accidental  nervous  cephalalgia  ;  and  it  has  been  successful  in  reliev- 
ing headaches  consequent  on  repeated  attacks  of  intermittent  fever,  those 
occurring  in  the  decline  of  low  fevers,  and  in  the  period  of  irritation  in 
typhus.  [Bulletin  Gen.  cle  Iherajwutique  and  Va.  Med.  Jour. 


THE  MICROSCOPE  BEFORE  THE  AN"ATOMICAL  SOCIETY  OF  PARIS. 

Dr.  Gallard,  secretary  to  the  society,  has,  in  his  report  upon  the 
transactions  of  the  society  for  1858,  examined  the  promises  held  out  by 
tho  microscope.  He  finds  that  hardly  any  have  been  fulfiled,  especially  as 
regards  the  cancer-cell.  Mr.  Gallakd  does  not  concede  that  heteromor- 
phous  matter  ever  exists  in  the  human  frame,  and  does  not  believe  that 
tubercular  or  cancerous  deposits  are  substances  differing  entirely  from  nor- 
mal tissues.  lie  lays  particular  stress,  whilst  passing  in  review  the  patho- 
logical preparations  which  were  brought  before  the  society  in  the  course  of 
the  year,  on  twenty-six  cases  of  cancer,  upon  only  six  of  which  the  cancer- 
cell  was  found.  He  sarcastically  alludes  to  the  fact  that  microscopists  have 
gradually  receded  from  the  cell  to  the  nucleus,  and  from  the  nucleus  to  the 
nucleolus,  driven,  as  they  were,  by  the  difficulty  of  finding  any  character- 
istic element  is  morbid  textures.  The  author  concludes  that,  in  the  present 
state  of  anatomy,  and  especially  histology,  no  criterion  exists  by  which  to 
distinguish  malignant  from  non-malignant  tumors. 

[Med.  and  Surg.  Rep. 


IjarmatnUitirl  gtprtmntt. 


♦»♦ 


INDIAN  MEDICINE, 

We   copy  with   pleasure  the    following    abstract    from   a   letter    of 

Dr.  Geo.  B.   Wilson,   of  Port  Huron,  written  while  on  Lake  Superior, 

to  the   Port  Huron   Press: 

When  day -light  broke,  after  we  left  Marquette,  there  was  nothing  to 
be  observed  in  the  character  of  the  scenery  more  than  we  had  seen  on  our 
way  from  Grand  Island,  and  the  weather  being  somewhat  disagreeable,  we 
remained,  the  greater  part  of  the  time,  within  doors.  We  had  for  a  fellow 
passenger  the  Kev.  Mr.  Shaw,  whose  acquaintance  we  had  made  in  Mar- 
quette. He  was  the  Methodist  Missionary  to  the  Indians  at  L'Anse,  (pro- 
nounced Lonce)  a  village  on  a  bay  of  the  same  name,  which  is  an  extension 
of  Keweenaw  Bay.  Having  seen  in  the  papers  that  the  United  States 
agent  who  distributed  the  presents  to  the  Indians  at  L'Anse,  this  year,  had 
failed  in  his  attempt  to  draw  from  the  Indians  any  information  with  regard 
to  the  medicinal  properties  of  plants  —  they  regarding  his  questions  as  an 
attempt  to  rob  them  of  their  religion.  1  thought  this  opportunity  a  good 
one  for  informing  myself  on  such  subjects,  and  accordingly  devoted  my 
time  to  Mr.  Shaw  and  an  Indian  aboard,  who  could  speak  English  quite 
freely.  Mr.  Shaw  was  quite  communicative,  and  having  succeeded  in  con- 
verting some  of  their  '"  Medicine  Men,"  he  had  in  his  possession  some  three 
or  four  of  their  medicine  bags  or  talismans,  which  thej'  use  much  in  the 
cure  of  disease.  From  him  1  received  much  interesting  information  with 
regard  to  the  superstitions  of  the  tribe.  The  Indian  on  board  was  not  in- 
clined to  be  communicative  at  first,  but  after  a  time  I  encountered  him  in  a 
quiet  place  all  alone,  and  on  making  another  attempt,  I  found  him  tolerably 
willing  to  converse.  From  these  two  sources  I  obtained  the  following  ac- 
count of  their  sj'stem  of  medical  practice:  Medicine  and  theology  with 
them  are  inseparable,  so  that  a  "Medicine  Man"  is  a  priest,  physician,  and 
philosopher.  The  common  Indians  suppose  that  their  Medicine  Men  are 
familiar  with  all  the  healing  virtues  of  every  plant  that  grows  ;  but  it  is 
not  likely  that  they  know  much  more  of  such  things  than  some  of  the  laity, 
for  they  receive  little  or  no  tuition  from  the  older  priests  on  any  thing  like 
Medical  Botany;  their  admission  to  the  fraternity  depending  more  upon 
their  performance  of  certain  ceremonies,  by  which  they  are  to  have  their 
spiritual  qualities  more  fully  developed.  When  a  person  desires  to  become 
a  Medicine  Man,  his  first  step  is  to  obtain  the  consent  of  the  other  members 
of  the  profession ;  but  that,  for  several  reasons  —  a  prominent  one  being 
the  avoidance  of  a  superabundance  of  doctors  —  is  not  easily  obtained.  If 
he  succeeds,  however,  his  next  step  is  to  offer  sacrifice,  and  this  is  done 
alone  in  the  wilderness.  He  is  to  lie  and  watch  his  sacrifice  until  he 
dreams  of  some  one  of  several  animals,  which  are  named  to  him  by  his 


Pharmaceutical  Department.  575 

teachers.     During  this  watching  he  must  fast  also ;  so  that  some  who  at- 
tempt the  feat  fail,  b}''  giving  way  to  the  cravings  of  hunger,  and  others  are 
reported  to  have  starved  themselves  to  death.     Having  dreamed  of  one  of 
the  designated  animals,  he  is  then  to  obtain  the  skin  of  that  one,  and  from 
it  he  manufactures  his  medicine  bag.     There  are  other  ceremonies  to  be 
performed,  with  regard  to  which  the  manner  of  proceedings  is  not  always 
the  same.     This  medicine  bag  is  not  designed  to  hold  medical  plants,  but  to 
become  the  repository  of  innumerable  odds  and  ends,  of  perhaps  a  thousand 
different  things,  which  are  supposed  to  have  a  magic  influence  over  disease, 
and  not  only  disease,  but  over  men  and  things  in  general.     These  talismanic 
objects  are  different   in  different  bags,  and  depend  in  great  measure  upon 
the  conjectures  of  the  individual  Medicine  Man,  although  there  are  some 
few  things  which  they  appear  to  regard  as  necessary  to  form  a  nucleus.     I 
forgot  to  mention  some  of  the  animals  from  whose  skins  medicine  bags  are 
made.     They  are  generally,  quadrupeds:  as  the  bear,  beaver,  otter,  &c. 
Their  contents,  as  stated,  are  various ;  as  a  boar's  tooth,  the  tip  of  a  deer's 
car,  the  claw  of  a  beaver,  certain  parts  of  a  sturgeon,  pieces  of  the  entrails 
or  viscera  of  various  animals,  a  crooked  nail,  pieces  of  copper,  and  other 
metals,  various  kinds  of  small  stones  and  shells,  the  claw  of  a  crab,  a  ver- 
tebra of  a  fish,  small  bits  of  wood,  fur,  &c.,  fi'om  different  trees,  and  quad- 
rupeds ;  these  are  enough  to  mention  as  illustrations.     The  filling  of  the 
bag  may  not  be  completed  for  years,  for  the  Medicine  Man  fills  it  by  adding 
to  it  during  his  whole  life  —  there  being  but  afew  things  in  it  when  he  first 
sets  out  in  practice.     The  conferring  of  his  degree  of  Medicine  Man,  is  of 
course  accompanied  with  what  they  consider  imposing  ceremonies.     Their 
manner  of  treating  a  diseased  patient  is  generally,  first  to  give  him  infusions 
of  powders  of  such  medicinal  plants  as  they  think  will  be  beneficial.     If 
these  do  not  effect  a  cure,  the  Medicine  Man  administers  more  of  the  same 
or  other  kinds,  and  uses  some  incantations  to  assist  their  operation.     One 
thing  indispensable  is,  that  the  Medicine  Man  shall  eat  during  the  whole  or 
the  'jrcatei'  part  of  the  time  that  the  patient  iaheing  medicated.     For  this 
purpose  the  patient  is  obliged  to  furnish  whatever  the  doctor  wants  to  eat, 
or  asks   for ;  and  in  doing  this,  the  patient  frequently  gives  away  all  the 
little  property  he  has  got,  to  obtain  the  edibles  which  the  Medicine  Man 
will  call  for. 

Occasionally,  in  severe  cases,  a  consultation  of  Medicine  Men  is  necessa- 
ry, and,  after  examining  the  patient,  and  ascertaining  that  the  more  ordi- 
nary modes  of  treatment  have  proved  unavailing,  they  may  decide  on  sub- 
jecting him  to  a  psychological  course  of  treatment.  In  other  words,  to 
cure  him  by  their  united  powers  of  conjuration.  For  this  purpose  they 
form  a  ring  and  place  him  in  its  centre.  They  then  walk  around  the  cir- 
cumference of  the  ring,  and  using  certain  incantations,  they  point  their 
medicine  bags  at  him,  and  after  a  time,  perhaps  —  effect  a  cure.  You  may 
smile  at  the  thought  of  a  cure  being  thus  wrought,  but  it  is  not  the  less 
true,  that,  by  their  magic,  they  sometimes  produce  wonderful  effects  ;  thus, 
by  merely  pomting  their  medicine  bags  at  a  patient  standing  in  the  ring, 
they  can  render  a  limb  powerless,  or  perhaps  make  him  fall  as  if  shot.  The 
immediate  cause  is,  of  course,  his  own  imagination.  But  as  that  cause 
would  not  have  been  so  excited  without  their  performances,  it  is  only  com- 
mon justice  to  regard  them  as  the  producers  of  the  cure,  when  it  results  as 
it  sometimes  does.  As  an  instance,  however,  of  what  may  be  generally  ex- 
pected of  them  in  any  disease  of  an  obscure  character,  I  will  relate  an  inci- 
dent communicated  by  Mr.  Shaw.  His  interpreter,  a  converted  Indian, 
was  taken  rather  suddenly  with  a  pain  in  his  thigh,  and  consequent  lame- 
ness, although  no  cause  could  be  assigned  for  the  disease,  and  no  lesion 
could  be  discovered  by  the  eye.     Mr.  Shaw  supposed  it  to  be  some  kind  of 


51 Q  The  Peninsular  and  Indej)endent. 

rheumatic  afFcction,  and  advised  him  to  use  such  things  as  he  thought  be- 
neficial, but  without  the  desired  ellect.  Other  means  were  employed,  and 
weeks  passed  on  without  amendment,  though  his  health  continued  good. 
After  some  time  he  conjectured  that  he  was  bewitched,  and  he  clandestinely 
applied  to  a  Medicine  Man.  The  latter  took  his  magic  diagnosticator,  (which 
was  nothing  more  than  some  kind  of  stone)  and  after  looking  through  it,  he 
gravely  told  the  patient  that  he  saw  two  large  worms  and  a  stone  in  his 
limb.  This  confirmed  the  patient  in  his  belief  of  the  skill  of  the  doctor, 
and  he  engaged  him  to  get  the  foreign  bodies  out.  After  a  long  course  of 
medication  and  conjuiation,  the  doctor  could  only  extract  one  of  the  worms, 
and  the  patient  })eing  but  little  better,  he  desjjaired,  and  demanded  coun- 
sel. Two  other  Medicine  Men  were  accordingly  called  in,  and  alter  proper 
deliberation,  the  oldest  and  largest  took  the  stone,  and  looking  through  it, 
examined  the  diseased  limb.  Horror  of  horrors!  He  discovered  the  re- 
maining worm,  t\r,o  stones,  and  a  good  sized  piece  of  iron  !  No  wonder  the 
poor  fellow  was  lame.  I^ach  df  the  other  sages  in  turn  examined  the  limb, 
and  of  course  they  would  not  acknowledge  blindness ;  so  each  conlirmed 
the  statement  of  the  "big  man." 

Then  came  the  grave  (luestion  —  the  probabilities  of  cure.  The  big 
man,  having  given  such  evidence  of  ability,  was  the  one  to  decide  the 
point,  and  on  his  expressing  favorable  hopes,  the  patient  was  turned  over 
to  him. 

After  a  trial  of  a  few  weeks,  the  great  Medicine  Man  succeeded  in  get- 
ting out  one  of  the  stones,  but  the  remaining  two,  with  the  worm  and  the 
piece  of  iron,  resisted  all  his  attempts  at  extraction.  A  united  attempt 
by  the  whole  fraternity  was  therefore  resolved  upon,  but  the  interference 
of  Mr.  Shaw  terminated  the  whole  afiair. 


SACCHARATED  LIME  FOR  USE    IN  MEDICINE.      CONCENTRATED  LIME 

WATER. 

Dr.  Cleland  has  introduced  a  solution  of  lime  in  syrup  for  use,  in  pre- 
ference to  ordinary  lime  water,  in  medicine.  He  prepares  it  as  follows: 
Slake  8  oz.  of  quick  lime,  rub  up  with  it  5  oz.  of  white  sugar,  add  1  pint  of 
water,  stir  for  some  time  till  the  hard  stiff  masses  which  the  sugar  and  lime 
are  apt  to  run  into  are  as  much  as  possible  dissolved ;  then  filter.  The 
product  should  be  perfectly  clear,  and  of  only  a  slightly  yellowish  tint.  A 
solution  made  in  this  way  will  contain  18  grains  of  lime  in  every  ounce,  by 
weight,  and  altogether  about  lOG  grains  of  solid  matter  to  the  ounce.  Taken 
undiluted  a  few  drops  are  sufficient  to  roughen  the  tongue.  "When  diluted, 
the  taste  is  at  first  an  acrid  one  of  lime ;  but  this  is  immediately  replaced 
by  a  sweet  taste  in  the  back  of  the  mouth,  admitted  to  be  plea.sant.  Made 
as  just  reccommended,  the  solution  is  not  liable  to  decomposition  unless  it 
is  exposed  to  the  air.  By  employing  a  smaller  proportion  of  water  to 
lime,  a  still  stronger  solution  ma}'  be  obtained,  but  not  with  any  practical 
advantage,  as  there  is  increased  difficulty  of  filtration  and  greater  tendency 
to  decomposition.  The  strongest  solutions  are  scarcely,  if  at  all,  afiected 
by  boiling,  but  if  diluted,  a  copious  precipitation  takes  place  on  application 
of  heat.  This,  however,  will  not  serve  as  a  test  of  strength,  as  addition  of 
sugar  in  sufficient  quantity  will  make  any  solution,  of  whatever  strength, 
remain  clear  on  ebullition.  This  peparation  may  be  given  in  doses  of  from 
20  or  30  to  60  minims  or  more,  in  a  glass  of  water,  two  or  three  times  a 
day.  \Lond.  Phar.  Journ. 


THE 

PENINSULAR  and  INDEPENDENT 

MEDICAL  JOURNAL. 

Vol.  II.  DETROIT,  JANUARY,  18G0.  No.  10. 


ART.  XIXVL— Operations  for  the  Permanent  Cure  of  Reducible  Hernia. 


By  D.  M.  Tyler,  M.  D. 


Presuming  that  all  are  familiar  with  those  operations 
described  in  the  Transactions  of  the  American  Medical  As- 
sociation for  the  year  1852,  I  shall  say  nothing  of  them  ; 
but  shall  limit  my  remarks  to  the  description  of  such  as 
have,  since  that  date,  been  devised;  Gerdy's  and  Yelpeau's 
methods  alone  being  exceptions. 

All  operations  for  the  radical  cure  of  reducible  hernia, 
involve  but  a  single  principle,  their  object  being,  the  oc- 
clusion of  the  hernial  sac,  through  the  agency  of  inflamma- 
tory action.  Castration;  dilatation;  ligature;  acupuncture; 
cauterization  ;  invagination  ;  incision  ;  excision  ;  organic 
plugging,  drawing  into  the  canal  a  bag  of  gold-beaters' 
skin,  or  shreds  of  gelatine;  injection;  perforation  of  the  sac 
with  pins,  or  of  the  canal  with  needles,  suture,  &c.,  these 
constitute  mainly,  the  operations  and  devices  for  the  radi- 
cal cure  of  hernia. 

Vol.  II.— 2M. 


5V8  The  Peninsular  and  Independent, 

The  principal  operative  methods  in  use  for  eighteen 
hundred  years,  were,  sutures,  incisions,  ligatures,  and  cas- 
tration. Surgery  of  a  more  modern  date,  however,  has 
devised  several  new  methods  for  the  accomplishment  of 
this  cure,  most  of  which  are  efficient,  though  unfortunate- 
ly no  one  of  them  is  entirely  unattended  with  hazard  to 
the  i^atient.  A  brief  history  of  these  operations  may  not 
be   without   its  element  of  interest. 

Dr.  Armshy's  Method. —  In  the  Transactions  of  the 
Medical  Society  of  the  State  of  New  York  for  the  year 
1858,  is  the  engraving  of  an  instrument,  the  inven- 
tion of  Dr.  Armsby  of  Albany,  New  York,  for  the  radi- 
cal cure  of  inguinal  hernia.  The  object  of  the  instru- 
ment is,  to  carry  a  seton,  or  single  thread,  through  the 
hernial  sac  and  inguinal  canal,  for  the  purpose  of  exci- 
ting inflammation,  adhesion,  and  occlusion  of  the  sac 
and  inguinal  canal,  up  to  the  internal  abdominal  ring. 
The  instrument  consists  in  a  curved  canula,  at  one  ex- 
tremity of  which,  is  the  handle,  the  other  being  closed. 
Within  this  sheath  is  a  needle,  which  is  also  curved  and 
attached  to  a  slide  moved  by  the  thumb,  which  causes 
it  to  protrude,  or  to  retract,  through  a  small  opening  near 
the  extremity  of  this  curved  tube  or  canula.  Near  the 
point  of  the  needle  is  the  eye  for  receiving  the  thread. 
After  reducing  the  hernia,  the  instrument  is  passed  into 
the  canal,  carrying  the  skin  of  the  scrotum  and  sac  be- 
fore it,  as  far  as  it  will  go  with  case.  The  needle  is 
now  made  to  perforate  the  soft  parts  opposite  the  inter- 
nal abdominal  ring,  and,  when  threaded,  and  the  instru- 
ment withdrawn,  the  thread  occupies  the  entire  sac  and 
canal,  one  end  coming  out  through  the  skin,  above  and 
in  front  of  the  internal  ring,  and  the  other  at  the  lower 
part  of  the  scrotum.  Inflammation  soon  follows,  increas- 
ed,  if  necessary,  by  moving  the  thread  from  time  to  time. 


Operations  for  the  Cure  of  Reducible  Hernia,         579 

The  seton  is  allowed  to  remain  from  eight  to  twelve 
days.  A  truss  now  supports  the  parts  until  the  adhe- 
sions  are  firm. 

Bonnet's  Method.  —  Bonnet,  of  Lyons,  obliterates  the 
sac  by  means  of  pins  passed  through  its  walls.  The 
hernia  being  reduced,  the  parts  at  the  root  of  the  scro- 
tum are  pinched  up,  so  as  to  raise  the  spermatic  cord 
between  the  finger  and  thumb,  and  a  pin,  previously  pass- 
ed through  a  small  piece  of  cork,  is  thrust  through  them, 
and  beneath  the  cord.  The  point  of  the  pin  is  then 
pushed  through  another  piece  of  cork,  and  bent  over  it, 
thus  firmly  compressing  all  the  intervening  parts  between 
the  two  bits  of  cork.  A  second  pin  is,  in  the  same  way, 
inserted  above  the  cord.  After  three  or  four  days,  in- 
flammation takes  place,  and,  between  the  sixth  and  twelfth 
days,  the  pins  are  removed,  entire  obliteration  of  the  sac 
being   efi'ected   in  about  one   month. 

Dr.  Bigfs  Method.  —  An  instrument,  invented  by  Dr. 
Rigg's,  of  New  York  City,  for  the  introduction  of  a 
tent,  or  seton,  into  the  inguinal  canal,  is  figured,  and  the 
operation  described  in  the  New  York  Journal  of  Medicine 
for  March,  1858.  In  its  general  appearance,  it  bears  some 
resemblance  to  the  ordinary  trocar,  except  in  its  curvili- 
near figure,  and  the  bulbous  extremity  of  the  canula. 
The  canula  is  about  ^ve  inches  in  length  and  open  at 
both  extremities,  at  one  of  which,  is  the  bulb,  and  at 
the  other,  a  flattened,  serrated  piece,  serving  as  a  handle 
to  facilitate  its  introduelion.  The  needle,  or  stylet,  is 
about  two  inches  longer  than  the  canula,  one  end  being 
ring  -  shaped,  the  other  pointed,  containing  the  eye  for  re- 
ceiving the  thread  of  the  tent.  The  steps  in  the  opera- 
tion are  thus   described : 

"  Before   proceeding  in    the  operation  itself,    the    sur- 


580  The  Peninsular  and  Independent. 

geon  will,  of  course,  provide  himself  with  whatever  sub- 
stance is  to  be  drawn  into  the  canal,  whether  this  con- 
sist of  a  small  skein  of  silk,  or,  of  compressed  sponge, 
the  latter,  in  our  estimation,  being  entitled  to  the  prefer- 
ence. 

The  patient,  placed  upon  his  back,  with  his  hips 
somewhat  elevated,  the  surgeon,  standing  or  sitting  at  the 
right  side  of  the  patient,  after  reducing  the  hernia,  places 
the  index  finger  of  the  left  hand  upon  the  integuments 
of  the  scrotum,  anteriorly,  and  at  a  point  not  higher  than 
the  juncture  of  the  lower  with  the  middle  third  of  the 
pouch.  Sufficient  pressure  being  now  made  with  the  fin- 
ger to  catch  and  hold,  upon  its  end,  the  tegumentary  tis- 
sues of  the  scrotum,  these  are  to  be  carried  upon 
the  end  of  the  finger,  upward,  over  the  testis  and  arch  of 
the  pubes,  until,  immediately  above  the  bone,  the  abdomi- 
nal ring  is  easily  found,  and  into  which,  the  end  of  the 
finger  readily  becomes  fixed,  where,  as  a  guide  to  the  in- 
strument, it  is  to  remain  stationary,  until  the  bulbous 
extremity  of  the  canula  is  made  to  take  its  place,  fairly 
and  securely  within  the  external  ring.  The  instrument,  in 
the  right  hand  of  the  operator,  and  held  at  the  serrated 
portion  of  its  handle,  between  the  thumb  and  fingers, 
something  after  the  manner  of  holding  a  pen,  is  passed 
into  the  pouch  of  the  invaginated  scrotum,  and  made  to 
glide  along  and  upon  the  back  of  the  finger  to  its  des- 
tination within  the  ring.  The  finger  may  then  be  with- 
drawn, and  the  left  hand  being  now  liberated,  the  thumb 
of  this  hand  may  be  placed  at  a  point  opposite  the  in- 
ternal ring,  where,  by  pressure,  all  danger  from  any  ten- 
dency there  may  be  to  partial  protrusion  of  the  intestine 
through  the  internal  ring,  can  be  effectually  obviated, 
while,  at  the  same  time,  the  pressure  exerted  at  this  point, 
tends  materially  to  facilitate  the  passage  of  the  instrument 
through  the  tissues.     The   instrument    is  now    carried   for- 


Operations  for  the  Cure  of  Reducible  Hernia.  681 

ward  until  the  bulb  approaches  as  near  as  practicable  to 
the  internal  ring,  when  the  handle  is  depressed  upon  the 
pubes,  which  serves  to  elevate  its  bulbous  extremity,  caus- 
ino"  a  prominence  on  the  surface,  and  indicating  both  to 
the  touch  and  to  the  eye,  the  exact  point  of  its  exit 
through  the  integuments.  The  operator  now  places  the 
index  finger  of  the  right  hand  through  the  ring  of  the 
stylet,  and,  with  a  single  movement  of  the  finger  thus 
placed,  pierces  all  the  tissues  involved  in  the  operation, 
and  brings  the  point  and  eye  of  the  instrument  into  view 
upon  the  surface  opposite  the;  internal  abdominal  ring. 

The  surgeon,  or  his  assistant,  now  arms  the  stylet  by 
passing  through  its  eye,  for  an  inch  or  more,  the  free  ends 
of  a  slender  cord,  or  tractor,  previously  passed  through 
the  silk,  or  sponge  ;  when,  by  a  single  reversed  or  backward 
movement  of  the  finger,  which  is  still  in  the  ring  of  the  sty- 
let, the  instrument  is  entirely  disengaged  and  freed  from 
the  tissues,  being  still,  however,  concealed  from  view  with- 
in the  pouch  of  the  invaginated  integuments.  The  entire  ' 
removal  now  of  the  instrument,  leaves  the  free  ends  of 
the  tractor  passing  through  the  puncture  in  the  scrotum, 
and  hanging  loose  below.  These  are  now  seized,  and  by 
the  necessary  traction,  the  foreign  body  is  drawn  from 
above  into  the  passage,  to  the  distance  of  two  or  more 
inches,  and  leaving  its  upper  extremity  protruding  from 
the  puncture  above  ;  when,  dropping  from  his  grasp,  one 
of  the  ends  of  the  cord,  the  surgeon,  by  means  of  the 
other  end,  draws  it  entirely  out,  and  thus  completes  this 
bloodless,  and  comparatively  painless  procedure.''  The  wa- 
ter dressing,  with  equable  and  uniform  pressure,  constitute 
the  after-treatment. 

Gurdifs  3fetJiod.  —  Gurdy's  method  consists  in  obliter- 
ating the  opening  by  means  of  a  plug  from  the  skin  cov- 
€ring  the  hernia.     This  is  fastened   in  its   new  position  by 


582  The  Peninsular  and  Independent. 

points  of  suture,  the  instrument  used,  having  some  resem- 
blance to  that  invented  by  Dr.  Arm  SB  y.  After  forcing 
up  the  skin  of  the  scrotum  through  the  external  ring  into 
the  inguinal  canal,  with  the  left  fore -finger,  the  surgeon 
takes  in  his  right  hand  his  needle -holder,  and  slides  it 
along  the  finger  which  is  thus  forcing  the  skin  into  the 
canal.  When  the  extremity  of  the  needle -holder  is  carried 
to  the  bottom  of  the  cul-de-sac,  it  is,  by  a  lever -like 
motion,  made  to  cause  the  skin  of  the  abdomen  to  pro- 
ject ;  now,  pushing  the  slide,  the  operator  forces  out  the 
needle,  which  pierces  the  cul-de-sac,  and  also  the  anterior 
wall  of  the  inguinal  canal,  coming  out  externally  and  in 
front.  An  assistant  secures  one  of  the  loops  of  the  double 
ligature  contained  in  the  eye  of  the  needle,  and  the 
needle  -  holder,  still  being  retained  in  the  cul-de-sac,  the 
needle  is  drawn  back  into  it,  and  again  thrust  through 
the  soft  parts  in  a  difierent  direction,  being  brought  out 
at  a  point  below  the  first.  The  remaining  end  of  the 
•  loop  of  thread  is  now  detached,  and  the  instrument  with- 
drawn. The  whole  is  made  fast,  by  tying  the  ends  of  the 
ligatures  over  two  pieces  of  gumelastic  catheter.  Oblitera- 
tion of  the  cul-de-sac  may  be  eftected  by  means  of 
spirits  of  ammonia  introduced  into  it,  followed  by  pres- 
sure. A  simple  dressing  being  applied,  the  patient  is 
kept  in  bed  for  two  or  three  weeks.  This  plan  is  ap- 
plicable  to   inguinal   hernia  alone. 

Wufzer'r  Method. — The  September  number  of  the  Lon- 
don Lancet,  for  the  year  1854,  contains  the  following  de- 
scription of  an  instrument,  the  invention  of  Wutzer,  of 
Bonn,    and  its  modus  oi^erandi : 

*^It  consists  of  a  wooden  cylinder,  a  needle  passing 
through  it,  an  outer  wooden  case,  and  a  screw  to  bind  the 
case  and  cylinder  together.  After  pushing  a  part  of  the 
skin   of  the   scrotum   before  the    fore -finger,    the    cylinder 


Operations  for  the  Cure  of  Reducible  Hernia,         583 

takes  the  place  of  the  finger,  the  needle  is  passed  through 
it  (i.  e.  through  the  sac  and  integuments)  and  serves, 
with  the  screw,  to  ^^  and  bind  the  cover  and  cylinder 
together,  so  that  the  invaginated  skin,  the  walls  of  the 
sac,  and  the  abdominal  integuments  are  pressed  together 
with  any  degree  of  force  that  may  appear  safe  and  ad- 
visable. The  instrument  is  left  in  situ  from  six  to 
eight  days,  with  the  effect  of  producing  adhesion  of  the 
whole  of  the  sac^  a  firm,  organized  plug,  filling  the  in- 
guinal canal.  The  patient  is  confined  to  a  sofa  until  the 
needle  puncture  is  healed,  and  wears  a  truss  for  three 
months  afterwards,  to  avoid  the  danger  of  the  breaking 
up   of  new   adhesions.'' 

A  similar  account  of  the  instrument  may  be  found 
in  Erichsens'  Surgery  : 

Velpeau's  Metliod.  —  The  plan  of  Velpeau  is,  to  pass  a 
flat  piece  of  wood  into  the  inguinal  canal  from  the  scro- 
tum, a  portion  of  which  is  carried  into  the  canal  upon 
the  end  of  the  wood.  An  instrument  resembling  a  large 
double  -  edged  needle,  is  introduced  into  the .  canal  upon 
the  wood,  and  with  it,  the  sac  is  lacerated,  by  changing 
the  point  of  the  instrument  by  a  sort  of  twirling  motion, 
until  the  entire  canal  has  been  touched,  and  slightly  la- 
cerated. The  patient  is  kept  on  his  back  for  a  few  weeks, 
and   pressure   applied  to  the  part. 

Dr.  Cooper's  Metliod.  —  Dr.  E.  S.  Cooper,  of  Califor- 
nia, combines  the  operations  of  Velpeau  and  Gerdy,  ex- 
cept, that  he  excludes  the  Liquor  Ammonia  and  the  ex- 
tensive manipulation  with  the  needle,  which,  he  deems^ 
are  sources  of  undue  inflammation  and  danger.  He  also 
applies  a  thick  coating  of  collodion  over  the  ensheathing 
of  the  scrotum  and  external  ring.  After  the  first  coating 
becomes   dry,    he  re -applies   the    collodion   every   hour   or 


584  The  Peninsular  and  Independent. 

two,  except  at  night,  fur  thirty -six,  or  forty- eight  hours, 
or  until  it  produces  a  deep  indentation  or  cup  over  the 
lower  part  of  the  inguinal  canal  and  the  ensheathing  of 
the  scrotum,  alter  whicli,  it  is  to  be  applied  only  two 
or  three  times  daily.  The  patient  during  this  time  keeps 
his  bed.  Dr.  Cooper  considers  the  collodion  indispensa- 
ble, deeming  it  quite  impossible  to  produce  the  same  re- 
sults by  pressure  in  the  common  way,  that  can  be  se- 
cured by  the  judicious  and  persevering  use  of  the  collodion. 

Bclma's  Method. — This  surgeon  obliterates  the  hernial 
opening  by  two  methods.  Tlie  first  consists  in  carrying 
into  the  sac,  by  means  of  a  peculiar  instrument,  a  small 
bag  of  gold-beaters'  skin,  which,  on  being  blown  up, 
fills  tlie  sac,  keeping  the  hernia  reduced,  and  producing 
inflammation  suflicient  to  completely  obliterate  the  hernial 
opening. 

In  the  second  plan,  which  is  more  easy  of  execution, 
threads  of  gelatine  are  substituted  for  the  gold  -  beater's 
skin  ;  these,  after  exciting  inllammatiou,  are  absorbed,  and, 
adhesions  following,  the  cure   is  completed. 

A  sailor,  while  adjusting  some  item  in  his  vessel's  rig- 
ging, missed  his  hold  and  fell,  alighting  upon  the  nates 
with  such  violent  succussion,  as  to  ruj)ture  the  abdominal 
parietes,  producing  that  form  of  ^'breach"  named  and  de- 
scribed in  the  books  as  ^^  direct  inguinal  hernia."  He  ap- 
peared at  this  hosjntal  for  treatment  of  this  misfortune. 
This  particular  form  of  hernia,  suggested  to  the  mind  of 
Dr.  Pitcher  the  devise  which  I  shall  next  describe,  and 
which  differs  in  several  particulars  from  any  heretofore  de- 
failed.     I  shall  call  it 

Dr.  Pitcher's  Operation.  —  The  instrument  used,  is  a 
large  needle,  slightly  curved,  about  seven  inches  in  length, 
and,   at   the  point,  somewhat  flattened,  and  double  -  edged. 


Operations  for  the  Cure  of  Reducible  Hernia,  585 

This  needle  is  armed  with  a  strong,  double  silk  ligature 
or  thread,  at  the  extremity  of  which,  is  attached,  a  small 
piece  of  sponge.  The  protruding  intestine  being  reposited, 
the  operator  invaginates  the  hernial  passage  with  a  cone 
of  scrotal  tissue,  by  means  of  the  left  indicator,  the  cone's 
apex  being  lodged  in  the  external  abdominal  ring,  where 
the  finger  retains  it  until  the  needle,  in  the  right  hand,  is 
passed  into  this  pouch  of  invaginated  scrotum,  being  made 
to  glide  along  upon  the  linger  to  its  destination  within 
the  ring.  When  its  point  is  felt  at  the  end  of  the  finger, 
it  is  made  to  penetrate  the  scrotal  cone,  and,  dipping 
deep  enough  to  transfix  the  upper  border  of  the  ring,  it  is 
made  to  emerge  upon  the  abdomen.  The  sponge  at  the 
extremity  of  the  ligature  is  now  drawn  in,  and  made  to 
occupy  the  site  of  the  end  of  the  indicator  which  is 
withdrawn,  leaving  the  left  hand  free  to  hold  it  in  place, 
by  making  traction  upon  the  thread,  still  attached  to  the 
needle.  The  two  strands  of  the  thread  are  now  separa- 
ted, and  another  piece  of  sponge  is  placed  between  them, 
over  which,  after  disengaging  them  from  their  attachment 
to  the  needle,  they  are  tied.  Thus,  the  scrotal  cone  and 
the  abdominal  tissues  are  closely  compressed  between  these 
two  bits  of  sponge,  which  are  not  to  exceed  three  -  fourths 
of  an  inch  asunder.  Water  dressings  are  applied,  and  the 
parts  are  kept  in  this  position  for  several  days^  when, 
after  sufficient  inflammatory  action  has  been  excited,  the 
thread  is  cut,  and  the  sponges  are  removed.  Little  pain 
attends  the  operation.  A  truss  should  be  worn  for  three 
or  four  months,  or,  until  the  new  tissues  and  adhesions 
have  become  firm.  Dr.  Brodie,  of  this  city,  informs  me 
he  has  made  three  operations  of  this  kind,  the  subjects 
of  them,  as  yet,  suffering  no  relapse. 

The  report  of  a  single  case  shall  conclude  what  I  have 
to   say  on  this  subject. 

On  the  6th  day  of  June,  1859,  Wm.  Hawkins,  a  col- 


586  The  Peninsular  and  Independent, 

ored  patient,  aged  twenty-eight,  was  admitted  into  this 
hospital  with  w^hat  was  formerly  a  congenital,  oblique 
inguinal  hernia  of  the  left  side.  From  long  continuance, 
it  had  grown  to  become  an  example  of  the  strait  variety; 
also  on  one  occasion,  it  had  become  strangulated,  for 
the  relief  of  which  condition,  the  patient  had  submitted 
to  an  operation  by  Dr.  Case,  of  this  city.  The  tumor 
was  large,  much  distending  the  scrotum,  into  which  it 
had  descended.  On  the  22d  day  of  the  same  month, 
at  the  request  of  Dr.  Pitcher,  I  made  the  operation  last 
described.  The  sponges  in  this  case,  were  removed  after 
remaining  in  place  for  four  days ;  water  dressings, 
together  with  careful  attention  to  the  condition  of  the 
bowels,  and  a  free  use  of  morphine,  as  iuculcated  by 
Dr.  Armstrong,  for  its  antiphlogistic  effect,  combined 
with  quinine,  constituting  the  after-treatment.  The  pa- 
tient remained  in  the  hospital  until  the  18th  day  of  the 
following  month,  when,  the  adhesion,  having  become 
quite  firm,  he  was  discharged  with  instruction  to  wear  a 
truss  for  two  or  three  months.  When  last  heard  from, 
the  parts  were  in  good  condition.  The  long  standing  of 
the  difficulty,  the  large  size  of  the  sac,  and  the  com- 
plete success  of  the  operation  considered,  I  have  thought 
it  proper  to  report  this  instance  of  cure. 
Marine  Hospital,  Detroit,  -December,  1859. 


-•♦» 


ART.  XXXVII.  — Ciitliartics  in  Peritonitis,  Etc. -Our  Reasons  for  Re- 

fasing  to  Reply. 

By  J.  A.  Brown,  M.  D. 

The  elaborate  article,  not  entirely  without  merit,  if  in- 
deed any  merit  can  be  attached  to  mere  words,  irrespective 
of  their  arrangement,  or    what    tliey  may  be   made  to  ex- 


Cathartics  in  Peritonitis^  Etc.  587 

press),  in  the  December  Number  of  the  Peninsular  and 
Independent,  with,  the  above  title,  from  the  pen  of  Dr.  0. 
C.  GiBBS,  (evidently  intended,  under  a  different  name  or 
pretended  change  of  subjects,  to  perpetuate  tbe  old  con- 
troversy,) but  really  nothing  more  nor  less  than  a  drive^ 
(not  a  criticism,)  upon  our  last,  and  hence  almost  as 
irrelevant  to  the  subject  named  in  the  caption,  (unless 
it  is  the  etc.  part  of  it),  as  that  '^obstruction''  would 
be  for  a  treatise  on  '^  inter susception,"  or  either  of  these 
for  an  essay  on  '^ p)eritonitis,"  in  accordance  with  our 
pledge,  we  shall  not  be  expected  to  answer.  We  decline 
for  the   following  reasons  : 

1.  We  are  not  particularly  at  issue  with  Dr.  G.  as 
we  conceive,  on  the  subject  of  ^*  Cathartics  in  Peritoni- 
tis,'' his  whole  force,  in  his  last,  having  been  expended 
in  trying  to  prove  what  nobody  has  denied,  as  is  clear 
by  the  numerous  and  irrelevant  quotations  with  which  he 
has  encumbered  his  article,  invariably  condemning  only 
"  violent  drastic  purgatives,"  or  these  or  any  others  after  re- 
peated and  long  continued  as  antijiogistics,  which  all  along 
we,  ourselves,  have  inveighed  vehemently  against,  while  on 
the  other  hand,  in  accordance  with  both  the  views  and 
practice  of  every  author  he  has  quoted,  we  have  advo- 
cated only  the  discreet,  careful  use,  of  mild,  unirritating, 
harmless,  aperient  agents,  in  just  sufficient  quantities  (more 
or  less,)  to  evacuate  the  bowels  freely,  (though  not  fre- 
quently nor  harshly,)  but  occasionally,  for  the  purpose 
of  removing  irritating,  and  when  absorbed,  which  is  un- 
avoidable except  by  removal,  virulently  poisonous  accu- 
mulations. 

2.  As  Dr.  G.  makes  us  say  that  our  fifteen  pages  (not 
sixteen)  "  were  aimed  to  be  courteous  and  gentlemanly," 
(although  they  have  not  been  shown  to  be  otherwise,) 
which  language  was  used  in  our  last,  in  relation  only 
to    our   first,  or  the  ^^ criticism,"  he  is  sufficiently  reckless, 


588  The  Peninsular  and  Indextendent. 

either  to  say,  or  to  make  us  say,  almost  anything  else,  as 
is  evinced  in  his  new  method  of  quoting  us,  which,  we 
think,  he  has  the  credit  of  being  entirely  original  in,  if  in 
nothing  else,  and  for  which  he  is  doubtlessly  deserving  of 
a  patent,  viz.  :  of  stopping  in  the  middle  of  a  sentence, 
which  will  effectually  pervert  any  man's  sentiment,  and 
make  even  a  penniless  apostle  allege  that  he  was  ricli^  in- 
stead of  'poor^  by  omitting  the  ''little''  word  none^  in 
the  following  sentence  :  '^  silver  and  gold  have  I:  {none)" 
— precisely  equivalent  to  making  us  say,  as  is  done  : 
'^  That  in  ordinary  peritonitis,  Watson  says  nothing 
against  the  use  of  cathartics  :  "  without  going  on  to  the 
comma,  or  to  the  end  of  the  sentence,  and  adding:  ^^  only 
as  antljiogistics  :  "  without  which  it  is  a  base  perversion, 
and  in  no  sense  our  teaching  ;  as  well  as  in  his  statement 
also,  that  the  former  of  two  quotations  we  made  from  his 
articles,  (not  of  the  words,  but  of  the  sentiment,)  one 
from  the  first,  the  other  from  the  second,  contradicting 
each  other,  "  ivas  a  fahricationj"  and  the  latter,  ''  a  sim- 
ple per^verslonj"  the  falsity  of  which  a  reference  to  the 
articles  will  at  once  demonstrate. 

3.  If  Dr.  Gr.  has  thus  far  failed  to  understand  us  in 
view  of  all  that  we  have  said,  and  has  not  yet  learned 
that,  so  fiir  from  our  considering  his  ^^  case  "  as  one  of  ''oi- 
structlon  from  hardened^  feces ^^  we  do  not  consider  it  one 
of  obstruction  at  all  ;  we  despair  of  anything  like  success, 
so  far  as  he  is  concerned,  in  a  future  effort. 

4.  If  the  Doctor's  perceptions  fail  to  distinguish  any 
difference  betwen  ''  brisk,  reliable  cathartics,"  used  only  oc- 
casionally, to  unload  the  intestines  of  their  accumulated, 
and  often  highly  irritating  contents;  and  '^  thorough,"  or 
"  active  cathartics," — which  terms  are  his,  not  ours, — and 
evidently  used  as  synonymous  with  '^violent"  ^^  drastic  " 
&c.,  '^purgatives " — the  very  appellations  invariably  em- 
ployed   by  every  author    on    ordinary    peritonitis    he    has 


Cathartics  in  JPeritonitis^  Etc.  589 

quoted,  and  whicli  only  are  condemned,  especially  tlie  re- 
petition of  tliem  ;  (being  ^^  fallible  "  as  they  all  are,  their 
favoring,  as  they  do  the  timely  use  of  mild  aperients  may 
be  a  weakness,  and  Eamsbotham,  in  puerperal  peritonitis 
seems  to  be  weak  enough  to  recommend  even  croton  oil,) 
and  considers  it  no  crime  in  asserting  that  '^  we  hold  the 
use  of  the  latter  to  be  a  part  of  all  good  treatment  of 
peritonitis  ; "  we  conceive,  either  any  exjDlanation  of  the 
former,  or  denial  of  the  latter,  at  least,  needless. 

5.  We  are  content  with  the  little  improvement,  we 
think,  we  are  able  to  discover  in  the  Dr.,  as  indicated  by 
his  last  article,  especially  in  the  modification  of  its  spirit 
and  tone,  not  deeming  it  policy  always  to  undertake  to 
accomplish  too  much  at  a  time, — hoping,  however,  that 
sooner  or  later,  he  will  come  to  the  knowledge  of  the  truth. 

6.  The  main  object  of  all  articles  for  such  a  journal, 
being  the  edification  of  its  readers,  and  conceiving  that 
our  position,  as  to  when,  how  far,  and  what  kind  of  ca- 
thartics are  applicable  in  the  disease  in  question,  is  already 
sufficiently  understood  by  our  readers,  if  not  by  Dr.  Gr., 
anything  further  on  this  point  we  should  deem  justly 
censurable. 

Will  Dr.  GiBBS  also  be  good  enough  to  favor  the 
readers  of  the  Pe7iinsular  and  Independent,  with  his  views 
as  to  the  consequences  of  distension  of  the  bowels  by 
repeated  ^'copious  enemas"  of  '^Teaic  chaud"  in  peri- 
tonitis, or  upon  the  subject  of  ^^  copious  injections,  &c./' 
in  this  disease. 

Kankakee  City,  111. 


590 


The  jPeninsular  and  Independent, 


ART.  XIIVIIL  — Meteorological  Register  for  Month  of  November. 

By  L.  S.  Horton,  House  Physician  to  U.  S.  Marine  Hospital. 

Altitude  of  Barometer  above  the  level  of  the  sea,  597  feet.     Latitude,  42*24' N  •  and 
Longitude.  82«58' W.  of  Greenwich. 


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liHiugnjIitEl  SlK0ri. 


PATHOLOGICAL  AND  PRACTICAL  OBSERVATIONS  ON  DISEA- 
SES OP  THE  ALIMENTARY  CANAL  —  (Esophagus,  Stomach, 
C^cuM,  AND  Intestines.  By  S.  0.  Habershon,  M.  D.  London. 
Fellow  of  the  Royal  College  of  Physicians ;  Assistant  Physician  to 
Guy's  Hospital,  and  Lecturer  on  Materia  Medica  and  Therapeutics, 
&c.  &c.     Philadelphia:  Blanchard  &  Lea.     1859. 

The  table  of  contents  of  this  volume  of  312  pages,  printed 
in  Blanchard's  and  Lea's  usual  excellent  style,  will  give  a 
better  idea  of  its  scope  than  any  other  brief  description,  and 
is  as  follows  :  Introduction,  On  Diseases  of  (Esophagus ; 
Organic  Diseases  of  Stomach;  Functional  do.  do.;  Hsema- 
temesis|;  Diseases  of  Duodenum;  Muco  -  Enteritis  and 
Enteretis ;  Strumous  Diseases  of  the  Alimentary  Canal ; 
Diseases  of  the  Ceecum  and  Appendix  Caeci ;  Diarrhoea  ; 
Colitis  and  Dysentery ;  Typhoid  Disease  of  Intestines  ; 
Colic  ;  Constipation  ;  Internal  Strangulation ;  Intussuscep- 
tion ;  Carcinoma  of  the  Intestines  ;  Intestinal  Worms  ; 
Perforation  of  Intestines  from  without ;  Abscess  in  the 
Abdominal  Parieties,  extending  into  the  Intestines,  and 
F83cal  Abscess  ;  to  which  are  added  a  general  Index  and 
an  index  of  Illustrative  cases. 

During  the  last  few  years  much  attention  has  been  given 
to  the  diseases  of  the  Alimentary  Canal  by  our  British 
brethren  as  will  be  apparent  when  we  call  to  mind  the 
works  of  BuDD,  Jones,  Chambers,  Brinton,  Murchison, 
and  others  ;  and  at  this  we  are  rejoiced,  as  diseases  of  the 
Lungs,  Heart  and  Kidneys,  from   their   admitting  of  more 


692  The  Peninsular  and  Independent. 

direct  physical  modes  of  examinations  —  of  more  positive 
modes  of  diagnosis,  have  tended  to  divert  attention  from 
the  somewhat  more  ohscure,  but  still  not  less  important 
diseases  which  are  the  subject  of  this  volume. 

Connected  as  Dr.  Harbershon  is  with  one  of  the  lar- 
gest and  best  endowed  hospitals  in  London,  and  one  which 
pays  more  attention  to  pathological  anatomy  than  any 
other,  he  has  had  excellent  opportunities  for  prosecuting 
investigations  and  observing  the  results  of  treatment,  and 
has  made  very  good  use  of  his  advantages. 

Our  present  space  will  not  allow  us  to  go  into  details, 
or  attempt  any  thing  like  a  descriminative  analysis,  but 
we  can  most  heartily  commend  the  volume  to  the  atten- 
tion of  the   profession.  A.  B.  P. 

TREATISE  ON  THE  IMMEDIATE  CAUSE,  AND  THE  SPECIFIC 
TREATMENT  OF  PULMONARY  PHTHISIS,  AND  TUBERCU- 
LAR DISEASES.  By  J.  Fiuncis  Churchill,  D.  M.  P.  Graduate 
of  the  Paris  School  of  Medicine;  Member  of  the  Imperial  Academy 
of  Medicine  and  Sciences.  Translated  from  the  French  by  a  Phy- 
sician. New  York :  J.  Winchester,  Publisher,  43  John  street, 
American  and  Foreign  Agency. 

This  is  the  title  of  a  pamphlet  of  111  pages,  including  an 
Appendix  written  by  the  author  of  the  theory  that,  ^'AU 
tubercular  diseases  arise  from  a  diminution  of  the  oxyda- 
ble  phosphorus  contained  in  the  human  system,''  and  that 
the  hypophosphitis  of  lime  and  soda  will,  when  properly 
administered,  remove  that  cause  and  correct  the  diathesis 
or  rather  that  '■'  a  combination  of  phosphorus  in  a  state 
at  once  assimilable  and  oxydable"  will  effect  that  object, 
when  properly  applied  in  the  disease.  This  hypothesis  does 
not  include  the  belief  that  all  cases  of  consumption  can 
be  cured,  as  when  structure  is  extensively  destroyed  it  can 
not  usually  be  restored,  and  the  process  will  very  generally 
go  on  ;  but  when  the  treatment  is  commenced  sufficiently 
soon,  aided  by  skillful  Hygienic   management,  the  progress 


Bihlio graphical  Record.  593 

of  the  case,  Dr.  Churchill  thinkSj  may  be  arrested  — 
its  developement  prevented  —  and  often  iojuries  already  in- 
flicted may  be   repaired. 

In  the  pamphlet  before  ns  is  a  paper  addressed  by  the 
author  to  the  Academy  of  Medicine  of  Paris,  in  which  the 
theories  and  facts  upon  which  his  conclusions  are  based^ 
are  set  forth,  a  considerable  number  of  cases  treated  after 
his  plan  reported,  an  addition  to  the  first  report  given,  a 
History  of  the  "discovery"  he  claims,  a  chapter  of  De- 
ductions, and  an  Appendix  containing  a  Memorial  on  the 
subject ;  various  letters,  notes,  &c. 

In  the  jjresent  period  of  skepticism  as  to  the  efficacy 
of  therapeutical  agents,  and  especially  of  such  as  are  brought 
forward  by  French  Physicians  with  the  possible  view  of 
attracting  notoriety,  making  a  sensation,  and  securing  fame 
and  business,  such  startling  conclusions  as  this  pamphlet 
contains  will  not  be  accepted  by  prudent  men  without 
careful  scrutiny  and  the  confirmation  of  extended  experience ; 
and  the  publication  of  this  pamphlet  by  a  house  having 
the  agency  for  the  sale  of  the  articles  prepared  from  Dr. 
Churchill's  formula  will  be  looked  upon  with  some  sus- 
picion ;  still  there  are  those  who,  from  careful  observation 
have  confidence  in  the  hypophospites,  and  these  articles 
are  doubtless  worthy  of  farther  trial  in  a  disease  so  often 
resisting  all  treatment  heretofore  practiced. 

Winchester's  preparations  may  be  obtained  of  various 
druggists  throughout  the  country,  and  we  have  for  some 
time  past  prescribed  the  preparations  manufactured  by 
Messrs.  Higby  &  Stearn's,  and  in  some  cases,  it  appears 
to  us,  with  evident  advantage.  If  the  hypophosphites  are 
not  specifies  for  consumption,  they  are  at  least  good  tonics 
in  various  low  conditions  of  the  system,  and  as  such  are 
entitled  to  attention.  A.  B.  P. 


VoL.II.— 2N. 


594  The  Peninsular  and  Independent. 

AN  INTRODUCTION  TO  PRACTICAL  PHARMACY.  By  Edward 
Parrish,  Second  Edition,  greatly  enlarged  and  improved.  Phila- 
delphia:    Blanchard  &  Lea. 

That,  Edward  Parrish,  in  writing  a  book  upon  'practical 
Pharmacy  some  few  years  ago,  —  one  eminently  original 
and  unique,  —  done  the  medical  and  pharmaceutical  pro- 
fessions a  great  and  valuable  service^  no  one,  we  think, 
who  has  had  access  to  its  pages  will  deny;  doubly  welcome, 
then,  is  this  new  edition,  containing  the  added  results  of 
his  recent  and  rich  experience,  as  an  observer,  teacher  and 
practical  02)erator  in  the  pharmaceutical  laboratory.  The 
excellent  plan  of  the  first,  is  more  thoroughly,  and  in  de- 
tail, carried  out  in  this  edition. 

We  will  give  our  readers  —  most  of  whom  are  medical 
men,  and  to  whom  we  would  particularly  commend  the 
book,  in   a    few    words   an   idea   of  it. 

Of  the  ^\Q  parts  into  which  it  is  divided  the  first 
is  devoted  to  a  consideration  of  the  implements  and  fur- 
niture of  the  Pharmaceutist  and  the  Physician  (who  has 
to  prepare  his  own  remedies)  explaining  the  methods  of 
selecting  and  using  such,  and  giving  such  suggestive, 
and  practical  details  as  guides,  that  we  think,  these  pre- 
liminary  chapters   alone   worth   the   price   of  the   book. 

The  second  part  is  devoted  to  Galenical  Pharmacy, 
giving  the  manipulations  required  in  j)roducing  the  various 
preparations  —  termed  pharmaceutical,  both  the  officinal, 
and  unofficinal.  The  preparations  of  the  Pharmacopoeia, 
and  the  new  ones  in  general  use,  are  classified  and  group- 
ed into  syllabi,  in  such  a  manner  that  the  relations  of 
menstru£e,  proportions,  dose,  &c.,  are  seen  at  a  glance, 
affording  additional  facilities  to  the  tyro  in  medicine  for 
becoming  easily  and  quicTdy  acquainted  with  the  agents 
he  is  to  employ  in  practice.  An  arrangement  we  have 
never  seen  employed  in  any  other  work,  and  one  which 
gives   a   special    practical  value    to    this.     Following  the 


Bibliographical  Record.  595 

remarks  upon  each  syllabus,  Mr.  Pakrish  gives  formula 
and  processes  for  the  new  preparation  which  belong  to 
the  class  under  consideration,  but  which  are  not  yet  re- 
cognized and  made   officinal. 

Part  third  treats  of  Pharmacy  in  its  relations  to  or- 
ganic Chemistry,  in  which  organic  substances  used  in  Me- 
dicine and  Pharmacy  are  treated  of  in  groups,  the  clas- 
sification being  founded  upon  their  chemical  analogy. 
The  chapter  on  volatile  oils  is  particularly  valuable  in 
new  tests  and  in  comprehensive  tables  showing  the  reac- 
tions  of  the   same. 

Part  fourth  is  upon  inorganic  Pharmaceutical  prepa- 
rations, the  mineral  acids,  alkalines,  earths,  metallic  and 
non  -  metallic   elements,   &c. 

Part  fifth  is  upon  extemporaneous  Pharmacy ;  this 
part  is  extremely  valuable  to  beginners,  in  both  the  office 
and  sho23,  and  is  filled  with  suggestions,  such  as  only, 
one  long  acquainted  with  the  practical  every  day  details 
of  the   shop  like   Mr.   Parrish,    could  gather  together. 

When  we  look  upon  the  book  as  a  whole  —  intended 
as  it  is,  as  a  text -book  for  the  student,  and  as  a 
guide  to  the  Physician  and  Pharmaceutist,  we  can  not 
but  say  we  believe  it  to  be  the  most  useful  one  of  the 
kind   ever  issued.  F.   S. 


A  MANUAL  OF  ELEMENTARY  CHEMISTRY,  THEORETICAL  AND 
PRACTICAL.  By  Geo.  Fownes,  F.  R.  S.,  late  professor  of  practi- 
cal chemistry  in  University  College,  London.  Second  American  from 
the  seventh  London  edition.  Edited  by  Robert  Bridges,  M.  D., 
Professor  of  Chemistry  in  the  Philadelphia  College  of  Pharmacy. 
12mo.  pp.  600.     Blanchard  &  Lea.     Philadelphia. 

A  new    and    revised   edition  of   this    popular  elementary 
chemistry. 

It  affords  in  a  compact  form  an  outline  of  the  general 
principal  of  chemistry  —  organic  and  inorganic — giving  the 


596  The  Peninsular  and  Independent. 

history   of  most   of    the   important,    among   the   numerous 

bodies   which   have   become   known    by   investigation.     An 

unusual   amount   of    space  —  for   a   work   of  the   kind — is 

devoted   to   organic   chemistry,   much   enhancing  its   value, 

on  that   account. 

While   the   working    processes    are    given   in   sufficient 

detail    to    be   easily   understood — the     book   is   illustrated 

with   numerous   wood -engravings   of  apparatus,    &c. 

Price   $1.50.     For   sale   by   the   publishers. 

F.  S. 

POISONS    IN    RELATION    TO    MEDICAL   JURISPRUDENCE  AND 
MEDICINE.     By  Alfred  Swaim  Taylor,  M.  D.,  T.  R.  S. 

A  second  and  revised  edition  of  Taylor  on  Poisons  having 
appeared  in  London.  Messrs.  Blanchard  &  Lea,  with  com- 
mendable  enterprise,   now  offer   their   republication   of  it. 

As  an  able  and  comprehensive  treatise  upon  that 
branch  of  Toxicology  involving  a  consideration  of  sub- 
stances the  misuse  of  which  gives  rise  to  medico -legal 
inquir}^,   we   believe   it   to   be   without   a   rival. 

In  this  edition  the  plan  of  the  former  one  has  been 
remodelled  to  meet  the  advancement  made  in  toxicologi- 
cal  knowledge,  and  to  more  particularly  adapt  it  to  the 
especial  use  of  the  practitioner  of  law  and  medicine. 
This  is  done  by  omitting  merely  historical  notices  of 
unimportant  persons,  while  the  consideration  of  substances 
most  frequently  employed  for  evil  purposes  receive  the 
care   their   importance   demand. 

For  sale   by  the  publishers.  F.   S. 


^Mtnrial  §t^Mtmtut. 


•♦  • 


The  Annual  Dinner  of  tlie  N^ew  York  Society  for  tiie  Relief  of  Widows 

and  Orphans  of  Medical  Men. 

This  charitable  Society  embracing  a  considerable  portion 
of  the  profession  of  the  city  of  New  York,  and  having 
well  invested  a  large  fund  ready  to  be  applied,  as  neces- 
sity may  demand  for  the  relief  of  the  surviving  families  of 
any  of  its  members,  sat  down  to  its  accustomed  annual 
dinner,  in  the  Saloon  of  the  Metropolitan  Hotel,  on  the 
evening  of  the  16th  of  November,  Dr.  Isaac  Wood, 
President,  in   the    Chair. 

After  the  discussion  of  a  sumptuous  repast,  a  report 
of  the  financial  condition  of  the  Society  was  read,  and 
various  toasts — to  the  Society,  to  the  three  learned  Pro- 
fessions, the  Medical  Charities  of  New  York,  the  Army, 
the  Navy,  and  to  Woman,  were  proposed  and  were 
severally  responded  to  by  suitable  representatives  present. 
and  an  agreeable  re-union  of  the  profession  was  enjoyed, 
Still  mingling  with  the  younger  members  were  two  of 
the  venerable  Nestors  of  the  profession  in  New  York, 
Drs.  Stevens  and  Francis,  and  again  their  voices  were 
heard  urging  on  the  fraternity  to  progress  and  improve- 
ment. Dr.  Francis,  as  ho  is  fond  of  doing,  carried  the 
company  back  for  half  a  century,  and  sketched  various 
characters  as  specimens  of  Clergymen,  Lawyers  and  Phy- 
sicians in  the  days  of  his  youth  and  early  manhood ; 
and    Dr.  Stevens    with  that  love  of   his  profession  and 


598  The  Peninsular  and  Independent, 

his  city^  which  has  ever  characterized  him,  and  never 
more  than  in  his  now  declining  years,  urged  upon  his 
brethren  those  improvements  in  the  methods  of  medical 
teaching,  which  the  wants  of  our  country  so  impera- 
tively demand,  and  for  which  the  city  of  New  York 
affords   so   excellent   a  field. 

By  the  suggestion  and  request  of  some  gentlemen, 
whose  wishes  are  entitled  to  respect,  we  present  in  our 
pages  a  sketch  of  a  portion  of  the  proceedings  at  the 
dinner,  reported  at  the  time  for  one  of  the  daily  papers 
of  the   city. 

Dr.  Jas.  R.  Wood,  Surgeon  of  Bellevieu  Hospital, 
who  has  been  so  active  in  suggesting  and  carrying  out 
improvements  in  that  great  institution,  and  who  present- 
ed the  Report  on  Medical  Education  to  the  American 
Medical  Association,  at  its  meeting  at  Washington,  spoke 
to  the  toast  of  the  Medical  Charities  of  New  York,  re- 
ferring to  the  great  numbers  who  receive  gratuitous  medi- 
cal and  surgical  services  in  that  city,  and  to  the  pro- 
priety of  making  such  patients  serviceable  in  furnishing 
the  means  of  clinical  instruction  to  those  who  are  to  be 
the  medical  advisers  of  the  people;  and  before  resuming  his 
seat  introduced  as  one  of  the  guests  of  the  evening, 
Dr.  A.  B.  Palmer,  of  the  University  of  Michigan,  who, 
he  said,  was  accidently  in  the  city,  and  though  scarcely 
off  his  ^ea-legs,  having  just  arrived  from  Europe,  yet  he 
hoped  would  make  some  remarks  which,  he  had  no  doubt, 
would   be  lissened  to   with   pleasure. 

After  other  calls.  Dr.  Palmer  arose  and  said :  He 
was  certainly  taken  by  surprise,  by  the  manner  in  which 
his  friend.  Dr.  Wood,  had  referred  to  him,  and  that 
three  minutes  before,  he  had  not  the  remotest  apprehen- 
sion that  he  was  thus  to  have  been  called  upon  for  a 
speech. 

As  had  been   before  stated   by  his  friend,  he  had  just 


Editorial  J)epartme7it.  599 

arrived,  after  a  long  and  boisterous  voyage  across  tlie 
Atlantic,  and  his  head  was  not  yet  settled  from  the  jost- 
ling it  had  received  ;  and  their  indulgence  must,  there- 
fore, be  craved:  but  he  could  at  least  say  to  them  that 
he  was  most  happy  at  being  among  his  medical  friends 
In  New  York,  on  the  present  occasion.  He  could  not 
fully  express  the  pleasure  he  felt  the  other  morning  as 
he  came  in  sight  of  his  ^^  own  native  land,"  after  an 
absense  of  so  many  months.  To  one  who  had  even  the 
feeblest  spark  of  patriotism  glowing  within  him,  a  re- 
turn to  his  own,  from  foreign  countries,  must  excite  pleas- 
ing  emotions — for   in   the   language   of    the    song — 

"  Be  it  ever  so  humble  there  is  no  place  like  home." 

But  to  return  to  such  a  home  as  ours — a  country  of 
such  freedom,  intelligence,  plenty  and  hope,  after  visit- 
ing those  less  favored,  must  fill  the  heart  with  over- 
flowing joy — and  especially,  as  in  that  return,  the  tedious- 
ness  the  annoyances,  and  the  perils  of  a  rough  sea  passage 
were  escaped.  It  is  true  our  country  has  not  the  long 
history — the  old  associations,  extending  back  to  remote 
periods,  as  is  the  case  with  the  countries  of  the  Old 
World,  but  we  could  forego  them,  especially  as  being 
thus  taken  back  we  were  carried  into  the  darkness  of 
barbarism,  through  scenes  of  tyranny,  of  oppression,  and 
of  aimless  and  bloody  strifes  ;  but  our  history,  though 
brief,  was  covered  with  glory  !  He  need  only  mention 
the  Pilgrim  Fathers,  the  heroes  of  the  revolution — and 
those  other  heroes,  the  race  of  whom  was  not  yet  ex- 
tinct,— who  had  not  won  distinction,  it  is  true,  by  triumph- 
ing over  their  fellow  men,  but  by  subduing  nature — heroes 
whose  trails  were  not  marked  by  the  blood  of  victims, 
but  by  evidences  of  plenty  and  prosperity — those  who 
had  felled  the  forests  and  subdued  the  soil — had  made 
the  solitary  places   to  rejoice — and  the  desert  to  bud  and 


600  The  Peninsular  and  Independent. 

blossom  as  the  rose — liad  clotted  the  land  with  hamlets 
and  cities — had  built  habitations  for  civilized  men — es- 
tablished institutions  for  the  education  of  the  peojile, 
and  the  loliole,  people,  and  erected  temples  for  the  wor- 
ships of  the  Christian's  God.  These  achievments  were 
our  chiefest  glory,  and  j^rominent  among  them  were  our 
Common  Schools,  which  notwithstanding  all  that  had  been 
said  of  the  Prussian  Schools,  gave  the  best  and  freeest 
education  to  the  masses  wliicli  was  given  anywhere  else 
on  the  face  of  the  earth.  Under  desj^otic  governments, 
education  was  conducted  not  so  much  with  reference  to  the 
production  of  good  scholars,  as  to  make  good  suhjecis  — 
the  masses  were  not  tauL^ht  in  a  manner  to  cause  them 
to  act  freely  and  independently,  but  rather  as  they  were 
directed  by  their  Superiors.  But  with  us  our  institutions, 
our  teaching,  and  our  habits  all  tended  to  i)roduce  that 
freedom  of  thought  and  action  —  that  individuality  and 
personal  independence  which  properly  belonged  to  a  na- 
tion  of  sovereigns. 

But  although  our  provisions  were  so  ample  for  the 
education  of  the  masses,  still  from  a  combination  of  cir- 
cumstances which  he  would  not  then  attempt  to  enum- 
erate, the  few  did  not  pursue  knowledge  to  as  great  an 
extent  —  we  did  not  educate  those  professing  science  and 
letters  as  thoroughly  as  the  same  class  were  educated  in 
most   countries  in   Europe. 

He  did  not  know  whether  he  was  expected  to  con- 
fine himself  in  his  remarks  to  the  toast  last  read,  or 
whether  a  greater  latitude  was  admissible.  Indeed  the 
lateness  of  the  hour  and  the  want  of  arrangement  of  his 
thoughts,  suggested  to  him  the  propriety  of  his  setting 
down ;  but  encouraged  by  their  attention  and  voices,  he 
would  make  a  few  suggestions  on  the  hacknied  theme  of 
Medical  Education,  suo^orestions  the  result  of  his  observa- 
tions  at  home  ^and  abroad,  and  of  his  reflections  on  those 
observations. 


Editorial  Department.  601 

That  there  were  defects  m  onr  system  of  Medical 
education,  all  admitted  ;  and  the  time  had  certainly  come 
when  we  should  look  those  defects  directly  in  the  face, 
with   reference   to    some   efforts   for   their   removal. 

He  was  fully  aware  that  great  and  radical  changes, 
in  a  matter  of  this  kind,  could  not  be  effected  in  a  day, 
and  could  not  be  accomplished  by  after-dinner  speeches. 
In  the  older  countries  of  Europe  particularly,  customs 
were  so  fixed  —  were  so  ingiained  into  the  very  consti- 
tutions of  the  i3eople,  that  reforms,  or  changes  of  any 
kind,  were  necessarily  slow.  With  us  it  should  not,  to 
any  thing  like  the  same  extent,  be  so.  We  had  so 
much  adaptiveness  —  were  so  ready  to  receive  suggestions 
and  act  upon  them,  that  reforms  respecting  the  propriety 
of  which  all  are  convinced,  ought  to  be  speedy — we 
ought  to  adopt  at  once  such  features  of  the  institutions 
of  other  nations  as  were  unquestionable  improvements, 
and   adapted   to    our   circumstances. 

Now  there  were  several  particulars  in  which  the  sys- 
tem of  Medical  education,  generally  prevalent  in  Europe, 
was  in  advance  of  our  own,  and  it  was  folly  for  us  to 
shut   our  eyes   to   the   fact. 

In  the  first  place  there  was  generally  required,  on  the 
other  side  of  the  water,  a  higher  standard  of  prelimin- 
ary education,  in  commencing  professional  studies,  than 
with  us.  The  importance  of  this  needed  not  to  be  dwelt 
upon,    as   it   was  apparent   at   a   glance. 

Both  the  rules  of  their  institutions  and  public  senti- 
ment prevented  totally  illiterate  persons  from  presuming 
to  enter  the  profession.  The  same  condition  should  be 
produced  among  us  by  public  and  professional  sentiment, 
and  by  the  rules  of  our  institutions  ;  and  it  was  for  us 
to  establish  that  sentiment  and  those  rules.  Was  it  not 
within   both  our   province   and   our   power  .^ 

Again,  they  took  more   time   in   Europe   than  with  us 


602  The  Peninsular  and  Independent, 

to  educate  a  medical  man.  M.  D.  there  did  not  mean, 
"made  in  a  day/'  Four  years  of  professional  study  were 
at  least  nominally  required  —  and  three  years  attendance 
in  Medical  Schools  was  demanded.  This  point  needed 
not  to  be  dwelt  upon.  The  vast  amount  that  was  at 
present  known  of  Medicine,  and  which  was  essential  to 
a  proper  practice  of  the  art,  could  not  be  speedily  acquired. 
This  was  well  understood.  Eight  months  attendance  at 
a  Medical  School,  with  a  certificate  of  a  few  additional 
months  of  office  study  (the  value  of  which  all  know), 
would  admit  a  man  to  the  profession  among  us.  Not 
more  than  three  years  study  in  all  was  anywhere  in  this 
country   pretended   to   be  required. 

Again,  the  different  departments  of  medical  science 
were  there  studied  with  some  reference  to  order  —  to  a 
succession  of  subjects.  All  the  various  branches  of  medi- 
cine were  not  attempted  to  be  crowded  down  a  student 
together;  and  in  four  months  —  the  next  year  repeating 
the  dose.  The  more  elementary  branches  w^ere  studied 
first,  proceeding  on  in  some  order.  With  them,  not  more 
than  three  lectures  a  day  were  delivered  to  the  same 
student  —  with   us,    six  or   seven. 

Again,  no  medical  school,  pretending  to  be  complete, 
existed  in  Europe  without  a  Hospital — the  school  being 
an   appendage   to   the   Hosj)ital. 

While  didactic  or  systematic  instruction  must  be  regarded 
as  the  foundation,  and  should  precede  in  time,  yet  cli- 
nical—  practical  instruction,  must  enter  largely  into  the 
superstructure  of  all  true  systems  of  medical  education — 
that  clinical  instruction,  which  not  merely  takes  the  stu- 
dent with  a  crowd  into  an  amphitheatre  once  a  week, 
but  to  the  bed  side  of  the  patient  from  day  to  day — fol- 
lowing up  the  case  from  the  beginning  to  the  end  of 
its  course,  and  into  the  dead-house  when  the  termination 
was  fatal.     How  was   this  with   our   schools,  even  in  New 


\ 


tutorial  Department.  603 

York  ?  Can  students  properly  attend  to  clinical  obser- 
vation when  listening  to  six  didactic  lectures  on  as  many 
different  subjects  the  same  day  ?  The  idea  was  a  glaring 
absurdity. 

Lastly,  in  Europe  the  Examining  and  Diploma -granting 
bodies  were  separate  from  the  teachingj  and  schools  were 
consequently  estimated  and  patronized  according  to  the 
excellence  and  thoroughness  of  their  teaching,  and  not 
according  to  the  facility  with  which  a  degree  could  be 
obtained   from  them. 

These  were  the  differences  in  favor  of  the  European 
schools  for  the  education  of  Medical  men.  Should  we 
adopt  them  ?  Had  not  the  time  come  when  we  were 
called  upon  to  take  these  matters  up  in  a  serious  manner.? 
What  stood  in  the  way  of  reform  ?  Were  there  any 
selfish  interests  concerned  ?  If  not,  what  were  there  ? 
There  was  indeed  custom.  But  were  we  so  bound  to 
customs  as  not  to  be  able  to  abandon  those  which  would 
be  more  honored  in  the  breach  than  in  the  observance  ? 
The  difference  between  our  country — its  materials  and  its 
wants,  and  those  of  the  old  world  might  be  urged.  But 
was  there  such  a  want  of  medical  men  at  the  present 
time  that  we  must  take  the  crudest  materials  and  trans- 
form them  into  Doctors  in  the  shortest  possible  time,  with 
but  little  reference  to  fitness  and  quality  ?  Was  human 
health  and  human  life  of  so  little  consequence  as  to  be 
dealt  with  in  such  a  manner  ?  These  were  serious  questions, 
to  be  seriously  met.  They  could  not  be  innocently  post- 
poned. 

But  it  may  be  asked,  may  not  our  students  be  sent 
abroad  —  to  Paris  for  instance,  to  obtain  that  higher  edu- 
cation not  generally  furnished  at  home.?  Now  on  this 
subject  he  had  a  word  to  say.  Whatever  perfections  might 
be  attributed  to  foreign  schools,  their  distance,  and  the 
other  inconviences  of  a  foreign  sojourn,  would  exclude  their 


604  The  Peninsular  and  Indepe^xdent. 

enjoyment  from  tlie  masses  of  students  as  effectually  as 
though  they  did  not  exist.  But  would  it  be  well^  if  these 
inconveniences  were  removed,  to  send  our  students  to 
Paris  ?  He  would  not  question  the  excellence  of  the  French 
schools  in  many  respects,  and  their  adaptation  to  the  edu- 
cation of  French  students,  where  they  were  fully  sub- 
mitted to  their  rules  —  subjected  to  repeated  and  rigid 
examinations  in  passing  from  one  grade  of  scholarship  to 
another,  to  a  final  ordeal  of  a  severe  character,  and  after 
long  study,  for  admission  to  the  profession.  But  did  they 
supply  the  wants  of  the  American  students  who  visit 
Paris  ?  And  what  was  the  ordinary  course  of  such  stu- 
dents ?  On  this  subject  he  had  made  some  observations 
and  inquiries,  and  could  speak  from  knowledge,  as  well 
as  from   reliable   information. 

He  wished  it  fully  understood  that  there  were  excep- 
tions —  perhaps  many  exceptions,  to  the  state  of  things 
he  was  about  to  describe  ;  but  exceptions,  however  nu- 
merous, would  not  alter  the  general  facts.  Most  Ameri- 
can students  who  go  to  Paris,  have  recently  graduated 
in   some  of  our   own   schools. 

They  go  with  an  imperfect,  often  with  no  knowledge 
of  the  language,  and  do  not  pretend,  indeed  can  not 
submit  themselves  to  the  discipline  of  the  School  of  Me- 
dicine. Many  in  fact  attach  themselves  to  no  special 
teacher,  are  submitted  to  no  examinations  —  have  in  pros- 
pect no  ordeal  to  test  their  knowledge,  expect  no  degree 
or  testimonial ;  and  the  result  is,  they  soothe  their  con- 
sciences by  spending  an  hour  or  two  a  day  in  visiting  some 
Hospital,  following  some  of  the  popular  physicians  or  sur- 
geons at  a  distance^  seeing  little  and  understanding  less,  and 
then  going  to  some  resort  of  amusement,  or  returning  to  their 
rooms,  and  not  always  to  the  exclusive  companionship  of  their 
books,  the  day  and  night  was  spent,  and  their  useful 
knowledge  was  but  little  increased.     Six  months  or  a  year 


Editorial  Department.  605 

was   thus  frittered   away,   and  the  young  Doctor  returned 
home,  too  often  with  his   mind   dissipated,  his   health  im- 
paired,  his    morals   corrupted,    and   actually   knowing  less 
of  Medicine   than  when  he  went  from   home  ;  but  having 
the  reputation  of  studying   abroad,  and  basing,  it  may  be, 
large    pretentions    upon    that   reputation.      He   wished   to 
repeat    that   there   were   exceptions  —  many   honorable   ex- 
ceptions  to   this   picture  —  but   even   if  such   were   tenfold 
more   numerous   than  they  were,  there  would  be  no  reason 
why   we   should   not  fully   develope   our   own   domestic  re- 
sources, and  give  as  good  and  extended  instruction  at  home 
as    could    be    obtained    abroad.      What   was   to   hinder  ? 
There  were   no   more   facilities,   in   any  part  of  the  world, 
than  in  New  York,  for  medical  instruction  of  every  grade 
and   character.     What   was  to  hinder  their  being  rendered 
fully   available  ?      Had   we   not   the  men   to   do   it  ?     He 
looked   around   him   and   saw  men   who   appeared   as    well 
as   those   he  had   seen   elsewhere  —  and  he   fancied  he  had 
seen  many  of  the  best  abroad.     If  then  we  had  the  men 
and   the   means,   he   repeated    the   question,  what   was   to 
hinder   which  might   not   be   overcome  ? 

He   would    not    say   there   were   no    difficulties   in   the 
way  of  rendering  our  schools   as   thorough   as   the   best  in 
Europe.     It  might   not   be   possible   to  induce   the   masses 
of  the   schools   throughout   the   country  to   adopt   the  im- 
provements  which  were   needed,  —  and  it    might    not    be 
practicable  for  one,  or  a  few,  to  succeed,  standing  alone  in 
their   adoption.      He   was   fully   aware   that   the  ideal   and 
the   practicable  were   often  at   variance.     But   if  our  com- 
mon medical   colleges  can  not  be   speedily  and  materially 
advanced,   what  is   to   hinder  the   establishment,    in    New 
York,  of  a  distinct  Clinical  School,   holding  its   chief  ses- 
sions   in    the  intervals   of    the   didactic    lectures    in    the 
existing  colleges  ?     Such   a   school,  so  far  from  interfering 
with  those  already  in  the  city,  would  rather  attract  students 


606  The  Peninsular  and  Independent. 

to  them,  by  making  New  York  the  Medical,  as  it  was  the 
commercial  emporium  of  the  New  World.  Such  a  school 
should  have  a  large  corps  of  teachers,  and  should  be  orga- 
nized in  connection  with  your  largest  Hospitals,  —  thorough 
daily  drilling  at  the  bed  -  side,  and  in  the  dead  -  house 
should  be  given  to  the  students  at  a  season  when  their  time 
and  attention  were  not  so  occupied  with  didactic  and  ele- 
mentary lectures  as  to  render  the  improvement  of  the  ad- 
vantages impossible. 

He  would  close  his  remarks  by  this  suggestion,  stating 
that  it  was  a  subject  upon  which  he  had  bestowed  some 
reflection,  and  which  his  tour  abroad  had  rendered  him 
more  anxious  to  see  realized.  He  was  aware  that  much  had 
already  been  done  of  late  in  the  right  direction,  but  there 
was  much  more  to  be  accomplished  by  a  more  thorough 
organization  and  a  larger  concert  of  action.  He  believed 
New  York  could  be  made,  not  only  the  medical  emporium 
of  this  continent,  but  that  students  might  be  attracted  even 
from  Europe,  as  he  believed,  with  all  our  imperfections  — 
such  was  the  activity  and  practical  adaptiveness  of  the 
American  Mind — we  could  teach  even  Frenchmen  and  Eng- 
lishmen many  practical  things  of  which  they  were  ignorant. 

Should  they  not  give  their  attention  and  a  hospita- 
ble entertainment  to  these  suggestions,  and  see  if  some 
practical  results  could  not  be  realized,  which  should  place 
our  noble  profession  in  a  position,  in  this  country,  which 
it  has   not   hitherto   occupied  ? 

Dr.  Alexandek  H.  Stevens  said,  by  the  permission 
of  the  gentlemen  present,  he  would  make  a  few  remarks. 
He  felt  constrained  so  to  do  because  the  subject  brought 
before  their  attention  by  the  gentleman  who  had  just 
taken  his  seat,  was  one  upon  which  he  had  long  re- 
flected, and  he  wished  to  say  that  to  all  the  remarks 
which  had  been  so  forcibly  made  on  the  subject  of  Med- 
ical Education,  he  could  heartily  respond,    "Ditto   to  Mr. 


I 


Editorial  JDepartment.  607 

Burke.  '     These   were   the  very   principles  which  had  set- 
tled  down  in  his   mind   as   the   result   of   thirty  years  re- 
flection,  and  he   was  most   anxious   to   see    them    carried 
out.     The   higher   standard   of    preliminary  education — the 
longer   terms   of    study   and   instruction — the  separation  of 
the    teaching    and    licensing    bodies  —  and   above   all   the 
practical,    demonstrative  character   of   hospital   instruction, 
as    an    absolutely   essential  part   of   medical   education  — 
all  met  with  his  most   decided   approval.      He   could   but 
bear   his   testimony  to    the    very   great  importance   of    all 
these  measures,   and  felt   under  obligation  to   the  gentle- 
man for  his  remarks  —  coming  fresh   as  he  did  from  Eu- 
rope  where  he  had   witnessed    the  operation   of    the   sys- 
tems of    education  prevailing  there,  his  remarks  had  more 
weight    than    though    coming    from    those   who   remained 
at  home.     He   was   also  pleased  with  the  suggestion  of  a 
distinct    Clinical    School    in   New   Yoik,   and   said  it  was 
absurd   to   think   of   giving   thorough  hospital  instructions 
while    students    were   listening   to   six   lectures   a   day   on 
systematic   and   elementary  subjects,    besides    attending  at 
night,    &c,.   to   practical   anatomy. 

As   to   the   students   going  abroad,   especially  to   Paris, 
he  had  long  been   of   the  opinion,  from  observing  effects, 
that    many,   very  many,   were    injured   rather   than   bene- 
fited—  that   they  often   came   back  with  their  heads  load- 
ed   with  nonsense   which   they  had   to   forget,  knowing   in 
fact  less   of   true   medicine    than    when    they   went   away. 
Those    who    have    received    their    impressions   from   Paris 
teaching  and   observation,   even   when  they  were   studious 
and   intelligent,   come    home    with    exagerated  notions   of 
the  importance   of    some   points  in  minute  pathology,   by 
no  means  settled,  while  they  lost  sight  of  the  great  object 
of  medicine^:— the  cure  of  disease.    They  were  led  astray  by 
the  novelties  of  the  passing  moment,  as  ephemeral  as  they 
were  unreal,  and  they  often  vainly  sought   to   enlarge   the 


608  The  Peninsular  and  Independent . 

boundaries  of  science,  while    ignorant  of  what  was    within 
its  present  domain. 

Our  system  of  instruction  was  in  the  last  degree  disor- 
derly, however  excellent  its  matter.  The  health  of  the 
student  was  often  broken  down  by  listening  to  so  many 
lectures  in  a  day,  of  which  they  did  not  carry  a  tithe  from 
the  lecture  room,  and  much  less  permanently  retain. 

His  heau  ideal  of  a  course  of  medical  education  should 
embrace  a  period  of  four  years,  and  not   more    than    threo 
hours  a  day  should  be  spent  in  the  lecture   room.    The  de- 
monstrative parts  of  the  science — those  addressing  the  eye 
and  the  touch  and  not  the  ear  exclusively  —  those  making 
a  smaller  draft  upon  the  reasoning  powers,  should  first   be 
addressed  to  the  youthful  mind  ;  and  the  healthy  condition 
of  the    structures    and  functions,  should  be  made  familiar, 
before  their  morbid  states  were   taught.      If  any  exception 
should    be    made    to    this    latter    rule,  it  would    be  in  the 
early  accustoming  the  student  to  the  observasion  and  treat- 
ment of  the  external    appearances   of  disease.      He    would 
not    only  have    a   small    number    of  lectures    per   day,  but 
would  have  intervals  between,  encouraging  students  during 
such    intervals  to  converse  together  on  the  subjects  of  the 
instruction.      He    need   hardly  add    that    the    manner  of  a 
professor  towards  his  students  should  be  kind  and    affable, 
while  the  reverse  of  these  qualities  should  render  a  teacher 
ineligible  to  a  position.     It  was  one  of  the  pleasantest  re- 
flections   of  his    life,    that    during   the    whole   time  passed 
among   students  and  in  familiar  intercourse  with  them,  no 
circumstances   had    ever    occurred    to    destroy  the  pleasure 
of  the   retrospect. 

He  would  close  his  remarks  by  repeating  his  approval 
of  the  suggestions  which  had  been  made,  having  the 
strongest  desire  that  the  city  of  New  York,  in  which  his 
life  had  been  spent,  should  be  the  great  centre  of  medical 
learning,  and    that   her  public  charities,  so   excellent   and 


Editorial  Department.  609 

ample^  should  be  rendered  available  to  large  numbers,  for 
the  highest  forms  of  practical  and  demonstrative  instruc- 
tion. He  must  be  permitted  to  urge  the  necessity  of  ad- 
dressing the  eye  as  well  as  the  ear,  with  the  truths  of  the 
medical  art.     The  well  known  words  of  Horace — 

*'  Segnius  irritant  animos  demissa  per  aures, 
Quam  quae  sunt  Oculis  subjecta  fidelibus," 

Were  as  true  now  as  in  the  days  of  the  Eoman  poet, 
and  peculiarly  applicable  to  the  teaching  of  our  profes- 
sion. The  eye  must  be  taught  to  observe,  and  through 
it  would  ever  be  received  the  strongest,  clearest  and  most 
lasting   impressions. 

At  the  expense  of  considerable  space,  we  have  pre- 
sented the  above  report,  as  at  once  expressing  our  own 
sentiments  on  the  subject  of  medical  education,  and 
showing  the  direction  in  which  the  opinions  of  the  pro- 
fession are  tending.  The  opinions  of  no  man  in  the 
profession,  on  this  subject,  are  entitled  to  more  weight 
than  those  of  Dr.  Stevens,  and  they  seemed  to  have 
the  hearty  approval  of  the  assembly  present  at  their 
delivery. 

A  New  Journal. 

The  first  number  of  "  the  Chicago  Medical  Examiner, 
a  monthly  journal,  devoted  to  the  educational^  scientific, 
and  practical  interests  of  the  Medical  Profession,^'  is  before 
us   and  will  be   placed  upon  our  exchange  list. 

Our  neighbors  at  Chicago  have  been  undergoing  a  re- 
volution—  a  dissolution  of  Union  (J)  has  taken  place,  and 
instead  of  one  Medical  School  and  one  Medical  Journal, 
two  schools  and  two  journals  are  in  existence.  Of  the 
causes  which  have  led  to  this  state  of  things,  we  are  not 
publicly,  or  at  least  publicly  and  fully  informed,  but  pre- 
sume an  incongruity  both   of  persons   and   principles    has 

Vol.  II.— 20. 


610  The  Peninsular  and  Independent, 

led  to  the  result,  as  certainly  there  are  not  more  stu- 
dents resorting  to  Chicago  than  could  be  accommodated 
in  one  school,  or  more  contributors,  correspondents  and 
readers  within  that  area  than  could  be  accommodated  by 
one  journal. 

With  the  incongruity  of  persons  we  have  no  concern 
—  the  differences  of  principle  are  matters  of  public  in- 
terest, and  to  them  we  wish  to  call  attention. 

Uiisli  Medical  College  has  been  in  existence  and  op- 
eration for  several  years.  It  was  established  on  the  old 
idea,  or  rather  after  the  plan  of  those,  founded  on  the 
idea,  that  medical  schools  were  places  where  students 
were  to  come  for  a  few  weeks  and  review  the  studies  they 
had  been  pursuing  with  private  perceptors,  to  witness  some 
demonstrations  in  chemistry  and  anatomy,  and  to  receive 
a  degree  recognizing  their  attainments  in  professional 
learning.  The  length  of  its  sessions  has  been  sixteen 
weeks,  and  the  plan  of  conducting  it  has  been  to  deliver 
six  lectures  per  day  on  six  different  branches^  carrying  on 
all  the  subjects  simultaneously  without  order  or  succession. 
It  has,  in  short,  been  anti  -  progressive,  and  has  turned  a 
deaf  ear  to  the  recommendations  of  the  American  Medi- 
cal Association,  and  all  those  who  have  insisted  that  the 
enlargement  of  the  field  of  science  and  the  change  in  the 
modes  of  obtaining  a  medical  education  (students  now 
depending  almost  exclusively  upon  the  schools,  and  very 
little  upon  reading  in  private  offices  for  their  instruction)  re- 
quire a  material  modification  of  the  whole  system.  One  gen- 
tleman formerly  connected  with  the  Kush  College,  and  now 
with  the  new  school  and  the  new  journal,  took  a  very  early 
and  leading  part  in  exposing  and  denouncing  the  absurdi- 
ties of  the  prevalent  system  which  Eush  College  still 
pursues,  as  it  ever  has  done,  and  he  has  at  length  made 
an  effort  to  relieve  himself  from  the  inconsistency  of  ad- 
vocating a  course  which  he   was  so  very  far  from  pursu- 


Editorial  Department.  611 

ing.  Nine  or  ten  years  were  quite  enough  to  stand  in 
sucli  a  position  before  the  profession,  and  we  can  but 
congratulate   him  on   the  occasion  of  his  change. 

In   the  number   of  the  journal  before  us  is  an  address 
from  Dr.    Davis,  the   Senior  Editor,   and  the  Professor   of 
Practice   in  the   new  school,   delivered   on  the  occasion   of 
the  opening   of  the   school,  which  bears   the   name  of  the 
Iledical  Department  of  Lind  University,  in  which   are  in- 
dicated the   improvements    attempted   to    be  made  in   the 
new    organization.     '^  They  are,''  to   use  his  words,  "  first, 
an  increase  in  the  number  of  Professorships   corresponding 
with  the  increased  number  and  extent  of  the  branches  in- 
cluded  in   the   great   field   of  medical    science  and  art   at 
the   present  time.     Second,    an  increase  in   the  length   of 
the  lecture   term   sufficient  to  allow  fewer  lectures  a  day, 
and   the   students   more   time    for  reflection   and    hospital 
attendance.     Third.    Such  a   division    of    branches   as   will 
enable   the    student   to    attend,    during  the  first   course  of 
lectures,    to    those  only    which     are    more    elementary   in 
their  nature  ;  and   in   his  second    course,    those  denomina- 
ted  practical ;    thereby    enabling   him   to    concentrate    the 
mind  upon  a  smaller  number  of  subjects  at  one  time,  and 
investigate  them  in   such   order  of  succession   as   will  fa- 
cilitate    both    the    acquisition   of  knowledge   and  the   at- 
tainment  of  a  high  degree  of  mental  discipline.     Fourth. 
The  establishment   of  systematic   hospital   clinical  instruc- 
tion  in  connection  with  the   course    on  practical  medicine 
and  surgery.     Fifth.  The  more  frequent  and   thorough  ex- 
amination of  students  during  their  attendance  on   lectures, 
as  well   as   at  the  close   of  the  period   of  their  privilege." 
These  are   certainly  very  worthy  objects  ;  but  what  are 
the  means   proposed  for  accomplishing  them  ?     Are   they 
adequate  to  the    demands   of    the   case  ?      Will   they   af- 
ford  a  complete  and  thorough  course  of  professional  train- 
ing ? —  for  we   must   bear    distinctly  in  mind    that    office 


612  The  Peninsular  and  Independent. 

instruction  is   in    a  vast   majority   of  cases   almost,  if  not 
wholly,  a  nullity. 

The  first  means  proposed  to  accomplish  these  purposes, 
is  to  extend  the  annual  college  term  to  five,  months.  This, 
we  must  confess,  is  an  advancement  beyond  four  months, 
but  it  is  far  less  than  we  had  anticipated  from  the  well 
known  views  of  the  principal  movers  in  this  project,  and 
'from  the  evident  demands  of  the  profession.  In  a  plan 
suggested  by  Dr.  Davis  some  two  or  three  years  ago,  nine 
months  was  the  length  of  the  term  he  then  proposed ;  but 
for  some  reason  those  of  a  prudential  character,  doubtless, 
the  item  of  four  months  is  thrown  off !  This,  in  order  to 
have  the  matter  fully  understood,  must  be  taken  in  con- 
nection with  ^'^the  division  of  the  term  into  junior  and 
senior  departments,  in  such  a  way  that  all  students  at- 
tending this  first  course  can  concentrate  their  attention 
upon  the  more  elementary  branches,  and  advance  in  their 
second  to  the  most  practical."  By  this  arrangement,  two 
courses  of  lectures  only  being  required  for  graduation,  the 
subjects  are  passed  over  in  the  school  but  once, — there  is 
no  opportunity  of  hearing  a  second  time  the  important 
facts  and  principles  enunciated,  and  if  not  comprehended 
the  first  time,  or  if  forgotten,  they  are  never  again  to  be 
called  up  by  the  teachers,  or  never  fully  impressed  upon 
the  mind.  We  need  but  appeal  to  the  experience  of  every 
student,  as  to  the  greater  satisfaction  with  which  he  has 
listened  to  a  repetition  of  medical  lectures.  However 
slowly  they  may  proceed,  many  lectures  and  subjects  will 
fail  to  make  their  proper  impression  the  first  time  of  their 
presentation.  It  must  be  remembered  that  the  study  and 
practice  of  medicine  is  quite  different  in  some  respects 
from  that  of  the  law  or  any  other  profession.  The  lawyer, 
for  instance,  has  ample  time  to  prepare  his  cases  for  trial 
in  court  —  weeks  and  months  usually  elapse  after  his  at- 
tention is  called  to  a  case,  before  his  knowledge  and  skill 


Editorial  Department.  613 

ure  brought  to  the  test.  With  him  a  knowledge  of  refer- 
ences is  a  knowledge  of  his  profession.  He  can  deliber- 
ately look  up  the  law^  and  make  up  his  brief.  The 
physician  or  surgeon,  on  the  other  hand,  is  usually  call- 
ed upon  to  act  at  once,  with  no  opportunity  for  consult- 
ing books  and  ascertaining  authoritative  decisions  in  simi- 
lar cases.  When  the  life  -  blood  is  flowing  forth,  he  must 
have  ready  knowledge  of  where  the  artery  lies,  around 
which  a  ligature  is  to  be  x^^-ssed.  When  the  exhausted 
brain  and  nerves  are  ceasing  to  act,  he  must  determine 
without  delay  the  agent  to  be  employed  to  keep  the 
functions  in  play.  He  must  have  his  knowledge  complete- 
ly at  his  command  ;  and  to  secure  this,  in  medical,  as 
in ,  moral  teaching,  "  line  upon  line,  and  precept  upon 
precept"  are    required. 

With  regard  to  the  means  for  accomplishing  the  other 
objects  specified,  they  are  generally  of  a  character  to  be 
approved  ;  yet  we  must  be  permitted  to  say  that  the  effi- 
ciency of  teaching  is  not  always  in  proportion  to  the 
number  of  teachers.  It  will  sim23ly  be  in  proportion  to 
the  extent  and  faithfulness  of  the  teaching ;  and  while  a 
certain  amount  of  division  of  labor  is  essential  to  secure 
a  proper  amount  of  concentration  of  mind,  of  familiarity 
with  the  subject  and  energy  in  presenting  them,  yet  there 
are  limits  to  this  division  of  labor  and  multiplication  of 
men  —  one's  efficiency  in  teaching  the  diseases  of  the 
chest,  for  example,  would  hardly  be  impaired  by  his  teach- 
ing also  those  of  the  abdomen,  provided  the  same  time 
was  afforded  him  for  his  work  that  would  be  given  to 
two,  and  the  different  departments  of  Anatomy  might 
perhaps  be  as  well  taught  by  one  qualified  anatomist,  as 
by  two  or  three ;  while  the  same  chemist  could  teach  as 
well  both  inorganic  and  organic  chemistry,  if  sufficient 
time  were  allowed  him   for  his  work. 

Our  own  ideal  of  a  proper  Medical  School  in  the  pre- 


614  The  Peninsular  and  Independent, 

sent  state  of  our  country,  would  be  one  that  should  con- 
tinue its  annual  sessions  eight  or  nine  months,  the  first 
half  of  the  term  being  devoted  to  the  primary,  and  the 
last  half  to  the  practical  branches,  —  nothing  short  of  two 
such  fall  courses  entitling  the  student  to  an  examination 
for  his  degree.  This  would  secure  order  and  succession 
in  the  presentation  of  the  subjects  of  study,  and  that 
repetition  necessary  to  ^-^   them   in  the  mind. 

But  the  ^^Q  months  plan  of  the  Medical  Department 
of  the  Lind  University,  we  regard  as  an  improvement 
upon  that  of  its  four  month  rival,  and  as  such  it  has 
our  sympathy  and  well  wishes.  The  journal  before  us, 
its  organ,  has  also  our  kind  w^ishes.  It  has  a  respectable 
appearance,  and  we  have  no  doubt  it  will  be  conducted 
with  ability.  The  qualifications  of  the  senior  editor  for 
the  task  undertaken,  are  too  well  known  to  require  our 
endorsement.  A.  B.  P. 

Blackwood's  Magazine  and  the  British  Reviews. 

We  would  call  the  attention  of  our  readers  to  the 
advertisement  of  Leonard  Scott  &  Co.,  in  the  present 
number   of  our   Journal. 

We  copy  the  following  notice  from  the  Philadelphia 
Evening  Neivs: 

The  British  Periodicals.  The  Messrs.  Leonard  Scott  &  Co.,  of 
New  York,  who  republish  the  four  great  British  Reviews  and  Black- 
Wood's  Magazine,  deserve  the  gratitude  of  all  friends  of  sound  and 
sterling  literature  in  this  country.  These  periodicals  have  long  been 
justly  celebrated  for  their  elaborate  and  able  criticisms,  their  learned, 
brilliant,  and  attractive  essays,  and  their  chaste  and  classic  style.  They 
represent  respectively  all  the  great  parties  of  England,  both  in  Church 
and  State  —  the  London  Quarterly  representing  the  Conservatives,  the 
Edinburgh  Review  the  Whigs,  the  ^Westminster  Review  the  Liberals, 
Blackwood's  Magazine  the  Tories,  and  the  North  British  Review  the 
Free  Church  of  Scotland.  But  although  each  is  thus  the  organ  of  a 
great  party,  none  of  them  are  illiberal  or  narrow-minded,  or  will  giv© 
any  countenance  to  the  prejudices  and  foolish  vainglorious  theories  which. 


Editorial  Department.  615 

sometimes  find  advocates  even  in  the  columns  of  the  Times.  The  reason 
is  obvious;  their  contributors  are,  without  exception,  men  of  superior 
education  —  men  who  are  famihar,  not  only  with  British  history,  but 
with  the  history  and  ethnology  of  every  civilized  country.  Hence  it  is 
that  the  English  newspapers  and  the  English  periodicals  are  as  unlike 
as  possible  on  most  international  questions  —  nay  on  most  subjects  re- 
lating to  England  itself.  The  former  can  seldom  see  any  faults  at  home, 
or  aught  that  is  commendable  abroad ;  while,  as  a  general  thing,  the 
latter  are  as  willing  to  do  justice  to  the  French  or  the  Germans  as  to 
their  own  readers.  This  cosmopolitan  spirit  is  a  striking  and  noble 
feature  in  the  periodicals  under  consideration,  especially  in  the  Eeviews; 
and  it  is  one  that  greatly  enhances  their  value.  If  they  were  merely 
local  in  their  views  and  sympathies  they  would  not  present,  as  they  do 
tvery  quarter,  an  epitome  of  the  literature  of  Europe  and  America;  for 
need  we  say  that  there  is  not  a  book  published  in  either  hemisphere 
that  contains  aught  that  is  new  or  valuable,  the  pith  of  which  is  not 
to  be  found  in  one  or  other  of  the  Quarterlies.  Was  it  too  much,  then, 
for  us  to  say,  as  we  did  at  the  beginning  of  this  notice,  that  the  gentle- 
men who  furnish  us  the  reprints  at  less  than  one  -  third  what  the 
originals  cost  in  England,  deserve  our  gratitude?  The  four  Eeviews 
and  Blackwood  only  cost  $10  in  this  country,  while  they  cost  $31  in 
England. 


jt^^Hon.  Judge  Mason,  of  Iowa,  who  made  himself  so 
popular  with  the  inventors  of  the  country  while  he  held 
the  office  of  Commissioner  of  Patents,  has,  we  learn,  asso- 
ciated himself  with  Munn  &  Co.,  at  the  Scientific  Ameri- 
can office,  New  York. 

Ei^^  We  regret  that  in  the  letters  of  our  Editorial 
Correspondent  so  many  typographical  errors  have  occurred. 
As  the  writer  will  hereafter  have  an  opportunity  to  cor- 
rect his  own  proof,  it  is  to  be  hoped  such  errors  will  be 
less  numerous.  There  would  doubtless  be  justice  in  the 
compositor's  claiming  that  the  manuscript,  written  without 
revision  and  in  a  scrawled  hand,  was  not  the  most  clear 
and  bright.  Some  of  the  errors  in  the  letter  in  the 
November  number  are  specified  :  on  the  456th  p.  3d  line 
from  top,  for  "  sublimary  "  read  sublunary  —  459th  p.  14th 


616  The  Peninsular  and  Independent. 

line  from  bottom,  for  "  Cicotraces''  read  Cicatrices  — 
four  lines  below,  for  '^  Orthopiclic "  read  OrtlioiJoedic.  On 
page  461,  six  lines  from  bottom,  for  ^^  Metatarsis ''  read 
Metastasis  —  and  on  462,  three  lines  from  top,  for  ^^Mu- 
rate  of  Soda ''   read    Urate  of  Soda. 


EDITORIAL    CORRESPONDENCE. 


BiUDFORD,  Eugland,  October  15tb,  1859. 
Dear  Readers  of  the  Peninsular  and  Independent : 

In  my  last,  I  gave  you  some  account  of  the  meeting  of 
the  British  Association  for  the  Advanceme7it  of  Science^  and 
intimated  that  in  my  next,  I  slioukl  resume  the  notice  of  me- 
dical men  and  institutions  in  London  and  elsewhere.  Since 
then  with  my  face  rather  liomeward,  I  have  spent  two  weeks 
most  delightfully  in  tlie  city  of  Edinburgh,  —  have  been  to 
Melrose,  Abbotsford,  and  througli  tlie  rest  of  the  "Border 
Country  "  —  the  scenes  of  so  many  bloody  contests  between  the 
Englisli  and  Scotch  in  times  gone  by  —  have  been  at  New- 
castle (but  not  for  the  purpose  of  carrying  coals  tliere),  though 
I  brouglit  some  coal  dust  upon  my  exterior  and  in  my  lungs 
lip  from  a  depth  of  1200  feet  below  the  surface,  and  a  mile 
or  so  from  the  shaft  —  have  examined  the  cottao^es  of  the 
miners  of  those  localities,  and  the  condition  of  their  inmates 
—  have  passed  over  a  large  region  of  country  where  the  plow 
and  other  implements  of  husbandry  are  doing  their  work  upon 
the  surface  of  the  earth,  while  the  j^ick,  and  shovel,  and  car, 
are  doing  their's  deep  in  its  bowels  —  have  been  through  Leeds 
and  heard  the  din  of  its  thousands  of  hammers,  and  seen  the 
blackening  smoke  and  brilliant  glow  of  its  forges ;  and  am  now 
in  this  city  of  Bradford,  in  the  West  Riding  of  Yorkshire, 
in  the  midst  of  very  beautiful  natural  scenery,  where  the 
earth  is  cultivated  in  the  greatest  perfection,  and  where  on 
all  sides  immense  structures  are  erected  in  which  u'on,  wor- 
steds, and  various  other  textile  fabrics  are  manufactured  to 
an   enormous  extent. 

I  have  been  here  for  the  past  week  in  attendance  upon 
the  N'ational  Association  for  the  JPromotion  of  Social  jScie?ice, 
and  it  has   been  a  meeting   of  so   much  interest  to  me,  and 


Editorial  Department.  617 

subjects  have  been  presented  and  discussed  having  such  im- 
portant relations  to  medical  science,  that  I  hope  I  shall  be  par- 
doned for  deviating  a  second  time  from  my  original  plan,  to 
give  you  in  this  letter  a  hasty  and  imperfect  sketch  of  a 
second  British  great  national  congress.  While  the  late  meet- 
ing at  Aberdeen  was  the  29th  of  the  British  Association  for 
the  Advancement  of  Science,  the  Bradford  meeting,  just  closed, 
is  only  the  3d  of  the  N"ational  Association  for  the  Promotion 
of  Social  Science. 

It  will  doubtless  be  asked  by  many  "  what  is  meant  by 
those  engaged  in  this  association,  by  Social  Science  ? "  and  an 
answer  (it  must  be  confessed  rather  vague),  has  been  given  by 
one  who  has  written  on  the  subject,  "that  it  is  the  Science 
which  has  for  its  object  to  promote  the  well-being  and  happi- 
ness of  the  human  race.  It  embraces  in  its  developement  a 
consideration  of  all  the  subjects  that  the  most  enlightened  phi- 
lanthropy can  suggest,  and  at  the  same  time  realizes  for  itself, 
by  the  foundation  on  which  it  rests,  the  dignity  of  a  science." 
It  is  in  fact  the  Science  of  Philanthropy  —  of  the  improvement 
of  men  in  society.  As  all  definitions  of  a  subject  so  extensive 
and  complicated  must  necessarily  convey  an  imperfect  impres- 
sion of  its  full  nature,  in  this  as  in  other  simular  cases,  descrip- 
tion must  be  resorted  to,  and  we  shall  find  in  the  enumeration 
of  the  difierent  departments,  and  as  we  proceed,  some  of  the 
special  subjects  embraced  under  them,  a  more  full  conception 
of  the  general  science.  It  is  divided  into  five  departments, 
viz.  I.  Jurisprudence  —  Improvement  of  the  Laws,  &c,  II. 
Education.  III.  Punishment  and  Reformation  —  Incentives  to 
and  Preventives  of  Crime.  lY.  Public  Health,  and  Y.  Social 
Economy. 

In  a  certain  sense,  social  science  may  be  said  to  be  the 
application  of  other  sciences,  to  human  progress  and  well- being. 

The  origin  of  this  association  is  attributed,  if  not  to  the 
original  suggestion,  at  least  to  the  active  promotion  of  that 
Singularly  energetic  and  versatile  man.  Lord  Brougham,  who  is 
the  permanent  president  of  the  council,  which  is  the  governing 
active  body:  and  although  so  advanced  in  years,  has  been  the 
most  active  member  of  the  present  meeting.  The  idea  of  such 
an  Association  was  first  suggested  to  Lord  Brougham  by  G. 
W.  Hastings,  Esq.,  who  is  now  its  general  secretary. 


618  The  Peninsular  and  Independent, 

Many  persons  for  a  long  time,  in  England  as  well  as  else- 
where, have  of  course  been  interested  in  different  departments  of 
reformatory  study  and  action,  but  there  needed  in  these  labors, 
as  in  those  of  physical  science,  a  concert  of  action,  the  influence 
of  one  mind  upon  another,  to  give  acuteness  and  comprehen- 
siveness of  views,  and  efficiency  of  efforts  to  all. 

Solitary  students  and  solitary  philanthropists  are  alike  liable 
to  take  very  limited  and  partial  views  of  the  great  fields  of 
truth  and  benevolence.  The  student  exaggerates  the  import- 
ance of  those  branches  of  science  in  which  he  has  been  engaged, 
disparaging  others ;  while  the  philanthropist  wlio  persists  in  pur- 
suing his  own  plans  for  the  reformation  of  society,  unenlightened 
by  the  experience  of  others,  may  come  to  regard  his  own  limited 
and  partial  schemes  as  alone  possessing  value,  neglecting  or 
condemning  others  fir  better  calculated,  under  many  circum- 
stances, to  accomplish  the  greatest  good.  Besides,  in  associa- 
tion will  be  found  a  true  division  of  labor,  each  with  a  com- 
mon object  working  in  his  alloted  sphere  ;  and  while  one  mind 
can  not  master  every  branch  of  knowledge,  it  may  suppliment 
its  experience  by  the  interchange  of  information  and  opinion 
with  other  laborers  in  the  same  field.  Some  minds  are  adapted 
to  the  observation  of  facts,  others  to  the  discovery  and  enun- 
ciation of  principles,  while  others  still  can  apply  the  knowledge 
of  fiicts  and  principles  to  the  accomplishment  of  ends.  In 
accordance  with  these  principles,  when  it  was  once  suggested, 
the  notion  of  an  Association  of  those  engaged  in  social  refor- 
mation was  at  once  acceded  to  by  many  distinguished  persons, 
and  a  meeting  was  held  at  Lord  Brougham's  house  in  July, 
1857,  consisting  of  some  forty  persons,  embracing  some  of  the 
most  distinguished  in  the  country ;  preliminary  measures  were 
entered  upon,  and  a  meeting  appointed  in  the  [next  October  in 
Birmingham,  which  was  numerously  attended ;  Lord  Brougham 
acting  as  President  of  the  Association,  while  ^the  department 
of  Jurisprudence  and  Amendment  of  the  Law  was  presided  over 
by  Lord  Johx  Russell;  that  of  Education  by  Sir  G.  S. 
PACKi:NrGT0X,  M.  P. ;  Punishment  and  Reformation  by  the  Bishop 
of  London ;  Public  Health,  by  Lord  Stanlet,  M.  P. ;  and  that 
of  Social  Economy,  by  Sir  B.  C.  Brodie,  F.  R.  S.  On  the 
afternoon  of  the  day  previous  to  the  evening  on  which  the 
meeting  was  regularly  opened,   a   special    service  was   held  in 


Editorial  Department.  619 

one  of  the  established  churches  of  the  place,  and  a  sermon 
preached  suitable  to  the  occasion.  The  Association  thus  in- 
augerated  has  continued  to  prosper.  Two  most  important  vo- 
lumes of  transactions  have  been  published.  Many  of  the  papers 
eminating  from  the  very  ablest  men  of  the  nation,  and  the 
present  meeting  has  sustained  the  high  reputation  which  those 
preceding  had  given  it.  The  influence  of  the  organization  is 
strongly  felt  in  every  department  of  reform  througout  the  land, 
and  is   not  without   it   effect   upon   Parliament. 

But  it  is  quite  time  that  I  begin  to  give  some  account  of  the 
present  meeting. 

On  Monday,  the  10th,  the  meeting  was  called.  In  the 
afternoon  a  special  service  was  held  in  the  Parish  church,  and 
the  Lord  Bishop  of  Ripon,  a  very  active  and  talented  prelate 
of  the  Established  Church,  preached  a  sermon  peculiarly  ap^ 
propriate,  from  the  text  in  Plosea,  "  My  people  are  destroyed 
for  lack  of  knowledge." 

In  the  evening  the  first  general  meeting  occurred  in  a  large 
and  beautiful  public  hall,  capable,  on  its  main  floor,  and  in  its  gal- 
leries, of  seating  4,000  persons,  and  was  opened  by  an  address 
from  the  President  of  the  Year,  the  Earl  of  Siiaftsbuet.  This 
nobleman  is  exceedingly  popular  with  the  masses  of  the  people 
here  and  elsewhere,  and  has  the  well  earned  reputation  of  a 
most  excellent  man.  He  was  the  originator  and  chief  supporter 
of  the  law  of  Parliament  reducing  the  hours  of  labor  to  factory 
hands,  and  is  constantly  engaged  in  the  most  arduous  labors 
of  christian  benevolence  among  the  poor  and  viscious.  He  is 
a  most  staunch  supporter  of  total  abstinance  from  alcoholic 
drinks,  and  urges  his  views  upon  the  people  with  the  warmest 
zeal  and  the  greatest  force.  I  have  seldom  heard  his  appeals 
equalled.  He  took  a  general  survey  of  the  field  of  social 
reform,  but  I  shall  here  only  refer  to  a  few  of  his  statements 
in  relation  to  public  health.  He  said,  "The  consideration  of 
public  health  involves  far  more  than  the  mere  physical  status 
of  the  population.  It  has  its  physical  aspect  certainly ;  but  it 
has  also  its  moral,  political  and  financial  aspects.  To  those  who 
have  never  investigated  these  things  our  activity  and  earnest- 
ness appear  speculative  and  fanciful.  But  they  are  not.  We 
observe  an  enormous  amount  of  physical  degradation  and  suf- 
fering, and  are  filled  with  alarm  and  pity.     We   examine   still 


620  The  Peninsular  and  Independent, 

farther,  and  we  perceive  its  direful  effects  on  the  moral,  social, 
and  political  condition  of  millions  of  the  human  race.  We 
continue  our  examination  and  soon  perceive  that,  though  death 
is  the  lot  of  all,  a  vast  portion  of  the  disease  that  hastens  its 
approach  and  incapacitates,  and  dishonors  life  before  it  comes, 
is  self-inflicted  by  man,  and  not  divinely  imposed.  The  health 
and  comfort  of  society,  with  the  decency  and  preservation  of 
individuals,  were  deemed  worthy  of  a  place  in  the  levitical 
code;  and  now,  aided  by  the  more  scientific  processes  of 
modern  days,  we  are  but  carrying  into  effect  the  principle 
laid  down  by  the  mspired  lawgiver.  The  enormous  mortality 
of  children,  and  the  premature  deaths  of  adults,  may  be  viewed 
both  in  a  formidable  and  consolatory  aspect;  formidable  in 
respect  to  its  amount ;  consolatory  that  it  is  so  largely  prevent- 
ible.  Now,  the  nation  has  a  deep  and  lasting  interest  in  the 
physical  welfare  of  all  her  children,  not  merely  in  their  numer- 
ical existence,  but  in  the  power  and  duration  of  their  working 
life.  She  needs  them  for  the  industrial  and  military  purposes 
of  the  country;  she  needs  many  to  be  retained  at  home,  and 
many  to  go  out  in  emigration,  peopleing  the  vast  wastes  of  the 
earth  with  the  Anglo  -  Saxon  race."  He  then  proceeded  to  show 
that  in  England  and  Wales  alone  statistics  demonstrate,  com- 
paring one  place  with  another,  that  there  are  60,000  preventable 
deaths,  and  more  than  a  million  cases  of  unnecessary  sickness 
occurring  annually,  with  all  their  train  of  evil  consequences  — 
the  smallest  being  the  pecuniary  loss,  of  supporting  hospitals, 
workhouses,  orphan  asylums,  tfcc,  and  the  heavy  expense  to 
familes  and  individuals,  rapidly  eating  out  their  substance.  He 
referred  to  the  city  of  Ely,  and  that  of  Macclesfield.  In  the 
latter,  five  years  ago,  the  rate  of  mortality  was  regularly  33  per 
annum  in  the  thousand.  For  the  last  five  years  it  has  been 
but  26  in  the  thousand,  the  reduction  being  produced  by  the 
action  of  an  efficient  board  of  health.  In  this  town  alone, 
though  not  of  large  size,  1,015  lives  have  been  saved.  In  fun- 
eral expenses  £8,729  have  been  saved.  There  have  been  28,420 
less  cases  of  sickness,  and  the  cost  of  these  cases  being 
estimated  on  the  data  of  the  benefit  society,  at  one  shilling  a 
day  for  20  days,  there  has  been  a  farther  reduction  of  expense 
by  £28,420.  The  average  age  of  all  who  died  in  the  former 
time  was  24,  while   in  the   surrounding   county  it  was  34.     In 


Editorial  Department.  621 

the  last  five  years  it  has  been  27.  Each  year  it  has  been  in- 
creasing,  so  that  last  year  it  was  near  29.  Thus  three  years 
has  been  added  to  each  inhabitant's  life.  Farther,  the  deaths 
of  children  under  one  year  of  age  has  decreased  16.3  per  cent; 
and  those  under  five  years  4  per  cent.  These  are  but  samples 
of  others.  Such  results  are  everywhere  due  to  the  improve- 
ments in  the  construction  of  dwellings,  streets,  courts,  alleys; 
of  drainage,  ventilation,  sujoply  of  good  water,  removal  of 
nuisances,  piggeries,  hay  stalls,  bone  boiling,  &c.,  and  fre- 
quently the  saving  in  life  and  health  will  within  the  first  year, 
pay  the  expense  of  the  changes  required. 

He  alluded  to  the  recreations  of  the  people,  strongly  re- 
commending parks  and  play  grounds,  harvest  -  homes,  excur- 
sions, Olympian  games  (tested]  by  the  experience  of  ten  years 
at  Wenlock,  in  Shropshire). 

Such  facts  and  sentiments  as  these  going  into  the  papers, 
and  being  impressed  by  the  authority  of  great  meetings  and 
well  known  names,  must  have  their  effect. 

Lord  Bkougham,  in  an  energetic  and  most  appropriate 
speech,  referred  to  the  deaths  among  their  number  which  had 
occurred  during  the  last  year,  and  among  them,  of  that  of  Dr, 
Allison  of  Edinburgh  (whose  funeral  I  had  the  melancholy 
satisfaction  of  attending  with  the  profession  of  that  city),  and, 
he  said,  "a  greater  loss  the  Medical  jorofession  and  society 
could  not  sustain."  He  then  moved  a  vote  of  thank  to  Lord 
John  Rtjssell  who  served  as  President  the  last  year.  The 
Rt.  Hon.  Joseph  Napier,  late  Lord  chancellor  of  Ireland,  se- 
conded the  resolution,  and  eulogized  Lord  John,  though  they 
were  political  opponents,  and  expressed  the  hope  that  the  in- 
fluence of  the  Association  would  be  felt  upon  Parliament  and 
the  Government  through  him  as  a  member  of  Parliament  and 
the  Government.  I  mention  these  details  to  show  that  the 
Association  is  composed  of  men  in  such  positions  as  to  render 
its  expressions  and  actions  of  ^weight  in  the  councils  of  the 
nation. 

On  Tuesday  morning  the  Association  met  again  in  the 
great  hall,  when  Lord  Brougham,  as  President  of  the  council, 
delivered  a  lengthy,  elaborate  and  able  address.  Though  Lord 
B.  is,  I  think,  over  80  years  of  age,  his  gait  is  still  elastic,  his 
motions  quick  and  steady,  his  voice  clear  and  firm,  his  memory 


622  The  JPeninsular  and  Independent. 


exceedingly  retentive,  and  all  his  intellectual  faculties,  though 
perhaps  less  intensely  active  than  once,  when  he  almost  shook 
the  world  with  his  eloquence,  still  as  compared  with  other 
men's,  are  perfectly  sound  and  bright.  Although  I  heard  him 
last  June  in  the  House  of  Lords,  I  was  greatly  interested  and 
gratified  in  hearing  him  again ;  and  as  I  have  since  again  and 
again  during  the  week,  heard  his  voice,  associated  as  he  has  been 
from  my  boyhood  with  our  great  Webster  —  the  one  as  the  great 
man  of  England  —  the  other  of  America — a  feeling  of  sadness 
could  not  be  suppressed,  when  thinking  of  the  far  more  majestic 
and  commanding  form  and  bearing  of  our  own  statesman  and 
orator — of  his  noble  organization  —  his  massive  yet  exquisi- 
tively  formed  brain,  being  imj^aired  and  finally  defaced  by  a 
cause  which  might  have  been  avoided.  I  have  learned  to  be 
cautions  in  expressing  opinions  of  the  comj^arative  merits  of 
speakers,  and  jjictures,  and  specimens  of  architecture,  music, 
&c.,  heard  or  seen  at  difierent  periods,  when  the  powers  of 
appreciation  might  be  supposed  to  be  in  difi*erent  conditions; — 
but  making  allowance  for  all  these  things,  and  also  for  the 
failing  of  powers  in  Lord  Brougham,  I  can  but  think  that  Mr. 
Webster,  though  not  a  match  for  Brougham  in  the  variety 
and  extent  of  his  knowledge,  or  perhaps  in  the  readiness  of 
his  resources  in  an  ofi"-hand  debate,  was  still  capable  of  making 
a  much  finer  impression  as  an  orator,  on  a  great  occasion,  than 
Lord  Brougham  ever  could  have  been.  The  vast  difference  in 
their  style  of  oratory  renders  it  somewhat  difficult  to  make  a 
comparison.  Li  manner,  Mr.  Webster  was  calm,  dignified, 
refined  and  elevated.  Lord  Brougham  is  forcible,  pointed, 
and  abrupt.  Mr.  Webster's  gestures  were  not  frequent,  were 
usually  slow,  but  always  appropriate  and  graceful.  Lord 
Brougham's  are  frequent,  rapid,  energetic  and  not  always 
marked  with  grace.  Mr.  Webster's  countenance  was  either 
composed,  or  slowly  changed  by  deep  emotion.  Lord  Broug- 
ham's features  are  seldom  approaching  a  state  of  rest,  when  he 
is  on  his  feet,  and  are  often  almost  distorted  to  a  grimmace 
even  on  not  very  extraordinary  occasions.  Mr.  Webster  always 
spoke  in  clear,  musical,  and  sustained  tones  of  voice;  Lord 
Brougham's  voice  is  frequently  changing,  and  the  sounds  are  often 
expelled  with  such  an  abrupt  force,  and  yet  so  restrained  as  to 


Editorial  Department.  623 

render  them  unmusical  and  harsh.  Mr.  Webster  always  spoke 
slowly;  Lord  Brougham  often  with  rapidly.  Lord  Brougham 
often  bends  his  knees  making  an  abrupt  though  slight  sinking 
and  rising  motion,  at  the  same  time  bending  forwards.  IsTo 
such  motion  belonged  to  Mr.  Webster.  He  stood  erect  and 
jfirm.  Mr.  Webster  was  peculiarly  graceful  and  great  by  nature. 
He  could  do  nothing  in  an  inferior  or  even  common  manner. 
Lord  Brougham,  though  endowed  with  superior  capacities  and 
powers,  has  made  himself  pre-eminently  great  by  incessant, 
and  systematic  labor.  He  said  in  a  speech  at  the  working  men's 
meeting,  a  few  nights  ago,  that  it  had  been  a  rule  during  his 
whole  life,  that  he  should  take  no  relaxation,  not  even  indulge 
in  reading  of  a  general  improving  character,  until  he  had 
earned  the  privilege  by  a  full  honest  day's  work.  He  said, 
he  worked  daily  still,  and  meant  to  work  as  long  as  God 
should  spare  his  faculties.  This  is  the  secret  of  his  power, 
and  his   present  vigor   of  mind. 

One  of  the  most  striking  features  of  his  address  on  this 
occasion  was  his  advocacy  of  temperance  organizations,  and 
of  the   benefit   of  prohibitory  legislation. 

He   said  the   connection   of  intemperance   and   crime   was 
demonstrated   in   the  clearest  manner.     He  refer ed  to  statistics 
in   Great   Britain   and   in   our   own  country,  and   said:     "That 
repressive  measures   are   loudly   called  for  in  this   country,   it 
is   difficult    to    deny;    but  if    there    are    objections   to  these, 
chiefly   from   the   public   mind    not   being   prepared   for   them, 
at   least  we  can  cease   to   encourage   intemperance   by  treating 
it   as   venial,   and   by   suffering  pernicious  customs   to  continue 
for    its    encouragement    and    protection.     Not   only   do   those 
greatly   err,   but   they   are  positively  criminal  who    treat   the 
subject    lightly;    and    yet   more    to   be  condemned   are   those 
who  regard  intemperance  as  an  extenuation  of  guilt,  of  which 
it  is   rather   an  aggravation.     How   much    more   criminal    are 
persons   in   authority  who  sometimes  so   consider  it  in  meeting 
out   the  inflictions   of  the   police,   or   even    of  the   penal   law! 
But   those   are  not   to   be   forgiven  who   indulge   in  light  talk 
upon  that  which  is   the   fruitful  parent  of  the  worst   offenses, 
even  murder  itself.    What  shall  we  say  then  of  customs  being 
maintained   directly  promoting  intemperance,   and   which  have 
neither    antiquity  to    plead    in    their  defense,   nor  any  neces- 


624  The  Peninsular  and  Independent, 

sity  whatever  to   require  their  continuance,  nor   even  the  fact 
of  their   universality   to   allege   in   their   favor?  ...     As   it   is 
clearly  not    enough    that   we   should    cease    to   encourage   in- 
temperance, and   as   2:)0sitive  repression  is  attended  with   f^^reat 
difficulty,   there   is   every   reason   to   rejoice    in    the    exertions 
which   have  been  made  by  individuals   to  apply  a  remedy,  or 
at  least   a  palliative,   by   such    proceedings   as   may   be  taken 
without  legislative   aid.     The   formation   of  Temperance  Asso- 
ciations have   been   highly   beneficial;    and   these   have   spread 
over  many  parts   of   the   country."      He   goes   on    to   say   of 
intemperance,   that   education    can   not    be   relied   on    to   stop 
its  ravages  —  that   "it   is   a   common   enemy;   it   attacks   even 
persons  of  cultivated   minds,  spreads  havoc  widely  among  the 
multitudes   of   our   inferior   orders;    and   fills    our   workhouses 
and  gaols.     To   lesson   its   force   and   contract    its   sphere,   no 
means  must  be   spared,    if  we   really   mean   to   stay   the  pro- 
gress  of    destitution   and    crime.      The    philanthropist    has   no 
more   sacred   duty   than    to   mitigate,   if   he   can   not    remove, 
this   enormous  evil.      The   lawgiver   is    imperatively   bound   to 
lend  his    aid,   Avhcn    it   aj^pears    manifest    that    no    palliatives 
can   avail."     He  then  refers  to   the   Maine  law   and  its   eflTects 
approvingly,  and   says,  if  the  j^ublic  mind  is  not   yet  j^repared 
for   prohibition,   palliative   measures  will   tend   to   prepare   it — 
and  when  thus   done,  prohibition  may  be  successfully  eflfected. 
He   then   indulged   in   the   painting   of  a   most   beautiful  word 
picture   of  the   state   of    things   which   would   exist   when   the 
drink   demon    was  destroyed,  when   the   poor  were   freed  from 
the   yoke   of  a   cruel  tyrant  by   a  law  which   might   be   ima- 
gined to  have   come   down   from   Heaven. 

I  could  not  refrain  from  making,  this  synopsis  of  Lord 
Beougham's  remarks  on  this  subject,  as  it  will  show,  more 
than  detailed  statements,  the  direction  and  tendency  of  the 
best  minds  here  —  and,  that  those  who  afi*ect  to  sneer  at 
temperance  sentiments  and  temperance  efforts,  are  sneering 
at  some  of  the  wisest  and  greatest  men  the  world  has  yet 
produced,  as  well  as  endeavoring  to  oppose  however  unwit- 
tingly the  best  interests  of  humanity.  I  wish  to  say  to  those 
who  know  something  of  my  sentiments  on  this  subject,  that 
the  more  extended  has  been  my  observations,  the  more  com- 
pletely am  I  confirmed  in  the  opinions  which  I  have  very  de- 


Editorial  Department.  625 

liberately  formed  and  repeatedly  expressed.  Since  I  have 
been  in  Europe  I  have  been  convinced,  if  possible,  more  than 
before,  of  the  truth  of  that  scripture  which  says,  "Wine  is 
a  mocker;  strong  drink  is  raging  and  whosoever  is  deceived 
thereby  is  not  wise." 

But  it  is  quite  time  I  proceeded  with  the  sketch  of  the 
meeting.  The  plan  of  proceeding  for  the  week  was,  that  each 
morning  an  address  was  delivered  in  the  great  hall  before 
the  whole  Association,  consisting  of  about  1,400  members  and 
associates,  by  one  of  the  presidents  of  the  five  departments, 
making  a  general  review  of  the  subject  coming  under  the  dis- 
cussion of  his  section.  Accordingly  most  excellent  addresses 
were  delivered  respectively  by  Vice -Chancellor  Sir  W.  Page 
Wood,  on  Jurisprudence  —  the  influence  of  laws  upon  the  in- 
terests of  community,  and  law  reform  —  insisting  among  other 
things  that  law -students  should  be  thoroughly  examined,  &c. 
By  Rt.  Hon.  C.  B.  Adderly,  M.  P.,  on  education  —  reviewing 
the  general  subject,  and  referring  repeatedly  to  the  schools 
in  the  United  States.  By  R.  Moxckton  Milnes,  M.  P.  on 
Punishment  and  Crime  —  urging  humanity,  &c.  By  Rt.  Hon. 
W:^r.  Cowper,  M.  P.,  step  son  of  Lord  Palmerston,  the  prime 
minister,  on  Public  Health  —  an  address  characterized  by  Lord 
Brougham  as  most  excellent  in  every  respect.  And  last  by 
J.  K.  Shuttleworth,  Bart.,  on  Social  Economy,  giving  a  sketch 
of  the  history  of  England  in  its  social,  industrial  and  econo- 
mic developement.  After  these  morning  addresses,  the  sections 
met  each  day  under  their  presidents,  and  papers  were 
read  and  discussed  until  near  5  o'clock;  while  each  evening 
there  was  either  a  public  meeting  and  addresses,  or  a  Soiree 
in  the   great  hall. 

The  business  in  the  sections  may  best  be  judged  of  by 
giving  the  titles  of  a  few  of  the  many  papers  which  were 
presented  during  the  week.  In  the  Jurisprudence  department 
were  papers  such  as  the  following :  "  The  Province  of  Legis- 
lation"—"On  a  Declaratory  Code"  — "The  Transfer  of  Lands" 
—  a  most  important  subject  affecting  all  the  interests  of  so- 
ciety, as  now  the  title  of  land  costs  so  much  as  to  exclude 
every  man  of  moderate  means  from  owning  any  soil,  keep- 
ing him  dependent  —  "On  Copyrights"  —  "On  the  Applica- 
tion of  Science  to  the  Administration   of  Justice "  —  "  On  the 

Vol.  II.  — 2P. 


626  The  Peninsular  and  Independent. 

Fusion  of  Law  and  Equity"  &c.  &c.  In  the  Educational 
department  were  papers  "  On  tlie  Importance  of  Natural  His- 
tory as  a  Branch  of  Education  "  —  "  On  the  Establishment  in 
Cambridge  of  a  School  of  Practical  Science "  —  "  The  Profes- 
sional Training  of  Teachers  "  —  Many  papers  on  governmental 
aid  to  schools  for  the  laboring  classes.  This  whole  subject 
was  very  thoroughly  discussed.  The  subject  also  of  the  Oxford 
and  Cambridge  Middle  class  Examination,  as  they  are  called, 
was  thoroughly  discussed.  Examinations  arc  made  by  these 
Universities  of  all  who  present  themselves  under  eighteen 
years  of  age,  from  whatever  school,  and  if  qualified  accord- 
ing to  their  standard,  the  title  of  A.  A. —  Associate  of  Arts 
is  conferred.  These  examinations,  as  their  standard  is  adop- 
ted for  Medical  Students  xmder  the  K'ew  Medical  Pe^jistra- 
tion  Act  of  Parliament,  I  shall  endeavor  to  give  a  more  full 
account  of  in  some  future  article.  Many  other  subjects,  such 
as,  "  How  our  Universities  may  be  made  more  available  for 
the  Middle  and  Working  Classes"  —  "On  Domestic  Tuition" 
—  "Working  Men's  Colleges"  —  "Adult  Education  for  the 
Poor "  <fcc.  c^c.   Avere   presented  and   discussed. 

In  the  Department  of  Punishment  and  Reformation,  or 
Incentives  to  and  Preventives  of  Crime,  there  were  papers 
on  "Intemperance  regarded  in  its  chief  causes,  its  relation 
to  Crime,  and  its  Remedy "  — "  The  Crimmality  of  Drunken, 
ness  "  —  "The  Licensing  system,  with  special  reference  to  Beer 
Houses"  —  "  Inexpediency  of  Capital  Punishment "  —  "  On  the 
Law  of  False  Pretences"  —  "On  Reformatory  and  Refuge 
Unions"  —  "Punishment  versus  Reformation"  —  "Industrial 
Homes   for   Vagrant   Children,"    and  many  others. 

In  the  Public  Health  Department,  very  many  exceedingly 
important  papers  were  presented,  and  perhaps  a  more  pro- 
found impression  made  upon  the  public  mind  than  in  any 
other.  The  following  are  the  titles  of  some  of  the  papers: 
"  Tlie  Air  we  Breath  —  ought  every  one  to  do  as  he  likes 
with  it?"  —  "On  the  Healthiness  of  the  Anglo-Saxon  Race 
in  Australia"  —  "On  the  relation  between  Density  of  Popu- 
lation and  Mortality  from  Consumption''  —  "The  Social  and 
Sanitary  Progress  of  Bradford "  — "  On  the  Physical  Eflects 
of  Diminished  Labor"  —  "Loss  of  Life  in  Coal  Mines"  — 
"  Mortality  in  Mews  "  —  "  Notes  and  Results  of  Sewerage  Irri 


Editorial  Department.  627 

gatioii"  —  "On  Deficiencies  in  Public  Records  of  Mortality 
and  Disease,  with  Suggestions  for  an  Improved  National  System 
of  Registration"  (an  admirable  paper)  —  "The  Use  of  In- 
toxicating Drinks  not  necessary  to  Workmen  in  Mines  and 
Forges,  illustrated  by  the  Low  Moore  Iron  Works,  Brad- 
ford "  —  "  Wet  ISTursing  "  —  Several  papers  on  "  Ventilation  " 
—  in  one  of  which  the  American  System  as  applied  to  Large 
Buildings,  Asylums,  &c.,  was  described,  and  several  others  on 
various  aspects  of  the  subject  of  Sewerage.  Both  these  sub- 
jects were  fully  discussed. 

The  following  are  the  titles  of  some  of  the  papers  in  the 
Department  of  Social  Economy:  "The  West  India  Labor 
Question"  involving  the  economy  of  Slavery  and  Abolition  — 
"  On  Direct  and  Indirect  Taxation,"  a  highly  interesting  dis- 
cussion on  these  questions  — "  On  Industrial  Employment  of 
Women "  — "  On  the  Method  and  the  Range  of  Statistical 
Science"  —  "How  to  make  Statistics  useful"  —  "On  the  Di- 
rection in  which  the  Census  Inquiry  of  1861  should  be  ex- 
tended." Several  papers  on  this  general  subject' — "Progress 
of  the  Free  Public  Drinking  Fountain  Movement "  —  a  new 
and  exceedingly  imjDortant  item  of  social,  economical  and  moral 
improvement  in  the  cities  of  England.  Several  papers  on  the 
subject  of  " Factory  Laborers,"  "Factory  Workers,"  —  its  phy- 
sical and  moral  effects,  &c.  Several  papers  on  "  Mechanics' 
Institutes,"  —  "  Savings  Banks,"  and  "Benefit  Societies"  —  "On 
Strikes,"  and  the  "Relations  of  Employers  and  the  Employed." 
&c.    &c. 

In  the  above  sketch  only  a  few  of  the  many  papers  — 
several  hundred  —  presented,  are  given,  but  they  will  serve  to 
give  an  impression  of  the  wide  range  and  interesting  character 
of  the  subjects  introduced ;  and  as  this  letter  has  already  ex- 
tended to  such  a  length  I  shall  not  attempt  to  give  a  special 
account  of  any  one  of  them.  I  will  only  give  some  general 
impressions,  which  my  week's  observations  left  upon  my  mind. 

I  was  struck  with  the  zeal  and  ability  manifested  in  most 
of  the  papers. and  discussions.  A  large  number  of  able,  thought- 
ful, conscientious  and  benevolent  men  are  zealously  at  work, 
informing  themselves  and  enlightening  the  public  on  these  great 
questions  of  such  vital  importance  to  the  welfare  of  any  people ; 
and  for  the  most  part,  they  are  men  of  such  position  as  will 
arrest  public  attention  and  make  their  opinions  felt. 


628  The  Peninsular  and  Independent. 

I  was  also  struck  with  the  enUghtened,  advancing,  pro- 
gressive views  generally  manifested.  There  was  no  wild,  dash- 
ing go-a-head  movement,  regardless  of  consequences  —  a  care- 
ful consideration  of  circumstances,  and  a  weighing  of  results, 
probable  and  possible  were  manifest ;  the  element  of  conserva- 
tism was  largely  mingled  with  progression ;  and  while  the  steam 
was  up,  the  breaks  were  under  control  —  often  pretty  firmly 
down  —  but  the  train  moved  on  —  slowly,  hesitatingly  it  may 
be,  but  it  moved,  and  in  the  riglit  direction.  It  is  true  there 
were  here  the  representatives  of  the  most  progressive  portions 
of  the  nation  generally  recognized  as  safe  and  substantial  per- 
sons. The  extreme  Radicals  in  politics  were  not  here;  but 
there  were  the  most  enlightened  and  progressive  persons  of 
moderate  parties.  Old  Fogyism,  for  the  most  part,  stayed  at 
home,  or  went  fox  hunting,  or  mused  on  the  good  old  times 
when  tliere  were  no  strikes,  and  no  clatter  about  reform  bills, 
and  suftVagc,  and  education,  or  any  such  nonsense:  —  and  when 
each  was  content  to  remain  (as  too  many  are  still)  "in  the 
position  of  life,"  as  the  cant  is,  "in  which  God  had  placed 
them."  But  the  representatives  of  the  great  moral  poAver  of 
the  country  were  here,  and  the  sight  was  one  of  the  deepest 
interest,  and  withal  most  hopeful  for  humanity. 

Again,  as  to  minor  matters,  I  could  but  notice  the  cour- 
tesy and  gentlemanly  bearing  of  the  speakers  towards  each 
other.  They  dealt  more  in  compliments  than  American  deba- 
ters aije  wont  to  do,  and  less  in  severity  towards,  and  denun- 
ciation of  opponents.  They  "ventured  to  state,"  and  "begged 
leave  to  suggest,"  and  "  almost  thought ;  in  fact,  on  the  whole, 
felt  quite  confident."  "While  they  agreed  with  most  that  the 
noble  Lord,  or  Right  Hon.  Gentlemen,  or  their  Rev.  or  Hon. 
friend  had  so  able  said,"  they  were  "obhged  to  question"  so  and 
so.  Xow  all  this  may  seem  a  trifling  aflTair  not  worthy  of 
being  recorded,  but  yet  soft  words  turn  away  wrath  now  as 
well  as  in  the  time  of  Solomon,  and  have  a  marvelous  tendency 
to  cultivate  that  charity  which  covereth  a  multitude  of  imper- 
fections. There  are  doubtless  occasions  when  denimciations  may 
be  called  for,  but  they  do  not  occur  among  gentlemen,  where 
all  parties  are  honestly  seeking  after  truth ;  and  amenities  of 
manners  beget  kindliness  of  feeling.  "  Grievous  words,"  do 
little  else  them    "  stir   up    anger."     They  certainly  neither  con- 


Editorial  Department.  629 

rince   or  persuade,  which   are  the   more  legitimate  objects  of 
debate. 

N'ow  as  to  their  relative  position  here,  compared  with  our 
own  country —  (I  speak  of  Michigan  and  other  states  in  which 
I  have  lived,  and  with  which  I  am  more  especially  acquainted) 
—  in  respect  to  the  different  departments  of  reform,  into  which 
the  Association  is  divided,  allow  me  a  word.  In  regard  to 
Jurisprudence,  I  may  not  be  qualified  to  judge  with  accuracy, 
but  the  impression  on  my  mind  left  by  the  papers  and  debates 
is,  that  in  very  many  particulars  England  is  decidedly  behind 
us.  We  should  indeed  be  very  culpable  if  we  were  not  in  ad- 
vance of  them,  especially  in  the  new  states,  as  we  have  the 
advantages  of  all  their  experience,  without  having  their  preju- 
dices and  customs ;  without  having  old  tares  so  mixed  up  with 
the  wheat  that  in  pulling  up  the  tares  the  wheat  might  be 
endangered.  However,  the  weeding  is  going  on  —  gradually 
but  surely,  and  the  time,  it  is  to  be  hoped,  is  not  far  distant 
when  a  transfer  of  a  piece  of  the  soil  may  be  made  for  a  sum 
less  than  would  be  sufficient  to  purchase  a  good  farm  in 
America.  Such  is  not  now  the  case.  I  speak  of  the  expense 
of  procuring  the  title,  independent  of  the  purchase  money, 
which  in  very  many  cases,  is  as  high  as  £300,  or  $1500! 

In  the  department  of  Education  —  Popular  Education  — 
we  are  vastly  in  advance  of  our  old  Mother,  and  she  has  come 
to  know  it  pretty  well.  We  are  greatly  in  advance  in  our 
system  and  in  our  execution  —  in  our  theory  and  in  our  prac- 
tical results.  I  have  not  time  or  space  now  to  dwell  on  this 
subject;  but  of  the  fact  there  can  be  no  doubt,  and  they  are 
here  beginning  to  look  to  us  as  an  example  and  a  guide.  Of 
this  we  have  reason  to  be  proud,  but  more  esj)ecially,  to  be 
thankful  for  circumstances  which  have  contributed  to  such  a 
glorious  result.  The  more  I  have  seen  in  Europe  on  this  sub- 
ject, the  more  am  I  impressed  with  the  excellency,  I  think  I 
may  say,  the  unrivalled  excellency  of  the  educational  system  of 
our  own  State  of  Michigan.  I  do  not  speak  of  the  fruit,  this 
may  and  must  he  much  farther  ripened.  But  the  system  is  the 
most  complete  —  the  tree  is  the  most  perfect  species  that  I 
have  seen. 

In  regard  to  the  other  departments  —  the  Public  Health, 
to  Punishment  and  Crime,  and  to   Social  Economy,  I  can  not 


630  The  Peninsular  and  Independent. 

speak  so  flatteringly  to  the  pride  of  my  own  country.  In  some 
particulars  we  are  superior  no  doubt,  while  in  others  we  are 
inferior  in  a  decided  degree.  We  are  much  inferior  in  Sanitary 
Statistics,  which  are  the  true  foundation  of  Sanitary  Science  — 
and  though  Ave  ventilate  our  liospitals  and  asylums  better,  we 
do  not  our  private  dwellings  as  well,  as  do  the  well-to-do 
classes  here.  And  our  people,  especially  our  women,  among 
what  are  called  the  higher  ranks,  do  not  compare  in  health  and 
physical  development  with  the  women  of  the  higher  classes  in 
England. 

The  English  woman  walks  more,  and  rides  more,  and 
breathes  more,  than  the  American.  She  is  consequently  stronger, 
and  firmer,  and  more  enduring. 

During  the  course  of  the  meeting,  I  had  an  opportunity, 
in  the  second  section,  to  give  some  account  of  the  educational 
system  of  Michigan,  and  its  operation  in  diffusing  the  blessings 
of  knowledge  among  the  i)eople,  and  tlie  xohole  people  —  the 
facts  being  received  with  very  flattering  attention.  I  also  had 
an  opportunity  of  urging  u2)on  the  section  of  Health,  the  im- 
portance of  having  physicians  keep  a  record  of  their  cases  of 
disease  in  private,  as  well  as  j^ublic  practice,  and  of  pointing 
out  some  of  the  benefits  that  would  result;  and  at  another 
session,  of  speaking  on  the  subject  of  the  American  system  of 
ventilating  and  warming  public  buildings,  and  of  expressing  my 
surprise  at  finding  some  of  the  most  famous  of  their  great  in- 
stitutions, heated,  so  far  as  heating  related  to  ventilation,  in 
the  very  worst  manner  possible. 

On  the  subject  of  the  restriction  of  the  sale  of  alcoholic 
drinks,  which  occupied  a  large  share  of  the  time  and  attention 
of  the  section  on  Crime  and  Punishment,  I  endeavored  to  say 
a  few  words  of  encouragement  and  caution. 

On  the  whole  I  can  not  say  that  I  have  spent  a  more  in- 
teresting and  profitable  week  than  the  past.  I  have  seen  a 
greater  number  of  the  leading  men  of  the  nation,  and  learned 
more  of  them  —  of  their  views,  their  feelings,  and  their  abilities 
—  and  more  of  the^^institutions,  their  condition,  and  tendencies 
than  I  could  by  ordinary  travel  and  inquiry  in  months. 

In  the  Science  and  Art  of  Agriculture,  England  and  Scot- 
land are  in  advance  of  any  other  country  on  the  face  of  the  earth. 
In  Manufactures,  on  the  whole,  the  same  is  true.     The  defects  in 


Editorial  Department.  631 

other  respects  still  existing,  are  beginning  more  fully  to  be  appre- 
ciated, and  systematic  and  vigorous  efforts  are  being  made  to  cor- 
rect them.  There  are  still  great  obstructions  in  the  way ;  moun- 
tains of  ignorance,  and  prejudice,  and  vicious  habit;  but  the  force 
being  brought  to  bear  on  these  obstructions  is  immense  also; 
and  I  can  not  doubt  that  ultimately  they  will  be  overcome. 
The  A^alleys  shall  be  raised,  the  mountains  leveled,  and  the 
crooked  ways  shall  be  made  straight.  By  an  increase  of 
knowledge,  of  refinement  and  of  means  among  the  masses, 
the  great  distinctions  in  society,  now  felt  and  acknowledged, 
and  freely  spoken  of  by  all,  will  gradually  melt  away,  and 
an  aproximation  to  equality  will  at  length  be  enjoyed.  This 
is  the  tendency,  and  to  this  will  efforts  be  ere  long  more 
specifically  directed. 

When  I  write  to  you  again,  the  waters  of  the  Atlantic 
will  not,  I  hope,  divide  us,  but  I  shall  continue  to  describe 
some  of  the  things  I  have  seen  here.  I  can  now  promise  you 
there  will  be  no  more  "National  Associations"  to  take  up  so 
much  time  and  space. 

Yours,   very  truly, 

A.  B.  P. 


tUttt^  Jirtiths,  Jibstratts,  ^t. 


♦»♦■ 


On  the  Effects  of  the  Use  of  Alcoholic  Liquors  In  Tubercular  Disease,  or  In  Constitu- 
tions Predisposed  to  such  Disease. 

In  July  last,  the  premium  of  two  hundred  dollars,  offered  by  the  Trus- 
tees of  the  Fiske  Fund,  for  the  best  dissertation  on  the  above  sub- 
ject, was  awarded  to  Dr.  John  Bell  of  New  York.  If  Dr.  Bell  has 
not  succeeded  in  establishing  his  conclusions  in  regard  to  the  repu- 
ted therapeutic  or  prophylactic  virtues  of  alcohol  "in  tubercular  dis- 
ease or  in  constitutions  predisposed  to  such  disease,"  to  the  entire 
satisfaction  of  the  Profession,  he  has  at  least  presented  some  valuable 
information,  drawn  as  far  as  posible  from  statistics,  which  must  have  the 
effect  of  inducing  every  conscientious  medical  reader  of  his  essay  to 
pause  and  carefully  review  the  testimony  for  and  against  the  use  of 
alcohol  in   tubercular  affections. 

That  the  treatment  of  consumption  will  remain  more  or  less  em- 
pirical, or  rather  experimental,  until  we  know  more  of  its  essential 
nature,  is  probably  true,  but  to  countenance  the  use  of  an  agent  al- 
ready far  too  popular  in  many  respects,  on  a  mere  assumption  of  its 
value  as  an  anti- tubercular  remedy  —  an  assumption  apparently  found- 
ed on  vague  theories  and  immature  clinical  deductions  —  will  neither 
subserve   the  cause   of  science  or  of  humanity. 

At  no  remote  period  the  opinion  was  quite  prevalent  that  the 
free  use  of  alcoholic  liquors  not  only  prevented  the  formation  of  tu- 
bercles, but  exerted  an  influence  decidedly  curative  in  phthisis ;  and 
this  opinion  is  still  entertained  in  certain  quarters,  as  will  appear  in 
the  sequel,  although  the  general  popularity  of  the  remedy  is  evidently 
on  the  wane.  If  alcohol  possesses  but  a  tithe  of  the  virtue  attribu- 
ted to  it  for  the  prevention  and  cure  of  consumption,  it  is  remark- 
able that  its  advocates  have  furnished  the  public  with  but  little  evi- 
dence of  the  fast  beyond   mere   assertion.     Dr.    Bell  remarks: 

"After  a  careful  examination  of  the  leading  medical  journals  of 
this  country  and  the  foreign  ones  which  circulate  here,  I  am  able 
to  present  only  the  following  instances  where  anything  has  been  said 
of  sufficient  importance   to  be   likely  to   give  a  direction  to   the  senti- 


Selected  Articles^  Abstracts^  <&g,  633 

ment  of  the  profession :  In  the  New  England  Quarterly  Journal  of 
Medicine  and  Surgery  for  1843,  Dr.  Jackson  has  given  the  results 
of  the  autopsies  of  thirty -five  persons  who  were  known  to  have 
been  intemperate;  in  these,  tubercles  were  found  in  the  lungs  in  five 
cases.  He  infers,  therefore,  that  the  use  of  alcohol  is  advantageous 
so  far  as  liability  to  phthisis  is  concerned.  In  the  New  lorJc  Jour- 
nal of  Medicine  and  Surgery  for  184:4,  Dr.  Peters  has  given  the  re- 
sults of  about  seventy  autopsies  of  persons  of  similar  habits ;  from 
the  appearance  of  the  lungs  he  draws  the  same  conclusions,  as  to 
the  effects  of  alcohol,  that  Dr.  Jackson  does.  In  both  these  papers, 
these  inferences   are   only   incidental  to   the   main   subject. 

•■  In  the  Nashville  Journal  of  Medicine  aud  Surgery  for  1856,  is 
an  essay  by  Dr.  Washington,  in  which  the  author  theorizes  that 
phthisis  has  its  origin  in  deficient  respiratory  action,  and  that  the 
use  of  alcohol  will  overcome  the  defect  by  causing  a  more  rapid 
breathing.  In  the  Buffalo  Medical  and  Surgical  Journal  of  the  same 
year  is  a  short  essay  in  which  the  writer  gives  his  opinion  in  favor 
of  the  use  of  alcohol  in  phthisis.  One  or  two  cases  are  also  related 
in  which  recovery  from  that  disease  occurred  under  its  use.  Various 
other  agents,  however,    were   used  together   with   the  alcohol. 

Two  theories  as   to  the   causes    of  the   deposition   of    tubercle  on 
the  lungs,   from  each   of  which   the  utility   of  alcohol   as  a  therapeutic 
agent   has   been  inferred,  have  been  extensively  circulated  in  the  medi- 
cal journals.     The   first  of  these   is   a   chemical   one.     It   supposes  that 
the  tissues  of  the  body,  and  particularly  of  the  luugs,  are  too  rapidly 
oxidized,   and,    accordingly,   that   alcohol,  like   cod  liver  oil,   might  sup- 
ply  the   fuel   for  this    abnormal  combustion,    and   thus   prevent  a   con- 
tinual   waste,    if   not    supply    material    itself     The    other   theory   is   a 
mechanical   one,   and    attributes   the    origin   of   tubercle   to   a  deficient 
circulation   of  the    blood,    and  a   consequent    retrograde  metamorphosis 
of    the   tissues.      In  this    hypothesis,    too,    alcohol   is   the    remedy,    by 
increasing  the    action    of   the    heart.      These   theories    are    mentioned 
here,    because   I   regard    them  as   having    assisted    in    giving  currency 
to   the    prevailing  opinion.      Besides  these   instances,    where   something 
like   argument   is   adduced  in  favor   of  the   opinion,    there  are   numer- 
ous other    instances   where   the    belief  is   avowed  without  any   attempt 
being  made  to  support  it.     It  will  be  observed  that  very   little  posi- 
tive proof  has  been   offered  to   the  public  as  yet  on  the  question." 

In  regard  to  the  results  of  the  autopsies  presented  by  Drs. 
Jackson  and  Peters,  Dr.  Bell  has  shown  from  counter  -  statistics 
the  fallacy  of  the  deductions  drawn  from  their  cases.  On  this  point, 
he  says: 

*'  Suppose,  for  an  instant,  that  the  influence  of  alcohol  were  fa- 
vorable on  those  predisposed  to  the  disease,  and  also,  that  its  thera- 
peutic effects    were  valuable.     In  a  person  continually  using  it,  it  is 


634  The  Peninsular  and  Independent. 

difficult  to  see  how  tubercle  could  gain  any  foothold.  For  then  the 
remedy  would  be  on  the  spot,  at  the  moment  when  the  malady  was 
commencing,  and  was,  consequently,  in  the  circumstances  most  favor- 
able for  cure.  Yet  cases  of  phthisis,  under  such  circumstances,  con- 
tinually occur  in  the  observation  of  every  one;  and  in  those  related 
in  this  essay,  they  occurred  more  often  than  among  the  temperate. 
Among  the  lower  classes  of  this  city,  the  statistics  already  given, 
show  that  more  than  half,  (36  against  31),  use  alcohol  throughout 
the  disease,  probably  to  at  least  as  great  an  extent,  as  it  would  ever 
be  recommended  as  a  medicine.  And  this  is  more  marked  among 
the  males,  more  than  four  -  fifths  using  it.  Yet  the  deaths  from  this 
disease  here,  among  the  males,  are  regularly  more  numerous  than 
among  the  females.  I  should  not,  probably,  overstate  the  facts  if  I 
said  that  of  the  1,500  males  dying  of  phthisis  each  year  in  New 
York,  1,000  were  attacked  with  the  disease  in  spite  of  the  reputed 
prophylactic  virtues  of  alcohol,  and  died  of  it  in  spite  of  its  vaunted 
curative  powers." 

After  detailing  the  effects  of  a  regular  and  moderate  use  of  alcohol 
in  several  cases  of  phthisis,  selected  for  that  purpose  at  the  Eastern 
Dispensary,  Dr.  Bell,  in  view  of  the  whole  subject,  regards  the  follow- 
ing conclusions  as  probably  true: 

1.  The  opinion  so  largely  prevailing  as  to  the  effects  of  the  use  of 
alcoholic  liquors,  viz.,  that  they  have  a  marked  influence  in  preventing 
the  deposition  of  tubercle,  is  destitute  of  any  solid  foundation. 

2.  On  the  contrary  their  use  appears  rather  to  predispose  to  tu- 
bercular deposition. 

3.  Where  tubercle  already  exists  alcohol  has  no  obvious  effect  in 
modifying  the  usual  course  run  by  that  substance. 

4.  Neither  does  it  mitigate,  in  any  considerable  degree,  the  mor- 
bid eflfects  of  tubercle  upon  the  system,  in  any  stage  of  the  disease. 

On  the  other  side  of  the  question  we  have  the  testimony  of  Prof. 
"Wood  of  Philadelphia  presented  as  follows,  in  his  late  work  on  Thera- 
peutics and  Pharmacology. 

"Nature  while  planting  in  so  large  a  proportion  of  the  human 
family  a  disposition  to  scrofulous  or  tuberculous  complaints  seems  to 
have  provided  in  the  fermented  liquors,  what,  if  properly  used,  may  be 
considered  as  in  some  degree  a  counteracting  agent.  Physicians  have 
often  noticed  that  drunkards  seldom  die  of  phthisis.  In  this  respect  my 
own  observation  coincides  with  that  of  others.  During  my  tour  of 
hospital  duty  in  the  winter  I  met  with  great  numbers,  both  of  drunkards 
and  of  tuberculous  individuals;  but  it  is  very  seldom  that  the  two 
classes  coincide.  This  is  a  singular  fact,  and  not  exactly  what  might 
have  been  anticipated;  for  the  tuberculous  constitution  belongs  to  the 
same  cachectic  category  with  that  which  gives  a  tendency  to  fatty  de- 
generation, cirrhosis  of  the   liver,  granular  disease  of  the   kidney,  &c.} 


Selected  Articles^  Abstracts,  <&c.  635 

and  is  not  unfrequently  associated  with  it.  A  priori,  it  would  have 
been  imagined  that  the  exhausted  state  of  general  health,  characterizing 
the  advanced  stages  of  intemperance  would  favor  tuberculous  deposition ; 
and  the  discovery  of  the  opposite  truth  has  been  something  like  a  sur- 
prise to  the  profession.  This  result  of  observation  has  been  singularly 
confirmed  by  recent  pathologico  -  anatomical  investigations.  Out  of  117 
cases  of  confirmed  drunkards  whose  bodies  were  examined  after  death 
by  Dr.  Ogsten,  there  were  only  two  who  exhibited  any  evidence  of 
tubercular  disease  of  the  lungs  {Brit,  and  For.  Med.  Chir.  Rev.,  April 
and  Oct.  1854).  In  the  same  number  of  temperate  persons,  of  different 
sexes  and  ages,  examined  after  death  from  other  causes  the  same  result 
would  certainly  not  have  been  obtained.  How  alcoholism  acts  adver- 
sely to  the  development  of  tubercle  may  be  conjectured,  but  is  not  cer- 
tainly known." 

Almost  the  only  allusion  to  this  subject  that  we  have  noticed  in 
the  recent  medical  journals,  appears  in  the  Review  Department  of  the 
American  Journ.  of  the  Med.  Sciences  for  October.  The  late  work  of 
Drs.  Cotton  and  Richardson  on  consumption  being  under  consideration, 
the  reviewer  says: 

"If  there  be  any  article  in  the  materia  medica  which  may  be  con- 
sidered as  in  any  measure  specially  efficacious,  that  is,  exerting  a  reme- 
dial effect  on  the  morbid  condition  or  cachexia  on  which  the  deposit  of 
tubercle  depends,  we  believe  it  to  be  alcohol.  The  effects  of  the  abuse 
of  alcohol,  terrible  as  these  are,  since  they  involve  destruction  of  the 
mental  and  moral,  as  well  as  the  physical  constitution,  are  antagonistical 
to  the  deposit  of  tubercle ;  and  clinical  experience  shows  a  decided  in- 
fluence of  alcohol  as  a  remedy  in  arresting  and  retarding  tuberculous 
disease.  The  extent  of  this  influence,  and  the  circumstances  which  in 
individual  cases  on  the  one  hand  favor,  and  on  the  other  hand  obstruct 
it  are  yet  to  be  determined." 

Most  of  the  writers  who  urge  the  claims  of  alcohol  in  the  morbid 
condition  in  question,  speak  also  in  deprecating  terms  of  the  danger  of 
intemperance  from  the  habitual  use  of  liquors  containing  alcohol,  even 
when  these  are  prescribed  by  physicians.  Professor  Wood  especially, 
while  recommending  fermented  liquors  as  less  dangerous  in  this  respect 
than  any  one  of  the  forms  of  ardent  spirit,  deems  it  his  duty  to  add 
some  strong  words  of  caution  which  do  honor  to  his  head  and  heart. 

If  then,  it  is  admitted  that  medical  endorsement  may  sanction  the 
habitual  use  of  fermented  or  distilled  liquors,  and  thus  aid  the  for 
mation  of  habits  of  intemperance  and  confirmed  drunkenness,  it  is 
assuredly  time  to  inquire  whether  those  agents  really  possess  the  prophy- 
lactic and  curative  powers  attributed  to  them  by  some  eminent  phy- 
sicians  whose   opinions   we   have   usually   regarded   with  respect. 

It  is  well  known  that  Alcoholic  and  especially  Fermented  Liquors 
have  been  long  used  as  stimulants  and  tonics  in   enfeebled  conditions 


636  Tlie  Peninsular  and  Independent. 

of  the  economy,  but  the  idea  that  these  agents  exert  a  special  or 
specific  action  —  a  something  indescribable,  and  beyond  a  merely  stimu- 
lating and  tonic  effect  —  which  give  them  a  power  in  direct  antagon- 
ism to  phthisis  and  its  essential  cause  is,  we  believe,  comparatively 
modern,  and  probably  originated  in  the  "surprise,"  as  expressed  by 
Dr.  Wood,  at  the  results  of  the  autopsies  given  by  Jackson,  Peters 
and   Ogsten,  of  drunkards,  and  their  apparent  immunity  from  tubercle. 

"Without  regard  to  the  important  question,  whether  the  autopsies 
referred  to  actually  represented  the  pathological  state  of  the  aggregate 
of  drunkards  throughout  the  country,  the  proof  afforded  by  these  au- 
topsies being,  as  we  are  informed,  in  accordance  with  preconceived 
opinion,  was  deemed  conclusive;  and  hence  the  practical  deduction  — 
if  drunkards  are  generally  exempt  from  consumption,  the  agent  used 
to  produce  drunkenness  must  be  the  remedy  for  the  antecedent  cachexia 
upon   which   consumption   depends. 

We  believe  that  this  conclusion  is  deceptive,  even  though  the 
facts  upon  which  it  is  founded  were  true,  and  may  lead  to  erroneous 
and  exceedingly  mischievous  practice.  It  is  not  unfref^uently  the  case 
that  mere  anatomico-pathological  demonstrations,  like  lamps  in  sepulch- 
res,   gleam   over   the   dead,    but   give   no   certain   light   to  the  living. 

That  intemperate  persons  are  not  necessarily  exempt  from  phthisis, 
is  well  known;  and  even  though  we  admit  that  they  are  more  liable 
to  die  of  some  other  disease  than  consumption,  the  mere  substitution 
of  one  fatal  malady  for  another,  certainly  does  not  prove  that  Alco- 
hol is  protective  or  medicinal,  but  rather  that  it  is  destructive.  Ex- 
aminations after  death  have  shown  that  fatal  lesions,  the  unquestion- 
able product  of  alcoholic  liquors,  are  almost  invariably  found  in  the 
bodies  of  intemperate  persons.  Now,  if  we  could  maintain  an  equally 
continuous  determination  to  the  ordinary  scats  of  those  lesions  —  the 
brain,  heart,  liver,  kidne3^s,  ko.. — and  produce  corresponding  changes 
in  these  important  organs  by  any  other  means  than  Alcohol,  who  can 
say  that  the  lungs  would  not  be  similarly  protected.  Alcohol  may 
indeed,  in  certain  cases,  neutralize  or  suspend  the  morbid  condition 
upon  which  the  deposition  of  tubercle  in  the  lungs  depends  by  the 
exercise  of  an  agency  equally  as  fatal  to  other  organs,  and  to  the 
whole  economy  in   the   end. 

Dr.  Bell  does  not  allude  to  Ogston's  autopsies,  quoted  by  Dr. 
Wood,  but  gives,  as  already  stated,  counter  -  statistics  to  disprove  the 
conclusions  of  Jackson  and  Peters.  Among  these,  he  refers  to  a  paper 
embraced  in  the  Report  of  the  London  Statistical  Society  for  1851, 
by  M.  Neisox,  the  actuary  of  a  London  Insurance  Company,  who  has 
given  the  results  of  the  autopsies  of  357  intemperate  persons.  Dr. 
B.   says: 

"The  diseases  of  which  the  357  intemperate  persons  died  are  also 
given.      Of  these,   40   died  of  phthisis,    and  3   others    of    hsBmoptysis, 


Selected  Articles^  Abstracts^  c0c. 

who  should,  probably,  be  classed  with  them.  These  cases  were  re. 
ported  to  him  by  various  physicians,  aud  therefore  represent,  probably, 
with  considerable  accuracy  the  diseases  of  which  they  really  died." 
The  following  table  includes  the  reported  autopsies  referred  to  by 
Prof.  Wood,    and   those  also   commented   upon    by   Dr.    Bell. 

Autopsies  of  Drunkards.  Phthisis. 
Reported  by  Jackson     .     .     35  5 

Peters   ...     70 

Ogston      .     .  117  2 

Neisen       .     .  357  40 


479  47 

The  tubercular  disease  discovered  in  Ogston's  cases  is  not  regarded 
by  him  as  the  cause  of  death.  Jackson  found  tubercles  in  the  lungs 
in  five  persons,  but  only  two  of  them  died  of  phthisis.  Peteks  re- 
ports "the  results  of  the  autopsies  of  ^nearly  seventy''  persons  dying 
suddenly,  or  found  dead  in  the  streets  who  were  intemperate."  Dr. 
Bell  justly  remarks,  "As  there  were  many  of  them  instances  of  per- 
sons found  dead  in  the  streets,  in  these  cases  it  would  seem  to  be 
difficult  to  substantiate  the  fact  of  intemperance  with  certainty."  He 
might  have  added  also  that  the  expression  "nearly  seventy"  is  vague 
and  indefinite.  Be  this  as  it  may,  for  the  present,  we  will  admit 
there  were  just  seventy,  and  that  they  were  all  intemperate,  and  then, 
if  from  the  whole  number  of  instances  of  phthisis  presented  in  the 
above  table  we  deduct  three  from  Jackson's  figures  and  two  from 
Ogston's,  we  still  have  forty -two  deaths  from  consumption,  or  nearly 
one- eleventh  in  a  list  of  autopsies  of  four  hundred  and  seventy -nine 
drunkards   or    "intemperate   persons." 

Making  due  allowance  for  errors,  we  have  in  the  above  table  ample 
ground  for  questioning,  if  not  for  absolutely  denying,  the  assumed 
fact  that  drunkards  are  less  liable  to  die  of  phthisis  than  temperate 
persons.  On  the  contrary,  we  believe,  with  Dr.  Bell,  that  general  sta- 
tistics, as  far  as  these  are  attainable,  will  show  that  any  given  num- 
ber of  intemperate  persons  are  more  liable  to  die  of  phthisis  than  an 
equal  number  of  temperate  persons  of  similar,  or  nearly  similar  ages 
as  the   intemperate. 

In  view  of  the  facts  above  prescribed,  we  can  draw  no  legitimate 
inferences  from  pathological  anatomy  in  support  of  the  opinion  that 
alcohol  is  capable  of  exerting  a  prophylactic  or  curative  influence  in 
tubercular   disease  or  in   constitutions   predisposed   to   such   disease. 

We  must  therefore  leave  this  branch  of  the  subject,  and  proceed 
to  inquire.  Where  is  the  evidence  "that  clinical  experience  shows  a 
decided  influence  of  alcohol  as  a  remedy  in  arresting  or  retarding  tu- 
berculosis ? " 


638  The  Peninsular  and  Independent. 

In  this  important  inquiry  we  ask  for  proof  of  tlie  efficacy  of  this 
agent  equal  at  least  in  certainty  to  the  danger  of  recommending  its 
habitual  employment.  Mere  opmions  and  theories,  no  matter  with  what 
show  of  authority  presented,  will  not  answer  the  inquiry.  We  want 
the  facts  upon  which  the  opinions  and  theories  arc  founded,  in  order 
that   we  may   draw   our   own   conclusions. 

Under  the  sanction  of  medical  authority,  thousands  of  persons  pre- 
disposed to,  or  already  affected  with,  tubercular  disease,  have  been 
subjected  to  the  influence  of  Alcohol  for  consecutive  months  or  even 
years.  After  such  long  and  varied  experience  it  might  be  supposed 
that  the  annals  of  medicine  would  furnish  numerous  and  well  authen- 
ticated facts  to  answer  a  question  so  important  as  the  one  proposed. 
Notwithstanding  this  supposition,  if  there  are  cases  on  record  which 
prove,  in  a  clear  and  satisfactory  manner,  that  Alcohol,  even  in  a  single 
instance,  prevented  the  final  deposition  of  tubercle  or  cured  a  person 
laboring  under  developed  tuberculosis,  it  has  not  been  our  fortune  to 
meet  with  the  record. 

In  all  the  reported  instances  of  presumed  benefit  from  the  use  of 
alcohol,  other  remedies  —  as  cod -liver  oil,  iodine,  quinine,  morphine, 
iron,  wild  cherry  bark,  &c.  — were  administered  at  the  same  time,  and 
a  rational  hygienic  course,  suggested  by  an  improved  pathology,  was 
generally  pursued,  to  which  the  benefit  might,  with  equal  or  more  pro- 
priet}^,  have  been  attributed.  Even  when  the  fermented  liquors  were 
used,  the  nutritive  and  tonic  properties  existing  in  these,  in  spite  of 
the  alcohol,  have  frequentl)'-  been  ignored,  and  the  credit  given  mainly 
to  the  alcoholic  element,  under  the  supposition  that  this  agent  mysteri- 
ously counteracted  the  malign  influence  of  the  tubercular  condition. 

ANTI-LACTISCENT  PROPERTIES  OF  COMPRESSED  SPONGE. 

In  the  i!\ew  Yorlz  Journal  of  Medicine  for  November,  Dr.  Stewart, 
of  Peekskill,  N.  Y.,  recommends  the  application  of  compressed  sponge 
to  the  breast  to  prevent  the  secretion  of  milk  after  confinement,  should 
the  condition  of  the  gland  require  such  treatment.  He  gives  a  case  in 
which  the  application  arrested  the  secretion  of  milk  in  the  left  breast 
while  in  the  uncompressed  right  breast  the  milk  was  secreted  as  usual. 
"The  sponge  was  applied  the  day  after  the  confinement  and  continued 
about  two  weeks,  and  up  to  the  present  time,  some  four  months,  no 
milk  has  appeared  in  her  breast." 


The  Medical  College  at  Bombay  has  forty -four  students,  of  whom  twen- 
ty-six are  Parsees,  ten  Hindoos,  two  Borahs,  four  Portuguese,  one  Mussul- 
man, and  one  Christian.  The  course  of  study  is  similar  to  that  of  Euro- 
pean schools,  but  is  said  to  be  longer  and  more  complete. 

[Med.  Reporter. 


Ijiirmar^utial  g^prtmnt. 


On  Syrup  of  Tar.    By  Thomas  A.  Lancaster. 

A  reliable  process  for  preparing  syrup  of  tar  has  long  been  a  desi- 
deratum. 

The  preparation  now  in  use,  "Tar  Beer,"  is  an  excellent  one  when 
freshly  prepared,  but  by  keeping  is  more  or  less  subject  to  decompose  and 
become  unpleasant  and  disagreeable  to  the  taste,  acquiring  a  rank  odor  and 
partially  losing  its  medical  properties. 

This  consideration  led  me  to  compile  a  formula  as  follows : 
^   Tinctura3  Picis  Liquidse,  |  ij. 

Magnesioe  Carbonatis,  |  j.  or  q.  s. 

Sacchari  Albi,  fcj.  av. 

Aqua3  Fontanae,  a  sufficient  quantity. 

Rub  the  tincture  first  thoroughly  with  the  magnesia,  and  then  add  half  a 
pint  of  the  water  gradually,  transfer  to  a  filter,  and  when  the  liquid  ceases 
to  pass  add  more  water  till  it  measures  half  a  pint ;  then  to  the  filtered 
liquid  add  the  sugar,  and  by  means  of  a  gentle  heat  convert  it  into  a  syrup. 
By  the  above  means,  the  pitch  contained  in  the  tincture  is  retained  in 
the  filter  along  with  the  magnesia,  whilst  the  filtrate  affords  a  syrup,  by  the 
addition  of  sugar,  of  a  beautiful  rich  straw  color,  being  agreeable  and  pal- 
atable in  its  taste,  and  advantageously  adapted  to  the  most  severe  cases  of 
chronic,  catarrhal  and  bronchial  affections. 

In  offering  this  formula  to  pharmaceutists,  it  is  with  a  hope  that  it 
may  induce  those  having  a  demand  for  a  reliable  article  to  prepare  it  for 
themselves,  and  to  attempt  further  improvements  in  the  mode  of  prepara- 
tion, as  it  will  be  seen  to  possess  the  merit  of  cheapness,  and  may  be  ac- 
complished without  unnecessary  trouble. 

The  essence  or  tincture  of  tar,  as  found  in  the  shops,  was  of  no  defi- 
nite strength,  but  according  to  various  samples,  was  found  of  the  following 
average:  two  ounces  of  tar  to  one  pint  of  rectified  alcohol. 

[Am.  Jour.  Pharmacy. 


Commercial  Chloric  Ether.   By  William  Procter,  Jr. 

It  is  a  source  of  some  inconvenience  to  apothecaries  to  know  what  is 
intended  by  the  physician  when  "Chloric  Ether"  is  prescribed.  On  turn- 
ing to  the  United  States  Dispensatory,  it  informs  us  that  a  mixture  of 
one  part  of  Chloroform  and  two  parts  of  nearly  absolute  alcohol  is  called 
"Strong  Chloric  Ether,"  by  Dr.  Warren,  of  Boston,  and  used  for  inhala- 
tion, and  that  in  London,  and  elsewhere,  a  weak  tincture  of  Chloroform  is 
sold  under  the  name  of  Chloric  Ether,  varying  in  strength  from  5  or  6  to 
16  or  18  per  cent.  Dr.  Thompson  originally  gave  the  name  of  "Chloric 
Ether"  to  the  Dutch  liquid  (0^  H*  CP).     In  the  commerce  of  this  coun- 


640  The  Peninsular  and  Independent, 

try,  there  is  a  preparation  that  goes  by  the  name  of  Chloric  Ether,  con- 
sisting wholly  or  chiefly  of  chloroform  and  alcohol,  which,  when  mixed 
with  water,  docs  not  separate.  On  inquiring  of  Mr.  William  Weightman 
(of  Powers  &  AVeightnuin)  what  the  article  prepared  by  them  under  this 
name  was,  he  stated  that  their  lirm  had  prepared  it  as  they  sold  it  for 
more  than  twenty -five  years,  since  soon  after  Mr.  Guthrie's  discovery  of 
chloroform,  which  he  called  Chloric  Ether.  The  preparation  sold  by  them 
is  obtained  by  distilling  together  chloride  of  lime,  alcohol  and  water,  in  the 
proportion  of  8  lbs.  aw  of  chloride  of  lime,  to  a  gallon  of  alcohol,  and  a 
suitable  quantity  of  water,  and  distilling  a  gallon  of  the  "  Chloric  Ether." 
As  chloride  of  lime,  on  the  average,  yields  from  0  to  8  per  cent  of  chloro- 
form, it  is  fair  to  infer  that  this  preparation  does  not  contain  more  than  8 
per  cent  of  that  substance.  It  has  the  following  properties:  It  is  color- 
less, has  an  agreeable  weak  odor  of  chloroform,  a  sweet  spicy  taste  of  chlor- 
oform with  a  cooling  after  impression  somewhat  like  that  of  peppermint. 
Its  specific  gravity  is  892.  When  mixed  with  water  in  the  propoition  of 
1  to  20  it  is  at  first  cloud}^  and  almost  instantly  becomes  clear,  with  but  lit- 
tle if  any  separation  of  chloroform.  It  is  this  latter  property  that  has 
caused  it  to  be  prefcrcd  by  some  practitioners.  That  the  proportion  of 
chloroform  in  this  preparation  varies  is  quite  certain,  as  Mr.  Weightman 
states  that  it  is  not  always  of  such  composition  as  to  mix  with  water  with- 
out precipitation.  It  is  quite  inflammable,  and  burns  with  a  yellowish 
flame,  tinged  with  bluish  green.  When  two  fluid  drachms  of  chloroform 
and  15  fluid  drachms  of  alcohol,  (li5  per  cent.)  are  mixed,  the  mixture  has 
a  specific  gravity  approximating  closely  to  that  of  the  above  "Chloric 
Ether."  Such  a  mixture  contains  about  10  per  cent,  of  chloroform,  and 
when  added  to  water  is  instantly  precipitated.  Whether  the  specific  gravi- 
ty of  the  commercial  article  is  due  partly  to  water,  or  whether  the  chloro- 
form is  so  intimately  combined  with  the  alcohol  in  the  process  of  making, 
as  to  render  the  mixture  stable  in  the  presence  of  water,  has  not  been  de- 
termined, but  there  is  a  marked  difference  in  the  behavior  of  the  liquids 
with  an  access  of  water.  \^Am.  Jour.  Pharmacy. 


Eighth  Annual  Meetiog  of  the  Midi.  State  Medical  Society, 

Tlie  Eiglitli  Annual  Meeting  of  the  JMicliigan 
State  Medical  Society  will  be  held  at  Coldwater 
on  the  third  Wednesday  of  January  (l81h),  com- 
mencing  at   10   o'clock   A.M. 

E.  P.  Ciiristiajst,  Sec, 


THE 

PENINSULAU  AND  INDEPENDENT 

MEDICAL  JOURNAL 

Vol.  II.         DETROIT,  FEBRUARY,  1860.  No.  11. 


ART.  IXXIX.— Puerperal  FeTer  and  Erysipelas. 


By  C.  Rtnd,  M.  D. 


Many  of  the  phenomena  connected  with  puerperal  fever 
are  enshrouded  in  mystery.  Thick  darkness  covers  the 
suhject,  and  all  our  experience  and  theorizing  have  heen 
fruitless  in  rendering  it  as  clear  as  could  he  wished. 
Many  of  our  hest  practitioners  differ  in  respect  to  its  na- 
ture, the  manner  of  its  propagation,  cause,  treatment,  &c. 
One  holds  it  to  he  contagious,  another,  non-contagious. 
One  holds  it  to  he  a  local  disease,  another,  a  general 
disease.  By  some  it  is  held  to  he  inflammatory,  by  others 
typhoid. 

It  will  thus  he  seen  that  we  are  very  far,  as  a  pro- 
fession, from  having  any  fixed  or  definite  notions  in  ref- 
erence to  this  fearful  malady.  But  it  is  by  honorable 
and  fair  discussion  that  we  arrive  at  truth,  and  truth  is 
useful  everywhere  ;  — just   what   we   want   in   medicine. 

Vol.  II.  —  2Q. 


o42  The  Peninsular  and  Independent. 

Faithful  Reports  of  disease  as  it  may  occur,  either  in 
its  sporadic,  endemic  or  epidemic  forms,  and  the  inter- 
change •  of  professional  opinions,  have  a  direct  tendency 
to  give  us  the  pure  truth  and  thus  elevate  our  Profession- 
al Literature.  On  this  matter  very  many  members  of  the 
Profession  are  moving  in  the  right  direction,  and  are  taking 
just  such  means  to  elevate  their  practice  and  literature 
as  have  been  taken  by  true  philosophers  for  the  advance- 
ment of  other  Departments.  The  philanthropic  object  of 
diffusing  such  knowledge  as  may  be  acquired  in  practice, 
and  thus  adding  to  the  great  store  -  houae  of  medical  facts, 
is  contemj)lated. 

On  this  principle,  we  communicate  the  following  pa- 
per, which   we   trust   will   not   be   wholly  without  interest. 

Cask  I.  —  Mrs.  S.,  aged  33,  advanced  about  six  months 
in  her  fourth  pregnancy,  called  upon  me  for  medical  ad- 
vice, on  August  25th,  1859.  I  found  slight  gastric  de- 
rangement, for  which  I  prescribed  a  moderate  dose  of 
hyd.  cum  creta,  to  be  followed  by  a  laxative  dose  of  oil. 
Her  health  improved  after  this  and  remained  good  till 
the  morning  of  September  15th,  w^hen,  it  would  appear, 
the   symptoms   of  premature  labor  set   in. 

'(It  may  be  proper  to  remark  in  this  place,  that  her 
husband,'  a  merchant,  to  whom  she  was  devotedly  attached, 
had  been  treated  by  me  in  the  mean  time  for  a  severe 
attack  of  cynanche  tonsillaris^  and  her  mental  agony  du- 
ring this  time  may  be  more  easily  imagined  than  de- 
scribed.) 

A  female  obstetrician  was  called  in,  who  attended  hen 
and  in  a  day  or  two  all  alarming  symptoms  passed  off, 
and  she  was  again  able  to  attend  to  her  usual  business. 

Sept.  19th.  Symptoms  again  set  in  which  were  thought 
sufficiently  decided  to  call  for  the  attendance  of  her  female 
friend.  But  the  threatmings  on  this  occasion  were  not  so 
easily   dispelled,  and   on   the   morning  of  the   20th,   I  was 


Puerperal  Fever  and  Erysipelas.  643 

called  in.  I  found  that  the  os  uteri  was  considerably  dil- 
ated/ and  that  'the  head  of  the  child  was  in  such  a  po- 
sition as   rendered   premature  labor  inevitable. ; 

I  remained  in  attendance  part  of  the  day,  during  which 
very  little  progress  was  made.  InTthe  evening  I  consider- 
ed it  advisable  to  administer  half  a  grain  of  morphine 
which  produced  refreshing  sleep,  after  which  we  had  a  re- 
newed.  effort  of  nature  —  hearing  down  pains — and  the 
child  was  almost  immediately  expelled,  as  was  also  the 
placenta,  and  we  had  reason  to  hope  for  a  speedy  conva- 
lescence.    This  was  on  the   morning   of  September  21st. 

A  case  of  dangerous  epistaxis  occurred  in  the  country, 
to  which  I  was  called,  which  prevented  my'f seeing  Mrs.  S, 
until  next   day. 

Sept.  22nd.  Called  on  the  evening  of  this  day  to  see 
my  patient,  and  found  her  in  a  very  happy  condition,  so 
far  as  her  own  feelings  were  concerned,  but  had  reason 
of  suspect,  from  slight  incoherency  of  talk,  and  suffusion 
to  the  eyes,  &c.,  incipient  delirium.  I  made  the  most  par- 
ticular enquiries  in  reference  to  her  condition,  and  was  as- 
sured by  both  patient  and   nurse,  that  "all  was  right." 

I  expressed  my  fears  to  the  husband  on  leaving,  and 
desired  him  to  send  for  me  if  any  untoward  symptoms 
presented.  In  about  two  hours  after  I  was  aroused  by  a 
messenger  who  told  me  she  was  delirious:  On  my  arrival 
I  made  the  fullest  investigation  and  found  that  my  officious 
female  friend  —  a  mass  of  obstetrical  ignorance  —  had  sagely 
concluded,  during  the  previous  day,  that  the  normal  dis- 
charge was  too  profuse,  and  had,  to  remedy  such  a  great 
evil  under  the  sun,  applied  cold  to  such  an  extent  as  to 
cause  a  total  suppression. 

It  would  seem,  therefore,  that  this  was  the  cause  of  all 
the  subsequent  morbid  phenomena. 

We  resorted  to  fomentations  to  the  abdomen,  warm 
napkins  to  the  vulva,  &c.,  which  restored  the  normal  dis- 


C44  The  Peninsular  and  Independent, 

charge  in  about  two  hours  from  our  arrival.  At  this 
juncture  the  symptoms  of  delirium  disappeared  and  the 
peritoneal  symptoms — 'acute  pain  and  tenderness^  followed 
by  tympanitis — became  abundantly  conspicuous. 

I  called  in  Dr.  Ford  of  St.  Mary's,  C.  W.,  who  assisted 
"in  the  management  of  the  case,  but  all  our  efforts  were 
unavailing,  —  she  departed  this  life  on  Sept.  24th,  a  vie- 
Hm,  as  I  supposed,  to   non- professional   ignorance. 

Case  II.  —  Sept.  24th.  Mrs.  R.,  aged  23,  was  this  day 
confined  of  her  second  child.  She  was  attended  by  the 
aforesaid  female  obstetrician.  The  labor  was  natural  and 
easy,  and  convalescence  was  progressing  favorably  till  Sept- 
26th,  when  she,  too,  was  attacked  of  puerperal  fever.  I 
was  called  |in  on  the  following  morning,  and,  in  conjunc- 
tion with  Dr.  Ford,  made  every  effort  to  save  her  life 
but  all  to  no  purpose.     She   died  on  Sept.   30th. 

Case  III.  —  October  12th,  was  called  in  to  attend 
Mrs.  C,  aged  38,  this  morning.  This  was  her  tenth  con- 
finement. I  told  her  husband,  before  going,  that  I  had 
Bome  fears  as  to  the  contagious  character  of  the  disease 
which  had  prevailed,  and  advised  him  to  employ  some- 
body else.  He  insisted,  and  said  he  would  ^^run  all  risks," 
which  decided  me.  I  found  her  in  the  Jirst  stage  of  labon 
and  although  rather  tedious,  yet  all  went  on  favorably, 
and  she  was  delivered  of  a  healthy  child  at  II,  P.  M.,  of 
the  same  day.  I  remained  about  three  hours  after  the 
labor  had  terminated,  least  any  unfavorable  circumstance 
should  transpire,  and  made  a  second  visit  on  the  I4th, 
when  we  found  her  very  nicely  and  in  good  spirits.  She 
was  attacked  of  peritonitis  on  the  evening  of  1 5th,  and, 
in  my  absence,  another  practitioner  was  called  in,  who 
treated  the  case  until  death  ended  her  sufferings  on  the 
evening  of  October  I7th.     Here  were  three  victims. 

In  all  these  cases  the  symptoms  of  peritoneal  inflam- 
mation  were   very    decided ;   tongue    coated    with    a  thick 


Puerperal  Fever  and  Erysipelas,  645 

whitish  coat  which  became  brown  ;  urgent  thirst ;  counten- 
ance flushed  in  the  early  stages;  pulse  rapid  (140  on  an 
average)  and  feeble,  great  tendency  to  sink  under  the 
pressure  of  the  morbid  condition  —  in  fact,  the  condition 
became  imminently  typhoid.  In  all  these  cases,  too,  the 
lochia  was  present  during  the  whole  course  of  the  disease. 
Death  was  preceded  by  a  muttering  delirium.  Kespira- 
tion,  too,  was  hurried  and  laborious,  during  the  latter  part 
of  the  illness,  more  particularly,  and  the  surface  was  bathed 
in  a  cold,  clammy  perspiration. 

The  treatment  adopted  was  such  as  was  calculated  to 
subdue  the  local  inflammation  and  support  the  system. 
Hop  fomentations  were  applied  to  the  abdomen,  alternated 
with  light  linseed  cataplasms  which  were  saturated  with 
oil  of  turpentine.  This  seemed  in  every  instance  to  give 
marked  relief. 

Internally  we  used  calomel  with  some  preparation  of 
opium,  sweet  spirits  of  nitre,  carbonate  of  ammonia,  wine, 
wine -whey,  turpentine,  castor  oil,  &c.,  varied  so  as  to 
meet  indications.  The  most  marked  cleanliness  was  adopt- 
ed in  every  case  and  the  mental  condition  of  the  patients 
supported  as  well  as  the   circumstances   would  admit. 

Shortly  after  this  I  was  called  to  attend  on  some 
other  obstetrical  cases  but  stoutly  refused,  and  advised 
that  a  strict  quarantine  should  be  instituted ;  that  all 
persons  who  had  attended,  or  even  seen  any  of  the  other 
patients  should  be  excluded,  and  that  medical  men  should 
be  employed  who  had  not  seen  any  of  the  puerperal  pa- 
tients. This  system  was  carried  out, —  strictly  adhered  to 
in  every  case  —  and  the  disease  disappeared  from  among 
us.  We  had  not  another  case.  It  may  not  be  amiss  to 
state,  that  in  subsequent  cases  the  morbid  condition  was 
anticipated,  and  the  patients  were  put  upon  tonic  treat- 
ment shortly  after  delivery.  One  physician,  particularly, 
administered   about   a    pint    of    wine    every    twenty -four 


646  The  Peninsular  and  Independent,  , 

hours,  together  with  quinine,    essence   of  beef,  &c.,  and  in 
every  instance  had  a  speedy  convalescence. 

The  three  fatal  cases  were  all  within  a  circle,  the  di- 
ameter of  which  was  about  one  and  a  -  half  miles,  and 
the  lying-in  cases  which  occurred  subsequently  without 
exhibiting  puerperal  symptoms  were  in  the  immediate  vi- 
cinity—  one  was  within  four  hundred  yards  of  the  house 
in  which  "Case  1"  occurred. 

In  connection  with  this  history  of  puerperal  fever  I 
shall  give  an  account  of  three  cases  of  Erysipelatous  In- 
fiammation  of  a  very  violent  character,  and  the  circum- 
stance of  their  occurring,  either  exhibits  the  relation  exist- 
ing between  puerperal  fever  and  erysipelas,  or  else  is  in- 
volved in  great  mystery. 

September  27th  1859.  Was  summoned  to  the  bedside 
of  Miss  F.,  found  her  suffering  from  a  severe  attack  of  ery- 
sipelas  phlegmonodes,  affecting  both  legs,  but  one  in  par- 
ticular was  in  a  wretched  condition.  She  had  for  several 
years  been  a  resident  in  the  house  of  "  Case  1,''  and  was 
living  there  at  the  time  of  the  death  of  Mrs.  S.  The 
disease,  as  we  have  said,  was  of  an  alarming  character, 
continued  for  several  weeks,  but  was  controlled  by  reme- 
dial measures  —  She  recovered. 

This  young  lady  had  enjoyed  excellent  health  up  to 
this  time,  and  had  not  been  exposed  to  any  morbid  con- 
dition capable  of  influencing  her,  save  "Case  1/' 

About  two  or  three  days  after  the  death  of  Mrs.  C, 
(Case  3,)  her  husband  was  attacked  of  erysipelas,  affecting 
the  face  and  scalp.  He  had  always  been  a  very  robust 
man,  and,  up  to  this  time,  enjoyed  excellent  health.  He 
was  much  prostrated  by  the  disease,  but  ultimately  re- 
covered. 

About  the  same  time  a  child  belonging  to  a  neigh- 
boring family  was  attacked  of  erysipelas.  It  commenced 
in  the  left   foot,  spread   rapidly   up   the   limb,  and   thence 


Pueperal  Fever  and  Mrysipelas.  647 

to  the  body.  This  child  was  about  ten  months  old  and 
had  enjoyed  good  health  previous  to  this  time.  The  mother 
of  the  child  had  been  an  assisstant  at  the  house  of  Mrs. 
C.  (Case  3)  at  her  confinement  and,  in  all  probability, 
carried  the  poison  on  her  person  and  communicated  this 
disease  to  her  babe.  The  mother  of  the  child  was  a 
remarkably  healthy  person.  The  child  was  restored  to 
health  in  about  ten  days,  although  the  disease  had  well 
nigh   produced   fatal   effects. 

The  treatment  I  resorted  to  in  all  these  erysipetatous 
cases  was  supporting  —  tonic  remedies  were  indispensable. 
Indeed  the  tendency  was  to  a  typhoid  condition  and  the 
most  strenuous  efforts  were  necessary  to  ward  off  the  evil 
consequences. 

Now  the  question  is,  '^  was  the  morbid  condition  known 
as  puerperal  fever  propagated  by   contagion  ?" 

Here  we  had  th7^ee  cases  of  the  most  marked  kind 
—  no  mistake  about  it.  There  had  never  been  a  case  of 
puerperal  fever  in  that  region  of  country  before,  so  far 
as  my  information  extends.  The  locality  was  remarkably 
healthy,  and  the  victims,  without  a  single  exception,  were 
persons  of  good  constitution.  In  the  first  case  we  had 
a  cause,  which  was  considered  by  all  the  medical  men 
in  that  locality  as  the  cause.  In  the  other  cases  we  had 
no  appreciable  material  cause,  and  except  we  admit  the 
contagious  character  of  the  disease  we  are  altogether  in 
the  dark  on  the  matter.  Besides,  just  as  soon  as  the  usual 
precautions  of  the  contagionist  were  adopted,  just  so  soon 
the  disease  disappears  from  our  midst. 

Again,  ivhat  relationship  exists  between  puerperal  fever 
and  erysipelas?  Can  the  scientific  physician  rest  satis- 
fied by  inferring  that  the  erysipelatous  inflammation  in 
these  cases  had  no  connection  with  the  puerperal  endemic  ? 

Or,  is  it  not  more  reasonable  to  conclude,  that  owing 
to  some  deleterious  poison  entering   the  blood  and  modify- 


648  The  Peninsular  and  Independent. 

ing  its  crasis  we  have  puerperal  fever  produced  in  lying- 
in  patients  and   erysipelas   in  other  persons  ? 

Now,  we  are  aware  that  a  large  number  of  instances 
are  required  in  medicine  to  establish  any  particular  rule  ; 
but  yet,  we  think,  from  a  few  cases  which  are  unmis- 
takable, and  the  phenomena  of  which  present  clearly  to 
our  view,  we  are  warranted  in  forming  pretty  definite 
opinions.     We   conclude. 

First:  The  first  case  of  puerperal  fever  originated  in 
a  vitiation  of  the  fluids  caused  by  a  suppression  of  the 
the  lochia. 

Second:  The  second  and  third  cases  of  puerperal  fever 
were  caused  by  contagion,  which  was  carried  by  the  re- 
spective  attendants. 

Third:  It  is  probable  that  the  disease  was  arrested 
by  the  strict  regulations  enforced,  as  detailed  in  this 
paper. 

Fourth:  The  legitimate  inference  is,  that  the  endemic 
of  erysipelas  ivas  caused  by  the  morbid  material  which 
emanated  from  the  puerperal  patients,  entering  the  blood 
of  other  persons,  and  there  producing  all  the  phenomena 
of  erysipelas;  —  let  it  be  remembered  that  no  communi- 
cation   existed    between  any  of  the   erysipelatous  patients. 

Fifth:  The  essential  pathological  condition,  in  both  puer- 
peral fever  and  erysipelas,  is  a  deterioration  of  the  fluids 
of  the  body. 

Adeian,  December,  1859. 


AET.  XL.— Anaesthesia  dnring  Sleep. 


By  J.  H.  Beech,  M.  D. 

Notwithstanding  the   doubt  entertained  by  distinguish- 
ed members   of  the  '^  Buffalo   Medical  Association/'  in  re- 


Anmsthesia  during  Sleep.  649 

gard  to  inducing  anassthesia  by  chloroform,  without  wa- 
^  king  a  sleeping  patient,  we  beg  leave  to  offer  an  in- 
stance from  two  or  three  which  we  think  were  clearly 
defined.  We  trust  that  the  accompanying  description  of 
the  method  used  will,  when  necessary,  satisfy  others  that 
we   do  not  relate   an  impossible  "  fact/' 

Just  at  twilight,  March  2d,  1858,  we  were  summoned 
to  the  house  of  Rev.  R.  S.  Goodman,  (Parson  of  the 
Presbyterian  Church  in  this  village,)  to  remove  a  kernel 
of  corn  from  the  nose  of  his  son,  a  restive  lad  3i  years 
of  age.  Some  ineffectual  efforts  had  been  made  by  the 
parents  to  extricate  the  kernel,  and  while  the  father  was 
absent  for  me,  the  mother  had  succeeded  in  getting  the 
boy  to  sleep.  On  my  arrival,  I  made  two  attempts  to 
pass  the  limbs  of  '"'strabismus  forceps"  into  the  nostril, 
but  the  instant  they  touched  the  pili  about  the  nostril, 
the  head  flew  right  or  left,  warning  us  not  to  proceed  in 
in  that  manner.  - 

The  sponge  of  a  Luer's  inhaler  was  then  charged  with 
chloroform  and  brought  to  the  face,  but  could  not  be  got 
near  enough  to  effect  our  object  without  as  prompt  ges- 
tures as  before.  I  now  took  the  sponge  from  the  "  inhaler," 
(or  a  pledget  of  cotton  about  as  large  as  a  filbert  moist- 
ened with  chloroform,  I  do  not  remember  which  in  this 
case,  for  I  have  used  both  articles  in  such  instances)  and 
holding  it  in  my  fingures  as  close  to  the  nose  and  mouth 
as  possible  without  touching,  during  inspiration,  turned  it 
aside  when  each  expiration  began,  and  by  such  alternate 
motion,  succeeded  in  influencing  the  patient  so  far  that 
the  breathing  indicated  more  profound  sleep.  The  "inha- 
ler" was  now  applied  to  the  face  with  a  damp  cloth 
around  the  edge  to  supply  the  difference  in  the  size  of 
the  face  of  a  child,  and  that  of  an  adult  for  whom  the 
instrument  was  made.  Complete  angesthesia  was  imme- 
diately induced  as  indicated  by  stertorous  breathing. 


650  The  Peninsular  and  Independent, 

The  "strabismus  forceps"  was  now  introduced  without 
the  least  motion    of  the  child,  and   the   corn  removed. 

After  waiting  until  the  breathing  became  natural,  we 
directed  the  boy  to  be  put  in  bed  as  usual,  and  not  dis- 
turbed unless  unnatural  symptoms  appeared,  and  left.  We 
were  informed,  that  he  awoke  at  his  usual  hour  in  the 
morning,  raised  himself  in  bed,  put  his  finger  to  the  un- 
fortunate nostril,  and  asked,  "  Ma,  is  that  torn  in  my 
nose."  Persons  sleeping  will  be  sooner  awakened  by  any 
article  which  resists  the  current  of  expiration,  or  turns  it 
upon  the  face,  than  by  offensive  odors  inhaled.  It  is, 
therefore,  important  to  turn  aside  the  substance  containing 
the  aniesthetic  during  expiration,  and  by  the  method  de- 
scribed we  have  succeeded  in  other  cases  as  well  as  the 
above. 

CoLDWATER,  Mich.,  Dec.  12,  1850. 


Meter eological  Begister.  '   651 

ART.  ILL  — Meteorological  Register  for  Month  of  December. 

By  L.  S.  Horton,  House  Physician  to  U.  S.  Marine  Hospital. 

Altitude  of  Barometer  above  the  level  of  the  sea,  597  feet.     Latitude,  420  24' N.;  and 
Longitude,  82°58' W.  of  Greenwich. 


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§ibli0gnt^hital  ^U0rL 


A  PRACTICAL  TREATISE  ON  THE  DIAGNOSIS,  PATHOLOGY, 
AND  TREATMENT  OF  DISEASES  OF  THE  HEART.  By  Austin 
Flint,  M.  D.,  Professor  of  Clinical  Medicine,  &c.,  in  the  New 
Orleans  School  of  Medicine ;  visiting  Physician  to  the  New  Orleans 
Charity  Hospital ;  Honorary  Member  of  the  Medical  Society  of  Vir- 
ginia, of  the  Kentucky  State  Medical  Society,  of  the  Medical  Society 
of  Rhode  Island,  of  the  Pathological  Society  of  Philadelphia,  &c. 
Philadelphia:    Blanchard  &,  Lea.     1859. 

We  have  had  occasion,  several  times,  heretofore,  and  in 
different  capacities  to  refer  to  Dr.  Flint  and  his  contri- 
butions to  our  national  medical  literature,  and  have  al- 
ready expressed  the  opinion,  that  ^^he  needed  only  to 
labor  on  with  the  same  industry  and  care  as  heretofore, 
to  establish  himself  in  the  first  rank  of  American  authors." 
He  has  labored  on  with  that  same  industry  and  care,  and 
his  place  among  the  frst  authors  of  our  country  is  be- 
coming fully  established.  To  this  end  the  work,  whose 
title  is  given  above,  contributes  in  no  small  degree.  It  is 
a  fitting  companion  of  his  treatise  published  some  two  or 
three  years  ago,  on  the  Exploration  and  Diagnosis  of  Di- 
seases of  the  Kespiratory  Organs,  though  more  complete 
than  that  work,  embracing  the  Pathology  and  Treatment, 
as  well  as  Diagnosis,  of  heart  affections.  A  work  well 
executed  on  this  subject,  as  Dr.  F.  justly  says,  was  a 
desideratum,  and  we  have  no  hesitation  in  saying  from  an 
examination  of  the  book  that  the  want  has  been  supplied. 
The  arrangement   of  subjects   made   by  the   author,   is 


Bibliographical  Record,  653 

different  from  that  generally  adopted.  Instead  of  com- 
mencing with  inflammatory  affections  and  proceeding  syn- 
thetically to  those  lesions  which  are  chiefly  their  results, 
he  commences  with  enlargement  of  the  organ  and  proceeds 
analytically  to  the  morbid  processes  and  conditions  pro- 
ducing it. 

The  first  chapter  is  devoted  to  enlargements  of  the 
heart,  the  second  to  lesions  affecting  its  walls,  the  third 
and  fourth  to  those  of  the  valves  ;  next  comes  congenital 
malformations,  then  affections  incidental  to  diseases  of  the 
heart,  then  inflammatory  affections,  and  after  these  funct- 
ional disorders,  and  to  conclude  all,  thoracic  aneurisms, 
which  claim-  consideration  in  connexion  with  diseases  of 
the  heart,  being  so  intimately  associated  with  them. 

Each  of  these  subjects  is  treated  in  a  careful  and  satis- 
factory manner —  clinical  observations  being  made  the  basis, 
while  the  author  has  availed  himself  of  the  labor  of  others, 
and  has  placed  before  the  reader  in  a  lucid  manner  the 
results  of  his  experience,  his  reading,  and  his  reflections. 
The  work,  moreover,  in  its  style  and  arrangement,  indicates 
the  practical  teacher  —  and  while  the  experienced  practi- 
tioner will  find  in  it  a  useful  and  important  work  of  re- 
ference, it  will  be  particularly  enjoyed  by  the  student  in 
his   labors  to  master  the   subjects  of  which  it  treats. 

Dr.  Walshe,  of  London,  is  soon  to  appear  in  a  new 
edition  of  his  great  work  on  the  chest,  in  two  volumes, 
carefully  revised  and  much  enlarged  —  one  volume  being 
devoted  to  the  heart.  It  will  doubtless  be  a  work  of  the 
profoundest  research,  the  fullest  detail,  and  the  nicest  dis- 
crimination, but  we  venture  to  predict  that  in  clearness 
and  precision,  and  in  those  happy  qualities  of  style  and 
-  arrangement,  commending  it  to  students,  it  will  be  found 
inferior   to  the  work  of  our  countryman. 

Our  space  will  not  allow  of  an  extended  analysis  of  the 
book,  and  we  will  close  this  brief  notice  by  commending  it 


654  The  Peninsular  and  Independent. 

without   reserve  to  every  class  of  readers  in  the  profession^ 
The  publishers   have  well   performed    their  part,  as  the 
paper,  type,  and  binding  are  all  good. 

A.   B.   P. 


(^)ixisxul  g^prtment* 


EDITORIAL    CORRESPOJfDENCE. 


Dear  Read  era  of  the  Peninsular  and  Independent : 

As  you  are  already  aware,  I  have  returned  from  my 
wanderings,  and  am  engaged  again  with  harness,  on,  in  the 
ordinary  duties  of  my  profession,  and  these  letters  must  now 
take  the  form  of  remembrances  of  institutions,  persons  and 
events,   not   only  past   but   distant. 

Since  my  last,  dated  at  Bradford,  I  have  traveled  through 
many  interesting  portions  of  England — have  visited  York, 
Lincoln,  and  Old  Boston — have  gazed  with  peculiar  interest 
upon  the  famous  cathedrals  of  the  two  former  places,  and 
upon  the  magnificent  towers  of  the  church  in  the  latter 
place  —  the  residence  of  JoHi^  Cottox,  and  of  many  of  the 
original  emigrants  who  settled  in,  and  gave  the  name  to 
Boston,  Maesachusetts, — hence  paid  another  visit  to  London, 
reviewing  many  of  the  objects  of  interest  there,  collecting 
books  and  documents  and  means  of  illustration — have  spent 
some  time  very  pleasantly  at  Oxford,  the  seat  of  England's 
greatest  University  —  have  made  a  pilgrimage  to  the  birth- 
place and  tomb  of  the  world's  great  poet,  at  Stratford,  upon 
Avon  —  have  visited  Warwich  and  Kennelworth  Castles  — 
have  gazed,  as  did  Tupper,  on  the  tall  spires  from  the 
railway  bridge  at  Coventry  —  have  wandered  through  the 
smoky  town,  and  many  of  the  immense  work  -  shops  of  Bir- 
mingham— have  seen  the  lights  of  its  thousands  of  furnaces 
blazing  in  the  darkness,  giving  some  faint  notion  of  the  im- 
mense manufacturing  interests  of  England  —  have  re  -  visited 
Liverpool,  the  great  support  of  the  kingdom  —  embarked  upon 
the  steamship  Asia  for  N'ew  York,  and  again  encountered 
the  storms  and  heavings  of  the  ocean,  and  the  prostrating 
sickness  dependent  upon  its  motion — suffering  even  more  than 


656  The  Peninsular  and  Independent. 

upon  the  outward  passage,  and  arriving  home  at  length,  re- 
ceiving the  kindly  congratulations  of  fi'iends.  With  the  ex- 
ception of  the  sickness,  and  the  minor  annoyances  necessarily 
incident  to  traveling  anywhere,  the  tour  has  been  one  of  al- 
most unalloyed  satisfaction.  There  have  been  no  specially 
thrilling  incidents,  startling  adventures,  or  "hair -breath  es- 
capes," but  new  objects  in  nature  and  art,  and  new  phazes 
of  human  society  and  characters,  have  constantly  been  pre- 
sented, and  new  enjoyments  have  as  constantly  been  spring- 
ing up.  The  period  of  the  tour  was  not  designed  as  one 
of  relaxation,  and  has  not  proved  such,  but  rather  of  active 
labor;  but  like  other  labor,  when  performed  under  proper 
circumstances  and  weight,  it  has  been  attended  with  pleasure, 
and  the   more   intense   from   its   novelty   and  variety. 

But  it  is  quite  time  to  proceed  with  the  promised  ac- 
count of  medical  institutions  and  medical  men,  and  there  are 
many   more   in   London   claiming   attention. 

I  should  state  here  that  it  is  quite  impossible  for  me  to 
give  a  full  account  of  all  the  medical  institutions  in  London 
—  a  volume,  rather  than  a  few  letters,  would  be  required  for 
this  —  and  I  shall  therefore  only  give  such  sketches  as  I 
may  think  w^ill  most  interest  you,  and  give  most  accurate 
notions,   by   proper   specimens,  of  the   whole. 

There  are  in  London  some  six  hundred  or  more  chari- 
table institutions,  or  parent  societies  for  charitable  purposes, 
most  of  them  making  provisions  for  the  care  of  the  sick 
poor  —  over  two  millions  of  pounds  sterling  are  annually  dis- 
bursed, more  than  one- half  of  which  being  raised  by  volun- 
tary contributions.  Three  of  the  institutions  for  the  cure  of 
disease  are  Royal  Hospitals,  viz.:  St.  Bartholomew'' s.,  St. 
Thomas'  and  Bethlehem  —  the  latter,  commonly  called  Bed- 
lam., is  for  the  insane.  Others,  as  Guy's,  are  supported  by 
large  endowments,  while  others  still  are  entirely  dependent 
upon  voluntary   subscriptions  and  contributions. 

St.  Bartholomew's  Hospital,  in  Smithfield,  not  far  from 
the  General  Post  -  Office,  and  St.  Paul's  Church,  is  the  earliest 
institution  of  the  kind  in  London,  and  is  now  one  of  the 
largest,  having  accommodations  for  about  600  patients  within 
its  wards,  and  relieving  vast  numbers  .as  out  patients.  In  all, 
some  '70,000  to  80,000  patients  are  annually  prescribed  for,  and 


Editorial  Department.      '  657 

provided  with  medicine,  in  connection  with  the  institution. 
It  is  a  general  hospital,  admitting  every  form  of  disease 
and  accident,  medical  and  surgical.  The  in-patients  are  visi- 
ted by  the  physicians  ai^d  surgeons,  and  the  out-patients  by 
the  assistant  physicians  and  assistant  surgeons.  The  medical 
school  attached  to  this  hospital  is  the  largest  in  London, 
and  a  place  as  teacher  in  it  is  consequently  considered  as 
most  desirable  —  fees  in  all  the  London  schools  depending 
upon  the  number  of  students.  As,  however,  the  teachers 
are  not  the  licensers  to  j^r^-ctice,  or  the  conferers  of  degrees, 
there  is  not  the  oi^portunity  to  lower  the  standard  of  re- 
quirements for   the  purpose  of  securing  members. 

The  men  I  saw  most  of  at  St.  Bartholomew's  were  Dr. 
West,  Professor  of  Obstetrics  and  Diseases  of  Women  and 
Chiklren  —  another  of  various  works  on  diseases  of  children 
and  females — Drs.  Baily,  Kirke  and  Maevijs",  physicians, 
and  Messrs.  Lawrence,  Skey,  Stanley  and  Paget,  surgeons. 
Dr.  West  is  a  man  about  medium  height  and  size,  in  the 
neighborhood  of  fifty  years,  and  is  quite  affable  and  attentive 
to  strangers.  lie  is  an  accurate,  direct,  and  clear  lecturer ; 
does  not  repeat  or  render  emphatic  important  points;  speaks 
rather  rapidly  and  without  notes,  keeping  his  eyes  upon  the 
floor  or  table,  and  is  decidedly  English  in  his  pronunciation 
and  manner.  Notwithstanding,  this  is,  I  believe,  the  largest 
school  in  the  metropolis,  the  numbers  attending  his  regular 
lectures  on  Midwifery  were  a  little  less  than  forty,  as  count- 
ed several  times  in  his  lecture  room.  The  ability  of  Dr. 
West,  and  the  classical  character  of  his  writings,  are  well 
known.  But  notwithstanding  all  this,  and  his  position  at  St. 
Bartholomew's  and  the  Hospital  for  Children,  his  success  in 
obtaining  private  practice  has  not  been  great.  He  has  a 
limited  number  of  beds  in  the  hospital  for  the  diseases  of 
women,  and  prescribes  for  a  large  number  of  out  patients,  all 
of  whom  are  females  effected  with  diseases  peculiar  to  their 
sex.  So  far  as  I  observed,  his  examinations  of  his  patients 
were  very  fairly  careful,  notwithstanding  the  large  numbers 
presented  to  him,  and  his  prescriptions,  w^hile  not  remarka- 
ble, appeared  judicious.  The  number  of  fibrous  tumors  of 
the  uterus,  which  I  saw  among  his  out  -  patients,  surprised 
me  —  four   cases    of    large  tumors  -  of   that    organ    presenting 

Vol.  II.-2K. 


658  The,  Peninsular  and  Independent, 

themselves  during  one  morning.  Most  of  them  liad  been  a 
considerable  time  under  liis  observation,  and  the  degrees  of 
suffering  in  the  different  cases  were  very  various  —  not  always 
in  proportion  to  the  size  of  tlie  tui^or  or  the  continuance  of 
the  disease.  Mucli  seemed  to  depend  upon  the  susceptibility 
and  power  of  endurance  of  the  ])atient.  Saw  several  cases  of 
cancer  of  the  Uterus,  Leucorrha'a,  Prolapsus,  Procedentia, 
itc.  One  case  was  presented,  of  extra -Uterine  pregnancy. 
It  had  continued  four  years,  the  patient  being  at  the  time 
pretty  comfortable,  having,  liowevcr,  occasional  attacks  of  pain, 
especially  after  severe  exercise.  The  woman  was  about  attend- 
ing to  her  family,  and  tlie  tumufaction  was  gradually  dimin- 
isliing. 

IJr.  West  informed  me  lie  had  seen  five  cases  —  most  of 
them  proving  fatal  at  periods  varying  from  a  few  months  to 
a  few  years.  This  had  already  continued  longer  than  any  of 
the  rest,  and  was  likely  to  continue  for  considerable  time  to 
come.  I  encouraged  the  poor  woman  to  hope  for  the  best, 
mentioning  the  case  published  some  years  ago  in  the  Penin 
sular  Journal^  taken  from  one  of  our  cotemporarics,  where  a 
patient  carried  a  foetus  for  about  fifty  years  witliout  much  suf. 
fering ;  she  dying  at  an  advanced  period  in  life,  the  fcetus  was 
found  completely  ossified,  and  is  now  in  the  Museum  of  the 
JMedical  college  of  Albany. 

Dr.  West  made  various  inquiries  and  observations  respect- 
ing some  of  our  writers  on  diseases  of  women,  particularly 
about  Dr.  Miller,  of  Louisville,  Ky.,  who  had  reviewed  some- 
what severely  his  Croononian  lectures  on  diseases  of  the  Os 
Uteri,  and  Drs.  Bedford  and  Meigs.  He  spoke  favorably  of 
the  abilities  of  all  these  gentlemen,  though  he  thouglit  the 
printing  of  so  much  conversation  with  patients  in  the  works 
of  the   two   latter,  very  strange. 

He  spoke  of  our  countryman.  Dr.  J.  Maeion  Sims,  in  strong 
terms  of  commendation,  regarding  the  use  of  the  Silver  Suture 
as  introduced  by  him,  and  his  full  method  of  operation  for 
visico  -  vaginal  fistules  as  among  the  most  important  triumphs 
of  modern  surgery.  Xot  only  Dr.  West,  but  all  others  with 
whom  I  met,  well  informed  on  the  subject,  spoke  in  very 
warm  terms  of  the  improvements  by  Dr.  Sims  —  and  I  may 
mention  here,  that  in  my  whole  tour,  I  have  seen  no  method 
of  examination  —  no  system   of  manipulation  in  diseases  of  this 


Editorial  Department.  659 

kind,  that  will  compare  with  his.  Those  whom  I  have  seen 
attempting  to  adopt  his  proceedings,  have  in  no  instance  equal- 
ed his  dexterity.  I  think  it  must  be  acknowledged,  that  at 
this  moment.  Dr.  Sims  stands  unrivaled  in  skill  and  success  in 
the  treatment  of  this  most  distressing  class  of  accidents.  This 
I  feel  bound  to  say  after  seeing  examinations  of  these  parts 
and  operations  in  Paris,  Edinburgh  and  Dublin,  upon  them,  as 
well  as  in  London;  and  while  impelled  by  a  sense  of  justice^ 
I  am  .proud,  as  an  American,  to  be  able  to  bear  testimony  to 
this  effect.  That  others  in  this  country  and  in  Europe  may, 
with  equal  opportunities,  acquire  all  of  Dr.  Sims'  skill,  and  at- 
tain to  all  his  success,  is  by  no  means  denied;  —  but  as  yet 
no  one  has  had  the  same  opportunity,  or  given  the  same  at- 
tention to   the  subject. 

I  was  very  glad  to  meet  with  Dr.  West,  and  see  so  much 
of  him,  and  especially  so  as  I  had  so  long  admired  his  excel. 
•  lent  work  on  the  diseases  of  children.  What  I  saw  of  him, 
confirmed  my  opinion  of  his  talent,  and  left  a  favorable  im- 
pression of  his  character.  I  must  say,  however,  that  in  a  lec- 
ture upon  the  signs  of  pregnancy,  I  was  surprised  to  hear 
liim  state  the  old  views  respecting  what  has  been  called,  the 
"placental  murmur,"  considering  it  as  being  produced  by  the 
blood  passing  through  that  organ,  and  as  an  evidence  of  preg- 
nancy, without  stating  the  reservations  which  more  recent  in- 
vestigations have  induced  others  to  make. 

I  had  but  one  interview  with  Dr.  Bailey,  but  it  was  of 
two  hours  or  more  duration,  among  his  out-patients  at  the 
hospital,  and  left  an  exceedingly  favorable  impression  of  the 
man  on  my  mind.  He  is  a  man  of  some  thirty -five  or  forty, 
of  about  medium  size,  with  a  very  intelligent  and  pleasing 
countenance,  and  a  finely  developed  brain.  With  his  patients 
he  was  kind,  sensible,  patient,  pains -taking  and  correct,  and 
towards  strangers  and  students,  afiable  and  communicative,  giv- 
ing to  the  four  or  five  young  men  who  attended  him  excel- 
lent practical  instruction,  considering  the  rapid  manner  in 
which  the  very  large  number  of  patients  compelled  him  to 
proceed.  I  was  glad  to  learn  that  his  good  qualities,  which 
I  felt  sure  he  possessed,  were  appreciated  —  that  he  had  re- 
cently been  appointed  Physician  Extraordinary  to  the  Queen, 
over  many  older  men,  and  that  he  was  enjoying  a  good  pri- 
vate practice. 


660  The  Peninsular  and  Independent, 

Dr.  Martin  was  a  man  still  younger,  of  very  superior 
physical  development,  of  good  mind  and  agreeable  manners. 
He  is  a  resident  upon  the  grounds  of  the  hospital,  is  ready  to 
be  called  upon  for  the  in  -  patients,  in  emergencies,  and  has 
charge  of  very  large  numbers  of  out-patients.  He  informed  me 
that  on  the  days  for  out  -  patients  to  visit  him,  he  often  examined 
and  prescribed  for  two  hundred  at  a  single  sitting  of  a  morning 
He  had  two  or  thre  assistants  who  aided  him  more  or  less  in 
examining  the  cases  and  prescribing  for  the  more  trivial 
complaints;  but  he  was  responsible  for  the  whole,  and  could 
neither  do  himself  or  his  patients  justice.  There  come  to  him 
almost  every  variety  of  mild  affections,  beside  many  of  a 
grave  character,  particularly  phthisis.  He  seemed  to  aj^pre- 
hend  this  disease  in  many  who  presented  themselves,  and  of- 
ten intimated  its  existence  before  a  careful  examination  was 
made.  There  was  nothing  unusual  in  his  treatment.  He,  how- 
ever, often  prescribed  doses  where  it  seemed  to  me  hygienic 
regulations   were  alone  required. 

Dr.  KiRKE,  the  author  of  the  compendium  on  Physiology, 
I  saw  among  his  out-patients.  He  is  a  small,  spare,  acute 
man,  rather  rapid  in  his  movements,  and  still  young  enough 
to  advance  in  his  profession.  Although  I  observed  nothing 
in  his  practice  demanding  special  record,  what  I  saw  of  him 
left  a  favorable  impression  of  his  abilities  and  character. 

Of  the  venerable  surgeon,  Mr.  Lawrexce,  the  author  of 
the  work  on  the  Eye,  and  various  other  productions,  meta- 
physical and  professional,  you  have  all  heard.  He  is  a  fine, 
genial- looking  old  man,  with  an  excellent  develojDement  of 
brain  and  body  well  preserved.  His  spirits  aj^pear  to  be  in 
their  bloom,  as  he  joked  and  laughed  more  than  any  of  the 
distinguished  men  with  whom  I  met  in  London  ;  but  his  in- 
tellect is  said  to  have  passed  its  prime  some  time  since.  He 
is  regarded  as  committing  the  error  which  other  aged  men 
have  often  done,  of  holding  on  to  a  position  longer  than  is 
desirable  or  proper  —  thus  marring  a  reputation  well  earned 
by  a  long  course  of  faithful  and  honorable  labor.  He  still 
retains  the  chair  of  didactic  surgery  in  the  school,  though  he 
has  outlived  his  efficiency  as  a  teacher.  This  is  as  much  to 
be  regretted  on  his  own  account  as  that  of  the  pupUs,  and 
the  interests    of  the  school   to   which  he  is  attached.     When  I 


Editorial  Department.  661 

saw  him  in  his  wards,  but  very  few  students  followed  him, 
and  their  quiet  but  significant  exchange  of  glances,  by  no 
means  indicated  that  confidence  in  his  sayings  and  doings 
which  should  be  extended  to  one  in  so  important  a  position. 
I  heard  many  express  themselves  on  the  subject,  all  regret- 
ting his  continuing  in  his  professorship,  —  the  only  excuse 
being  offered  for  it  was,  that  he  had  an  expensive  family, 
and  needed  the  income.  I  had  no  opportunity  of  hearing 
him  lecture,  and  judging  of  his  present  capability  for  myself, 
but  the  common  expression  was  as  I  have  stated.  It  was 
not  so  particularly  used  that  his  intellect  had  far  ^  decayed, 
but  that  he  was  antiquated  in  his  matter,  his  methods,  and 
spirit  of  teaching  —  not  being  up  to  the  demands  of  the  pre- 
sent day.  All  this  I  felt  the  more  to  regret,  as  I  have  a 
high  appreciation  of  Mr.  Lawrence's  moral  and  social  puali- 
ties,  and  of  his  former  professional  labors.  But  men  must 
grow  old,  and  their  confidence  in  themselves  is  not  usually 
the   one  first  to  fail. 

Mr,  L.  was  very  affable,  showing  me  all  his  cases  of  inter- 
est, and  speaking  of  them  freely.  I  saw  in  one  of  his  wards 
a  case  of  chronic  synovitis  of  the  knee,  with  thickning  of  th'e 
fibrous  structures  about.  The  patient  was  a  young  woman 
from  the  country,  of  a  better  class  than  are  usually  found  in 
hospitals,  of  fair  constitution,  not  scrofulous,  and  the  bones 
were  unaffected  —  but  the  disease  had  continued  for  five 
years,  though  without  supuration,  was  somewhat  painful,  and 
so  tender  as  to  prevent  the  patient  from  walking.  Mr.  Stan- 
ley was  called  in  consultation  to  determine  the  question  of 
amputation  of  the  thigh  for  the  purpose  of  relieving  the  fuf- 
ferer  of  a  useless  and  troublesome  member.  Much  treatment 
had  been  suffered  without  any  beneficial  effects!  Mr.  Stan- 
let  said,  and  repeated,  that  he  knew  of  no  treatment  that 
did  any  good  in  such  cases — none  whatever;  but  gave  the 
opinion  that  the  case  was  hardly  bad  enough  to  justify  an 
amputation.  The  operation  was,  however,  afterwards  perform- 
ed, and  a  few  days  subsequently  I  saw  her  in  a  state  of  fu- 
rious delirium,  alternating  with  spasms,  and  in  [a  most  preca- 
rious condition.  There  was,  indeed,  a  strong  probability  of  a 
fatal  termination,  but  this  being  my  last  visit  to  the  hospital, 
I  did  not  learn  the  result.  The  patient,  previous  to  the  opera- 
tion, was  in   a  very   comfortable    condition   of  health,  though 


662  The  Peninsular  and  Independent, 

lame,  and  it  seemed  to  me  so  severe  an  operation  in  an  hospi- 
tal where  fatal  results  are  so  likely  to  follow,  was  not  justifi- 
able. 

Mr.  Stanley,  the  author  of  the  excellent  work  on  the 
Bones,  is  a  short,  rather  stout  man,  fifty  or  upwards,  with  gray 
hair,  thick  pouting  underlip,  and  is  rather  abrupt  and  gruff"  in 
his  manners.  He  is  a  prompt,  vigorous,  decided  man  —  a  cool 
operator,  and,  I  have  no  doubt,  a  good  surgeon. 

Mr.  Skey  is  also  rather  a  stout  man,  somewhat  taller 
than  Mr.  Stanley,  and  a  few  years  his  senior.  He  is  a 
clear  -  headed,  straight  -  forward,  energetic  man,  an  excellent 
operator,  and  in  every  respect  a  good  surgeon.  His  remarks 
at  the  bed  -  side  were  always  sensible  and  to  the  point,  and 
he   was  followed  by  a   crowd   of  students  through  his  wards. 

Mr.  Paget  is  a  much  younger  man  than  either  of  the 
other  surgeons  mentioned,  is  slightly  above  the  medium 
height,  not  stout,  and  appears  remarkably  active  and  ener- 
getic. He  has  resigned  his  professorship  in  the  school,  his 
large  private  practice  rendering  it  no  object  for  him  to  re- 
tain it,  but  he  continues  ardently  devoted  to  the  science  of 
his  profession,  and  is  thought  to  be  '"destined  to]  rise  much 
above  even  his  present  very  high  position.  Those  who  are 
familiar  with  his  admirable  work  on  Surgical  Pathology,  have 
some  idea  of  his  abilities  as  a  thinker  and  writer  on  scientific 
subjects ;  and  he  is  thought  to  be  equally  clever  in  practice. 
He  retains  his  position  as  one  of  the  surgeons  of  the  hospi- 
tal, and  while  his  retiring  from  the  duties  of  a  didactive 
teacher  is  a  matter  of  much  resrret  to  the  friends  of  the 
school,  it  will  give  him  more  time  for  pursuing  his  scientific 
investigations,  and  his  private  practice  —  objects  which  he 
seems  to  have  more  at  heart.  All  agree  that  his  future  pro- 
mises will  be   even   more   brilliant  than  his  past. 

Of  the  other  physicians  and  surgeons  connected  with  St. 
Bartholomew's,  there  are  several  of  eminence  and  promise, 
but  I  saw  too  little  of  them  to  have  received^a  distinct  im- 
pression. The  institution  itself,  as  already  stated,  is  the  lar- 
gest and  most  ancient  in  London,  and  one  about  which  you 
will  be  most  interested,  perhaps,  to  know.  The  statistics  of 
the  amount  of  medicines  used,  show|  that  dosing  is  by  no 
means  given  over.     It  is  stated  that  2,000   pounds  weight   of 


Editorial  Department.  663 

castor  oil,  1,000  '^pounds  of  senna,  21  cwt.  of  salts,  12  tons 
of  linseed  meal,  are  among  the  annual  items.  The  number 
of  surgical  cases  may  be  judged  by  the  fact  that  5.000  yards 
of  calico  are  used  for  bandages  every  year.  They  seem  to 
have  confidence  in  sarsaparilla,  as  more  than  half  a  hundred 
weight  is  used  every  week,  and  that  they  are  not  altogether 
insensible  to  the  good  effects  of  blood  -letting,  is  shown  hj 
the  fact  that  within  a  single  year,,  not  long  since,  29,700 
leeches  were   bought  for   the   use   of  the   establishment. 

St.  Bartholomew's  has  many  associations  connected  with 
it.  Wm.  Harvey,  the  discoverer  of  the  Circulation  of  the 
Blood,  was  physician  to  this  hospital,  doing  duty  for  thirty- 
four  years,  and  establishing  rules  which  governed  his  succes- 
sors for  nearly  a  century.  A  little  more  than  one  hundred 
years  ago,  Edw^ard  Nourse  delivered  the  first  course  of  lec- 
tures on  the  subject  of  Anatomy  in  the  institution,  and  a 
few  years  later,  Percival  Pott  commenced  his  courses  on 
Surgery,  and  about  the  same  time,  Drs.  Wm.  and  David 
PiTCAiRN  commenced  courses  on  Medicine.  In  1787,  Mr. 
Abernethy  commenced  his  career  there.  From  these  begin- 
nings the  school  was  built  up  —  students  were  attracted,  and 
museums  and  other  appliances  were  provided.  To  the  funds 
of  the  hospital  Dr.  Radcliff  gave  £500  a  year  forever  to- 
wards "Mending  the  Diet,"  and  £100  forever,  for  the  pur- 
chase of  linen.  The  income  of  the  hospital  is  between  £30,- 
000  or  £40,000,  or  near  $200,000  a  year.  But  I  have  given 
quite  as  much  space  to  this  institution,  great  and  venerable 
as  it  is,  as  can  be  afforded.  I  will  close  this  letter,  already 
becoming  long,  by  a  brief  mention  of  the  great  Eye  Infir- 
mary at  Moorfield,  towards  the  Eastern  part  of  London. 
This  is  said  to  be  the  largest  establishment  of  the  kind  in 
the  world.  There  are  four  responsible  surgeons  in  attendance, 
with  several  assistants  and  patients,  are  met  daily  —  one -half 
of  the  staff  being  in  attendance  one  day  and  the  other  the 
next  —  alternating,  I  saw  most  of  Messrs.  Dixon  and  Hutch- 
inson—  the  former  author  of  an  excellent  practical  hand- 
book on  the  Eye,  and  the  latter,  the  editor  of  the  Medical 
Times  and  Gazette.  The  other  two  are  Messrs.  Crickett 
and  Bov^^man;  the  latter  of  whom  I  referred  to  in  a  former 
letter.  Mr.  Crickett  is  regarded  as  an  able  man,  and  ap- 
pears  well  among  his  patients. 


664  The  Peninsular  and  Independent. 

The  number  of  cases  returned  in  the  hospital  for  the 
establishment,  in  the  course  of  a  year,  is  almost  fabulous, 
affording  the  largest  opportunity  for  statistics  and  compari- 
sons of  different  modes  and  treatment.  The  opthalmiscope  is 
constantly  brought  into  requisition  in  diagnosis — a  solution 
of  the  sulphate  of  Atropine,  being  droped  into  the  eye  in- 
stead of  the  old  plan  of  painting  the  extract  xr^oxi  the  skin 
about  the   organ. 

They  depend  here  much  upon  mercury  in  Syphilitic  Iritis, 
treating  very  lightly  the  assertions  of  some,  that  it  may  be 
as   well  treated   without   it. 

In  Ulcers  of  the  conjunctivia  over  the  cornea,  accompa- 
nied with  vascularity,  &c.,  they  relied  entirely  on  general 
treatment — applying  only  placebos  to  the  part  to  prevent 
other  things  being  used.  Small  setons  in  the  temples,  and 
blisters,  were  sometimes  used  as  means  of  counter  -  irritation, 
but  no  caustic  or  irritating  applications  were  made  to  the 
ulcer. 

Inflammation  of  the  cornea  with  a  ground  glass  appear- 
ance—  a  general  haze,  indicated,  they  said,  a  hereditary  Sy- 
philitic taint.  The  teeth  would  be  found  in  nearly  all  of 
such  cases  peg -shaped  —  contracted  at  the  extremity  with  a 
concavity  or  notch  on  the  surface.  These  cases  of  ground  - 
glass  haziness  will  get  well  in  time  of  themselves  —  are,  ac- 
cording to  Mr.  Ckickett,  sure  to  recover,  but  some  mouths 
will  elapse. 

I  saw  under  Mr.  Dixon's  care  a  case  of  spontaneous  cure 
of  cataract  —  the  opaque  lens  having  fallen  below  and  out 
of  the  axis  of  vision.  Mr.  D.  said  he  had  seen  several  such 
cases.  It  would  seem  that  there  are  few  morbid  conditions 
entirely   beyond   the   curative   powers  of  nature. 

All  the  surgeons  at  this  institution  are  able  and  atten- 
tive, and  from  the  vast  numbers  of  patients,  excellent  oppor- 
tunities are  afforded  for  studying  this  interesting  class  of 
diseases. 

Yours    truly,  A.  B.  P. 


We  insert  the  following  letter  with  pleasure,  and  would 
be    glad  to  hear   from  other  of  our   former   students,  who 


Editorial  Department.  665 

have    suggestions    to   make  on   any  subject  connected  with 
the  profession. 

Houghton  Co.,  Mich.,  Jan.  1st,  1860. 
Prof.  A.    B,   Palmer.     Dear  Sir  :  —  I    am  truly   obliged 
for  your   invitation   to  report   for  your  Journal  such  cases 
of  interest  as  have  occurred  in  my  practice. 

Though  I  have  myself  been  deeply  interested  in  the 
progress  of  many  cases  coming  under  observation,  yet  the 
details  thereof  might  not  be  of  equal  interest  to  those 
older  practitioners  who  mostly  read  your  Journal. 

Yet  I  can  hardly  forbear  —  as  I  turn  over  the  pages  of 
my  Note  Book,  and  "pass  in  review''  the  associated  cir- 
cumstances of  certain  deeply  interesting  physical  and  psy- 
chical manifestations  of  a  morbid  nature  exhibited  in  the 
gemus  homo, — to  avail  myself  (in  all  modesty)  of  this  op- 
portunity to  offer  a  few  suggestions  for  the  benefit,  as  I 
hope,  of  the  candidate  for  professional  honors. 

There  is  a  period  in  the  history  of  nearly  every  scienti- 
fic and  approved  Physician,  when  though  nominally  shilled 
in  the  tactics  of  the  Healing  Art,  he  finds  himself  in  the 
condition  of  a  skillful  navigator,  thrown  upon  an  unknown 
sea,  without  chart  or  pilot,  surrounded  by  many  unfore- 
seen difficulties,  and  compelled  to  advance,  guided  only  by 
the  "general  principles,"  belonging  to  his  art,  and  that 
time  is  the  hour  of  graduation.  But  as  the  navigator,  who, 
aware  of  this  extremity,  and  realizing  the  value  of  the 
human  lives  intrusted  to  his  care,  eagerly  avails  himself 
of  all  the  knowledge  which  his  fellow  travellers  may  pos- 
sess so  the  young  physician  may,  we  believe,  profit  by 
the  counsel  of  those  who  have  passed  the  shoals  and 
quicksands  which  lie  in  his  course. 

We  ask  your  attention,  therefore,  while  we  cite — briefly 
—  a  few  of  the  errors  into  which  students  are  liable  to 
fall,  and  some  of  the  evil  consequences  resulting  therefrom. 
The  advanced  and  ambitious  student  charmed  by  the  beauty 


606  The  Peninsular  and  Independent. 

and  harmony  which  his  growing  knowledge  of  physiology, 
chemistry,  pathology,  &c.,  unfolds  to  view,  where  chaotic 
darkness  formerly  reigned,  is  prone  to  imagine  that  a 
clearer  understanding  of  those  principles  (so  requisite  to 
success)  will  illumine  every  dark  way,  and  shield  from  eyery 
embarrassment,  and  hence  he  passes  unregarded,  not  only 
minor  details,  but  the  isolated,  yet  important  facts  and 
teachings  brought  out  in  his  lecture  course. 

Again,  respecting  the  nature  and  treatment  of  not  only 
many  rare  and  grave  diseases  and  surgical  injuries,  but  also 
of  certain  whole  departments  of  professional  knowledge,  — 
(as  for  example  inflintile,  cutaneous,  syphilitic  or  conta- 
gious diseases)  students  sometimes,  we  believe,  exhibit  a 
total  disregard  or  neglect  during  the  lecture  term  (unless 
expected  to  appear  upon  the  examination  programme)  either 
through  a  dangerous  and  deceptive  belief  that  they  will 
never  come  up  for  treatment,  or  if  ever,  at  least  not  until 
time  has  been  allowed  to  master  them  in  some  uncertain 
hereafter.  Students  should  cultivate  the  habit  of  weighing 
duly  every  circumstance,  and  placing  an  appropriate  value 
upon  each  of  the  many  symptoms  which  may  point  per- 
chance in  opposite  directions,  and  after  arriving  at  a  care- 
ful diagnosis  should  recall  every  means  which  hygiene  and 
therapeutics  can  furnish,  and  thus  become  enabled  to  choose 
intelligently  from  the  entire  field.  It  is,  we  believe,  a 
"besetting  sin''  of  many  intelligent  practitioners  to  neglect 
important  points  in  diagnosis  and  important  adjuvants  in 
treatment  through  simple  forgetfulness,  hence  the  habit 
should  be  guarded  against  by  the  student. 

Again,  students  should  guard  against  treasuring  up 
those  general  and  important  facts  very  properly  dwelt 
upon  and  emphasized  in  a  course  of  lectures,  as  so  many 
fixed  and  unchanging  latvs,  or  adopting  certain  theories 
and  particular  modes  of  treatment  or  reasoning,  through 
mere  fancy,    or   on   account  of    their    simplicity,   or    sup- 


\ 


Editorial  Department,  667 

posed  harmony  with,  other  and  known  facts,  thereby  shut- 
ting out  from  the  mind  a  recognition  of  other  theories; 
—  and  also  the  habit  of  hoarding  up  old  recipes  and 
specifics  for  particular  disease,  because,  perchance  they  have 
been  used  by  older  and  wiser  heads  to  fulfill  some  cer- 
tain indications.  How  often  indeed  do  we  meet  with 
practitioners,  whose  only  idea  of  an  alterative  is  of  the 
Iodide  of  Potass  or  Calomel,  and  whose  alpha  and  omega 
prescription  for  pthisis,  of  all  grades  and  conditions,  is 
cod  liver  oil ;  or  cathartics  for  the  dysentary  of  all  sea- 
sons, climates  and  severities,  or  who  regard  the  double 
inclined  plane  as  the  only  safe  splint  for  fractures  of  the 
femur,  or  who,  recognizing  in  chloroform,  brandy  or  blood- 
letting (as  we  must  in  nearly  all  therapeutical  applian- 
ces) a  power  for  evil,  discard  them  in  toto  from  their 
list   of  medicaments. 

There  are  all  modifications  of  the  same  great  system 
of  quackery,  dwarfed  and  narrow  modes  of  reasoning, 
which  carried  into  practical  life  are  fraught  with  much 
evil  to  society,  and  are  to  be  carefully  shunned  in  the 
outset.  Since  they  lay  the  foundation  for  an  empirical 
routinism,  and  preclude  from  the  mind  of  the  physician 
a  full  appreciation  of  all  those  facts  and  symptoms  which 
incorporated  into  a  diagnosis,  form  the  only  reliable  basis 
for   the   application   of  our   therapeutics. 

It  was  in  the  summer  of  18 —  that  we  entered  upon 
our  professional  career  in  the  midst  of  a  rural  popula- 
tion, upon  the  shores  of  Saginaw  Bay,  our  saddle-bags 
plethoric  with  supposed  cures,  and  our  conceptions — we 
confess  it  —  befogged  by  some  of  those  mistaken  notions 
which  we  have  described,  exercising  but  imperfectly  the  glo- 
rious prerogative  of  independent  thought  and  action,  har- 
monized by  the  sure  light  of  science  ;  and  then  took  our 
first   real  lesson  in   the   art   of  healing. 

It  is  not  our  plan    to  detail    particular  examples  il- 


668  The  Peninsular  and  Independent. 

iQstrative  of  what  we  have  said,  or  to  spread  out  to 
view  isolated  cases,  the  disastrous  termination  of  which 
we  are  impelled  to  ascribe  (on  our  own  private  memor- 
andum) to  misconceptions  such  as  we  have  named,  or 
venture  to  suggest  whether  a  want  of  knowledge,  the 
highest  possible  degree  of  our  duty  as  physicians,  is  placed 
to  our  debit  upon  the  record  of  High  Heaven.  But  if 
ever  it  has  been  our  unenviable  fortune  to  protract  suf- 
fering or  hasten  dissolution  in  lieu  of  fulfilling  the  kindly 
office  of  relieving  or  restoring  our  diseased  fellow  crea- 
tures we  attribute  the  result,  not  alone  to  mental  defi- 
ciency and  professional  indifference,  but  in  part  also  for 
our  having  failed  to  survey  the  whole  ground  of  action, 
and  to  having  sacrificed  many  of  the  precious  hours  of  our 
pupilage  to  a  sceptical  incredulity  or  procrastinating  as- 
surance, which  has  left  us  in  the  very  morning  of  battle 
with  our  Strong- Holds  insecure^  and  our  forces  quite  un- 
skilled in  the  tactics  which  ;the  opening  movements  have 
demanded. 

The  Jiumility  at  least,  which  we  gain  from  our  own 
private  reminiscences  we  would  fain  spare  others  from  ex- 
periencing, and  we  believe  we  may  justly  admonish  the 
student  against  deferring  till  the  morrow  a  preparation  for 
every  duty  which  in  the  capacity  of  physician  can  pos- 
sibly stare  him  in  the  face.  So  that  whether  he  meets 
—  at  the  very  outset  —  with  a  strangulated  hernia,  a  de- 
veloping abscess  or  enlarged  sympathic  in  the  injunial 
region :  —  A  patient  suffering  from  simple  diarrhoea,  or 
from  a  typhoid  fever,  in  which  diarrhoea  is  the  most  pro- 
minent symptom  —  a  case  of  puerperal  convulsions  or  hys- 
terical fits  —  a  child  with  chronic  peritonitis,  or  simply 
indigestion  —  a  patient  laboring  under  cerebral  compression, 
or  beastly  intoxication — a  joint  attacked  with  synovitis, 
or  with  rheumatism — a  case  of  ovarian  dropsy,  of  normal 
pregnancy,    or    one    of   pseudo  -  pregnancy    with    apparent 


Editorial  Department.  669 

quickening,  occurring  without  conception  (an  anomaly  some- 
times observed  in  the  childless  matron)  —  an  infant  dying 
from  the  [opium  of  his  physician,  or  from  a  natural  di- 
sease—  a  2^1euritic  inflammation  or  a  rheumatic  stitch  — 
in  short,  any  of  the  fearful  and  unwelcome  cases  classed 
as  organic  disease,  or  any  of  the  mainfold  vagaries  of  the 
nervous  system,  he  may  be  equally  at  home  and  fully  pre- 
23ared   for   every   emergency. 

Though  the  time  allotted  th^  American  student  -  for 
his  preparatory  course  is  short,  yet  we  believe  if  it  be 
economically  and  wisely  employed,  he  may  enter  upon  his 
practical  duties,  better  prepared  to  assume  the  responsi- 
bilities, and  ^^bear  the  heat  and  burthen"  thereof,  than 
are   the   majority   of  our  young   recruits   at   present. 

We  think,  however,  it  can  not  be  doubted  that  a 
judicious  system  of  hospital  instruction  is  almost  indis- 
pensible,  and  we  are  truly  glad  that  our  State  Univer- 
sity  is   already   feeling   the   importance   of  the   demand. 

E— . 


For  the  Peninsular  and  Independent. 

Messrs.  Editors: — In  accordance  with  a  resolution  passed 
by  the  "Serapion  Society  of  the  Medical  Department  of  the 
University  of  Michigan,"  I  hereby  beg  leave  to  tender  our 
most  sincere  thanks  for  your  valuable  journal,  which  you  have 
so  kindly  sent  the  Society. 

The  Society  is  in  a  flourishing  condition.  The  regular  meet- 
ings are  held  on  Saturday  evening  of  each  week.  Through 
the  instrumentaHty  of  our  President,  Prof.  A.  Sager,  we  have 
obtained  a  spacious  and  elegant  book  case,  which  is  nearly 
filled  with  a  choice  collection  of  medical  works,  which  have 
been  principally  donated  by  publishers^  and  other  friends  of 
the  society,  to  whom  Ave  return  our  grateful  acknowledgments. 
We  hope  they  may  continue  their  good  work,  and  others,  see- 
ing this  notice,  may  be  induced  to  do  likewise,  i.  e.  send  the 
society  a  copy  of  their  journals. 


670  The  Peninsular  and  Independent, 

We  formerly  received  several  periodicals,  which,  I  am  sorry 
to  say,  have  not  been  received  for  a  few  months  past.     Should 
this   fall   under   the    notice   of   any    of  them,    they  will    please 
take  notice  that  "The  Sera])ion"  is  still  alive  and  kicking. 
]iespectfully  yours,  tS:c., 

J.  II.  FiNFiiocK,  Corresponding  Secretary. 
Serapion  Hall,  January  21st,  18G0. 


Proceedings  of  the  American  Pharmaceutical  Association,  1859. 

The  Minutes  of  the  Eii^^hth  Annual  meeting  of  the  above 
named  Association,  together  with  the  reports  and  scientific 
papers  read  at  its  sessions,  in  the  shape  of  a  neatly  juinted 
volume  of  over  400  pages,  is  beferc  us  for  notice.  The  min- 
utes of  the  meeting  were  copied  in  our  Journal  for  October, 
and  we  propose  here  only  to  notice  briefly  the  papers  read  at 
the   meeting. 

The  report  of  the  Committee  on  Weights  and  Measures, 
the  work  of  Mr.  At.fred  ]>.  Taylor,  of  l*hiladelphia,  is  the 
most  elaborate  and  complete  paper  on  any  subject  which  has 
ever  been  presented  to  the  Association.  It  consists  of  a  re- 
view of  all  the  existing  and  proposed  schemes,  and  while  vir- 
tually endorsing  the  decimal  system,  so  strongly  advocated  by 
its  friends,  yet  goes  farther,  in  proposing  an  entirely  new 
scale  of  notation,  the  octonary.,  the  scale  where  the  radix  is 
eight  instead  of  ten,  as  in  the  present  denary  one,  and  from 
this  scale,  he  proposes  to  create  a  new,  comprehensive,  and 
yet  uniform  system.  While  we  admire  Mr.  Taylor's  ideas 
upon  the  subject,  we  cannot  believe  the  world  yet  ready  for  so 
srreat   an   innovation. 

The  ability  and  thorough  research  displayed  by  Mr.  Tay- 
lor in  making  up  his  report,  will  give  him  a  prominent 
and  honorable  position  among  writers  upon  Weights  and 
Measures. 

The  report  upon  Progress  of  Pharmacy  occupies  65  pages 
of  the  proceedings,  and  consists,  as  heretofore,  of  condensed 
notices  of  improvements  and  discoveries  made  in  Pharmacy 
and  its  accessory  arts.  Abstracts  of  this  report  will  be 
found  in   our  Pharmaceutical   department. 

The  report   upon  the  Revision   of  the  Pharmacopacia,  con- 


Editorial  Department.  671 

tains  a  digest  of  the  most  important  suggestions  of  the  pre- 
vious Committees,  the  principles  upon  which  the  Committee 
acted  are  the  following : 

"1st.  There'' should  be  no  important  changes  in  nomencla- 
ture or  in  processes,  unless  imperatively  demanded  by  the 
requirements  of  practice,  or  necessary  to  keej)  pace  with  the 
progress  of  Pharmaceutical  Science. 

2d.  The  Pharmacopoeia  not  being  a  scientific  but  a  prac- 
tical code,  should  contain  none  but  the  most  plain  and  prac- 
ticable formula3 ;  its  nomenclature  should  be  maintained  upon 
such  a  basis  as  will  not  be  liable  to  fluctuation,  and  simplici- 
ty and   accuracy  should  be  its   leading  features. 

3d.  No  drug  or  preparation  should  be  inserted  in  the 
Pharmacopa'ia  until  it  has  an  extended  reputation  in  at  least 
several  localities  —  except  improved  forms  of  preparation  for 
well   known   drugs. 

4th.  The  Pharmacopoeia  not  being  designed  to  furnish  all 
the  combinations  called  for  in  practice,  should  contain  only 
a,  limited  number  of  extemporaneous  preparations  which  are 
well  adapted  to  general  wants  and  of  utility  to  both  Physi- 
clan  and  Pharmaceutist." 

The  process  of  Percolation  is  recommended  to  replace  the 
ordinary  methods  of  Maceration  as  now  directed,  and  the 
admirable  suggestions  of  Prof.  Graham,  in  this  department  of 
Pharmacy,   are  advocated. 

The  additions  proposed  to  the  primary  list  of  the  Materia 
Medica,   are   16   in   number,   as  follows: 

List  of  articles  it  is  proposed  to  transfer  from  the  Se^ 
condary   to   the   Primary   List : 

1.  Arnica  —  Leopard's  Bane.  The  flowers  of  Arnica  Mon- 
tana. 

2.  Asarum — Wild  Ginger  (Canada  Snake  Root).  The  root 
of  Asarum  Canadense. 

3.  Cataria  —  Catnip.     The  leaves  of  Nepeta  Cataria. 

4.  Coptis  —  Goldthread.     The  root  of  Coptis  Trifolia. 

5.  Extractum  Cannabis — Extract  of  Hemp.  An  alcoholic 
extract  of  dried  tops  of  Cannabis   Satavia,  Var.   Indica. 

6.  Filix  Mas — Malefern.  The  rhizome  of  Aspidium  Filix 
Mas. 

7.  Heleanthemum  —  Frost  Wort.  The  herb  of  Heleanthe- 
mum  Canadense. 


672  The  Peninsular  and  Independent. 

8.  Oleum  Cajiiputi  —  Oil    of   Cajeput.     The   volatile    oil   of 
the  leaves   of  Mulaleiica   Cajuputis. 

9.  Pareira — Pareira  Brava.     Tlie  root   of  Cissampelos  Pa- 
reira. 

10.  Salvia  —  Sage.     The   leaves   of  Salvia  Officinalis. 

11.  Saiubiiciis  —  Elder   Flowers.     The   Flowers   of  Sambu- 
cus   Canadensis. 

12.  Scoparius — Ijroom.     The    fresh    tops   of  Cytisus    Sco- 
pariiis. 

13.  J\racis  —  Mace.     The  anyllus   of  the   fruit   of   Myristica 
Morchase. 

14.  Marrubiuni  —  Ilorehound.     ,The    herb     of    Marrubiuiu 
Vulgare. 

15.  ]\Iatricaria  —  German   Chamomile.     The   tlowers  of  Ma- 
tricaria  Chamomilla. 

10.     jMelissa  —  lialm.     The    herb    of  Melissa   Officinalis. 

PllOrOSED    NEW    OFFICINAL.S. 

Acidum   Lacticum  —  Lactic   acid    (descrijjtion    and   tests). 

Acidum   l^hosphoricum — Glacial  Phosphoric   Acids  (descrip* 
tion   and   tests). 

^tlier  (description   and   tests). 

Alcohol  Amylum  —  Fusil  Oil  (description  and  tests). 

Ammoniiv)  Carbonas. 

Ammoniie   Sulphas. 

Aqua   Flores  Aurantii. 

Artemisia   Contra    (Levant   Worm    Seed,)    or  Santonica   Se- 
men. 

Belladonna  Radix. 

Caffea  — Coffee. 

Capsicum  Baccatum — Birdpepper.      (Change    Capsicum,    as 
at   present,  to    Capsicuum  Annuum. 

Chiretta  —  The   herb   and   root  of  Agathotes    Chirayta. 

Chloroformum — (description   and   tests). 

Gelseminum — Queen's  Delight.     Root  of  Gelsemiuum  Sem- 
pervirens. 

Glycerina  —  Glycerin.     A  peculiar  sweet   principle   obtained 
from   fats. 

Gossypii  Radix  —  Cotton    Root.      The   root   of    Gossypium 
Herbaceum,   and  of  other   species   of  G. 

Hydrastis  Canadensis — Yellow    Root.     Golden    Seal.     The 
root  of  Hydrastis   Canadensis. 


*  Editorial  Department.  673 

Ignatia  Amara — St.  Ignatius  Bean.    The  seeds  of  Strychnos 
St.  Ignatia3. 

Leptandra,  Culver's  Physic.     The  root  of  Leptandra  Virgin- 
ica. 

Lobelia  Semen. 

Lycopodium — A   peculiar  powder    from    Lycopodium   Cla- 
vatum,   and  other  species. 

Oleum  Adipis — Lard  Oil.     The  fluid  portion  of  lard,  separa- 
ted by  expression. 

Oleum  ^thereum  —  Ethereal   Oil.    With  description. 

Oleum  Camphora3  —  Oil  of  Camphor.     With   description. 

Oleum  Succini —  Oil  of  Amber    (with  description,   from   the 
preparation). 

Saccharum  Lactis  —  Sugar  of  Milk.    Lacten.    The    peculiar 
sugar  obtained  from  milk. 

Spiritus  Lauri  Folios  —  Bay  Rum.     The  distilled  spirit  from 
bay   leaves. 

Vanilla  —  Vanilla  Beans.     The  prepared  unripe   Capsules  of 
Vanilla  Aromatica. 

Amygdala  Persica  —  Peach  Leaves.     The  leaves  of  Amyg- 
dalas  Persica. 

ADD   TO    SECONDARY   LIST. 

Achillea  Millefolium — Millefoil.     Yarrow. 

Angelica  Archangelica  —  Angelica  Root. 

Baptisia  Tinctoria  —  Wild  Indigo.     The   herb. 

Berberis   Vulgare  —  Barberry.     The  root. 

Caulophyllum   Calactroides.     Blue  Cohosh.     The  root. 

Corydalis   Formosa — Turkey   Corn.     The  tubers. 

Cucurbita  Pepo  —  Pumpkin   Seeds. 

Cyprepedium  Pubescens — Nerve  Root. 

Epigea   Repens  —  Trailing  Arbutus. 

Euonymus  Atropurpureus  —  Wahoo.     Bark. 

Eupatoreum  Purpureum  —  Gravelroot.     Ironweed. 

Hydrangea  Arborescens  —  Hydrangea  Root. 

Myrica  Cereca  —  Bayberry  Bark, 

Rubus  Idea3us  —  Raspberries.     The    fruit. 

Rumex  Crispus — Yellow  Dock.    The  root." 

It  is  recommended  to    reduce    the   specific   gravity  of   the 
Liquor  Ammonia  fortior    on    account  of  accidents    resulting 

Vol  II.-2S 


674  The  Peninsular  and  Independent. 

from  handling  it,  to  920,  so  that  by  dilution  with  an  equal 
bulk  of  water,  it  shall  be  of  the  proper  strength  for  ordinary- 
use. 

8pts.  Ainmon.  Aro.  is  recommended  to  be  made  by  dis- 
solving carbonate  of  Ammonia  in  spirits  with  the  addition  of 
the  essential  oils  of  Cassia,  Clover  and   Orange  peel. 

Several  formula)  are  proposed  as  substitutes  for  inferior 
ones,  now  oflicinal  in  nearly  every  class  of  the  preparations  of 
the  PharmacopoDcia,  many  of  which  we  would  like  to  insert 
here,  but   want  of  space  forbids  doing  it. 

The  report  upon  Home  Adulteration  we  copied  in  full 
some  months  back,  it  being  the  most  complete  one  on  the  sub- 
ject which   has  ever  been  written   for  the   Association. 

Among  special  reports,  that  of  Prof.  Picoctor  on  Fluid 
Extracts,  is  especially  worthy  of  notice.  We  take  the  follow- 
ing from   the   prefatory  remarks: 

"After  some  reflection,  it  was  determined  to  consider  in 
groups  the  several  drugs  approj^riate  for  fluid  extracts,  the 
generic  character  of  which  was  to  be  derived  from  an  analogy 
of  composition  or  of  behavior  with  solvents,  by  which  the 
same  process  could  be  employed  for  each  member  of  a  group ; 
leaving  all  those  drugs  which  possessed  some  peculiarity  of 
constitution,  rendering  it  necessary  to  be  treated  by  special 
process. 

In  the  formulae  adopted,  it  has  not  been  designed  to  re- 
tain in  solution  all  tlie  matter  dissolved  by  the  menstruum 
from  each  drug,  as  suggested  by  some ;  nor  to  reject  all  not 
usefully  medicinal  as  sought  by  others ;  but  to  extract  as  flir 
as  possible  all  the  valuable  ingredients,  and  to  condense  them 
into  the  required  bulk,  of  an  ounce  to  the  fluid  ounce,  except 
in  the  oleoresins,  in  the  way  least  calculated  to  injure  then* 
medicinal  virtues  and  sensible  qualities,  leaving  the  resulting 
menstruum  appropriate  for  retaining  the  active  matter  in  solu- 
tion. 

As  regards  the  means  for  their  preservation  from  decom- 
position, alcohol  and  sugar  have  been  employed,  as  the  cases 
demanded,  and  in  a  few  instances  acetic  acid  is  added  for 
special  reasons.  The  process  of  percolation  have  been  almost 
nvariably   used,  as   best   adapted  to  effect  the   desired  objects 


Editorial  Department.  675 

and  the  formulae,  both  in  manipulation  and  quantities,  are 
based  on  the  supposition  that  they  are  to  be  carried  out  in 
the  shop  or  laboratory  of  the  apothecary,  and  not  on  the 
large   scale   by  the  manufacturer. 

Where  alcohol  has  been  used  as  the  agent  for  preserva- 
tion, it  has  been  employed  in  the  form  of  the  first  dense  so- 
lution obtained  in  the  percolation,  regulating  the  quantity  re- 
served for  this  purpose  by  the  quantity  of  alcohol  to  be  re- 
tained in  the  fluid  extract,  and  evaporating  the  weaker  liquors 
till  reduced  to  a  bulk  sufficient  to  make  up  the  required 
measure  by  an  indirect  heat  of  about  150^  F.  in  an  open 
vessel. 

When  sugar  has  been  employed  as  the  preservative  agent, 
it  is  added  to  the  percolate  before  the  completion  of  the 
evaporation,  so  as  to  take  advantage  of  the  well  ascertained 
solvent  power  of  sugar  in  regard  to  resmous  and  apothemic 
matter. 

A  new  class  of  oleoresinous  fluid  extracts  has  been  sug- 
gested in  whicli  the  stronger  aromatics  have  been  introduced, 
such  as  cloves,  cinnamon,  cardamon,  &c.,  and  which  possess, 
for  certain  uses,  very  desirable  advantages  from  their  concen- 
tration. 

Tlie  number^of  oleoresins  has  been  considerably  increased  on 
the  ground  that  they  represent  their  respective  sources  more 
completely,  and  in  smaller  bulks  than  any  other  form  of  fluid  or 
semi  -  fluid  extracts.  For  this  reason,  also,  it  is  insisted  that 
they  should  occupy  a  distinct  position  under  the  name  of 
"  Oleoresins,"  and  thus  avoid  the  necessity  of  making  a  dis- 
crepancy in  the  proportional  strength  of  all  those  preparations 
which  go  by  the  name  of  fluid  extracts." 

The  seventy -five  formulas  brought  forward  by  Prof.  Peoc- 
TOR,  show  an  amount  of  labor  and  experiment,  at  once  of 
value  to  the  prospective  Convention  on  Revision,  and  com- 
plimentary  to   the   author   of  the   report. 

Edwaed  Pareish,  in  a  report  upon  Mustard,  thinks  there 
is  no  liquid  preparation  of  it,  equal  in  value  as  a  rubifa- 
ciant,  to  the  form  in  which  it  is  ordinarily  employed,  viz.: 
the   cataplasm. 

Edwin  O.  ,  Gale,  of  Chicago,  who  has  investigated  to 
some   extent  the   properties   of  the  resin  of  the  Silphium  La^ 


676  Ihe  Peninsular  and  Independent, 

ciniatum^  or  rosin  weed,  reports  that  its  similarity  to  raus- 
tich,  on  physical  properties,  leads  him  to  believe  that  it  may 
advantageously  be   substituted   for  it. 

Robert  Battey,  M.  D.,  of  Georgia,  furnished  an  able  re- 
port upon  the  Sorghum  Saccharatum,  its  culture  and  pro- 
ducts, after  detailing  his  experiments,  which  prove  that  crys- 
talizable  sugar  can  be  made  from  it.  He  offers  the  following 
conclusions. 

"With  reference  to  the  economical  production  of  sugar 
from  this  plant,  no  satisfiictory  conclusions  can  be  drawn  as 
yet;  much  careful  experiment  and  research  will  be  required 
to  ensure  the  production  of  a  juice  which  shall  contain  the 
maximum  quantity  of  *  crystalizable  sugar  with  the  minimum 
of  the  objectionable  vegetable  principles.  It  is  also  probable 
that  the  discovery  of  some  additional  means  of  defecation 
may  become  necessary  before  the  desired  object  can  be  re- 
alized. It  would  seem  not  unreasonable  to  believe  that  a 
plant  so  easily  [grown  in  all  sections  of  our  country,  and 
containing,  under  favorable  circumstances,  so  large  a  percen- 
tage of  cane  sugar,  will  eventually  be  made  a  valuable 
source   of  this  important   staple. 

For  the  production  of  syrup,  if  we  could  but  succeed  in 
defecating  the  juice  upon  a  large  scale  and  by  simple  means 
of  easy  attainment,  so  as  to  make  it  keep  good  for  an  in- 
definite period,  we  should  accomplish  very  much  for  the  be- 
nefit of  the  Southern  planter  and  the  negro.  It  is  found  by 
experience  that  however  well  the  syrup  may  be  boiled,  and 
however  palatable  it  may  be  for  the  first  few  months,  as 
the  season  advances,  if  it  be  not  so  thin  as  to  ferment  and 
sour,  it  undergoes  a  quiet,  viscous  fermentation,  which  ren- 
ders it  slimy,  in  some  instances  gelatinous,  and  always  ruins 
the  flavor.  Until  this  trouble  is  overcome,  the  sp'up  will  be 
made  only  upon  a  small  scale,  and  this  for  early  consumption.'' 

The  volume  of  proceedings  contains  many  other  interest- 
ing reports  which  our  space  will  not  even  allow  us  to  men- 
tion. Suffice  it  to  say,  that  at  the  price  the  Association  of- 
fer it,  it  should  be  in  the  hands  of  every  medical  practitioner, 
as   well  as  pharmaceutist    of  the  country. 

The  publishers  of  this  Journal  will  forward  it  to  those 
desiring  it.     Price   $1.25,  which  includes  postage. 

F.  S. 


Editorial  Department,  677 

THE  CATALOGUE  of  the  Officers  and  Students  of  the  State  Univer- 
sity of  Michigan,  for   1860. 

This  neat,  and  for  a  catalogue,  portly  looking  document 
of  over  70  pages,  is  before  us,  giving  a  list  of  its  Board  of 
Regents,  consisting  of  ten  members  elected  by  the  people, — 
one  from  each  of  the  judicial  districts  of  the  State,  with  the 
President  of  the  University  as  its  presiding  officer,  and  a 
Secretary,  Treasurer,  i^  and  Steward  —  the  Superintendent  of 
Public  Instruction  and  the  Board  of  Visitors,  consisting  of 
three,  appointed  by  the  Superintendent,  and  having  a  Super- 
visory capacity  —  of  the  members  of  the  Faculty  and  [officers 
of  the  instructing  corps,  twenty -eight  in  number,  including 
all  the  departments  —  of  the  separate  Faculties  of  the  De- 
partment of  Science,  Literature,  and  the  Arts  —  of  Medicine 
and  Surgery,  and  of  Law.  It  contains,  also,  a  list  of  the 
graduates  of  the  different  departments  for  the  last  year,  sev- 
enty-seven in  number,  and  of  the  students  in  all  the  depart- 
ments at  the  time  of  publication.  Besides,  a  large  amouat 
of  information  respecting  the  organization  of  the  University, 
the  terms  of  admission,  the  courses  of  instruction,  and  the 
means  of  illustration  is  given,  and  various  remarks  upon  the 
endowment  of  the  University  and  its  popular  character  —  its 
freedom  to   all,   are   made. 

As  to  the  number  of  students,  we  learn  by  counting  them 
up,  and  not  from  the  exceedmgly  erroneous  "summary"  of 
figures  in  page  36,  that  in  the  Department  of  Science,  Liter- 
ature, and  the  Arts,  there  are  285,  viz :  in  the  first  year's 
course,  52 ;  in  the  second,  57  ;  in  the  third,  59 :  in  the  fourth, 
35 ;  in  select  courses,  42  ;  and  of  resident  graduates,  and  stu- 
dents in  special  courses,  not  otherwise  designated,  40 ;  in 
the  Department  of  Medicine  and  Surgery,  169;  and  in  the 
Department  of  Law,  92 ;  making  in  all  546.  These  numbers 
indicate  a  very  high  degree  of  prosperity,  and  must  be  re- 
garded as  reflecting  credit  upon  those  to  whom  its  general 
affairs  have  been  entrusted.  From  a  moderate  beginning,  the 
University  of  Michigan  has  come  to  be  a  fact  of  no  small 
importance  in  the  history  and  condition  of  the  State,  and  in- 
deed of  the  country,  and  from  the  foundation  already  estab- 
lished, if  the  management  continue  to  be  wise,  and  in  ac- 
cordance  with  the    requirements    of   the  times,   it  must   con- 


678  The  Perdnsular  and  Independent. 

tinue   to   prosper,   and   maintain  its   position    among    the  very 
first  institutions  of  learning  in   the   country,    as   it  now  stands 

first  among  those   of  the   enterprising   and   energetic  West. 

A.  B.  P. 


THE  USE  AND  ABUSE  OF  TOBACCO.  By  John  Lizars,  late  Pro- 
fessor of  Surgery  to  the  Royal  Col.  of  Surgeons,  and  Surgeon  to 
the  Royal  Infirmary  of  Edinburgh.  From  the  8th  Edinburgh  Edi- 
tion.    Philadelphia :   Lindsay   &   Blakiston,  •  1859. 

This  brochure  of  138  pages  contains  a  faithful  exposition  of, 
and  an  earnest  protest  against  the  pernicious  habit  of  Slow 
Tobacco  poisoning,  so  exceedingly  common  among  us,  sapping 
the  energies  of  so  many  of  our  young  men.  Agreeing  with 
the  author  in  liis  leadmg  object,  Ave  commend  the  work  to 
the  attention  of  all.  *  A.  B.  P. 

The  Woman's  Uospitnl  Association  of  New  Torlf. 

We  see  from  the  secular  papers  that  the  Fifth  Anniversary 
of  this  Association  took  place  on  a  recent  occasion,  at  the 
building  temporarily  occupied  as  a  Hospital  for  the  treatment 
of  Vesico  -  Vaginal  Fistulte,  and  similar  accidents  and  diseases 
of  women,  under  the  charge  of  Dr.  J.  Marion  Sims.  Our 
readers  may  not  all  know,  that  an  organization  for  placing  Dr. 
Sims  in  a  position  to  extend  the  benefits  of  his  very  success- 
ful mode  of  treatment  in  these  distressing  cases,  has  been 
formed  by  some  of  the  leading  ladies  and  gentlemen  of  New 
York ;  —  that  the  State  has  presented  the  Institution  with 
$10,000,  with  encouragement  for  further  aid  provided  money 
was  raised  fi*om  other  sources ;  —  that  the  city  of  New  York 
has  presented  it  with  a  large  and  healthy  site  for  the  Hospital 
of  a  whole  square,  designed  to  include  a  Lying  -  in  -  depart- 
ment ;  —  that  a  building  300  feet  long  by  four  stories  high, 
containing  at  least  200  beds,  and  costing  $200,000,  is  in  con- 
templation of  as  speedy  erection  as  possible  —  that  during  the 
past  year  in  their  temporary  and  limited  rooms,  158  patients 
have  been  admitted,  of  whom  83  have  been  permanently 
cured,  40  permanently  relieved,  2  died,  and  3  incurable,  —  30 
remaining  under  treatment ;  —  and  that  patients  to  the  Insti- 
tution have   been   supported  from    nearly   every   State    in    the 


Editorial  Department.  '  679 

Union,    from    Central   and    South    America,    from  the    British 
Provinces,  and  from  England  and  even  China. 

We  rejoice  at  these  evidences  of  success,  not  merely  on 
account  of  the  relief  afforded  to  suffering,  but  for  the  appre- 
ciation of  the  merits  of  Dr.  Sims  by  non  -  professional  citizens 
of  New  York,  as  well  as  by  the  profession  throughout  this 
country  and  Europe.  On  the  occasion  of  the  Anniversary  re- 
ferred to,  Drs.  Feancis  Stevens,  and  Geegoey,  and  Hon.  J.  W, 
Beekman  and  Petee  Coopee,  —  the  Revs.  Messrs.  Peime  and 
WiLBUEN  made  speeches,  and  Petee  Coopee  made  a  munifi- 
cent donation   of  815,000  towards   the   building. 

We  congratulate  Dr.  Sims  and  the  ladies  of  New  York, 
who  have  so  warmly  sympathized  with  him,  upon  the  pros- 
pects of  their  enterprise.  It  is  honorable  alike  to  them  and 
him,  and  also  to  a  department  of  American  Surgery,  which 
he  so   ably  represents.  A.  B.  P. 


ALCOHOL:     Its  Place   and   Powers.     By  James    Miller,   Professor  of 
Surgery   in    the   L^niversity    of    Edinburgh,    Surgeon   in   Ordinary 
to   the   Queen,   for    Scotland,    &c.,   &c.      From    the   19th    Glasgow 
Edition.    Philadelphia:     Lindsay  &  Blackiston,  1859. 

The  subject  of  the  little  volume,  whose  title  is  as  above, 
must  be  acknowledged  to  be  one  of  very  great  interest  and 
importance  —  interest  as  a  scientific  question,  and  importance, 
as  proper  decisions  of  the  questions  involved,  and  accordant 
action  upon  them,  have  such  intimate  relations  with  the  wel- 
fare of  mankind.  Fortunately  or  unfortunately  —  for  good  or 
evils,  alcohol  has  a  place  in  nearly  all  civilized,  ^and  most 
barbarous  communities,  and  deeply  influences  the  weal  and 
woe  of  a  large  portion  of  the  human  race.  That  it  does  incalcula- 
ble harm,  none"  deny,  while  it  is  capable  of  good  most  be- 
heve.  An  article  of  such  immense  capabilities,  and  really  ex- 
erting so  much  power,  is  certainly  worthy  of  careful  ex- 
amination and  study,  and  deserves  more  scientific  attention 
from  the  profession  than  it  receives.  As  a  basis  of  social 
custom  and  of  legislative  action,  its  character  and  place 
should  be  accurately  determined.  Though  many  of  the  facts 
in  relation  to  this  subject  are  open  to  the  observation  and 
judgment  of  all,  so  that  whosoever  runs  may  read,  yet  there 
are   others     more  hidden   and    obscure,   capable    of   being  un- 


680      -  The  Peninsular  and  Independent. 

derstood  by  members  of  the  medical  profession  alone  —  by 
those  familiar  with  the  elements  of  nature  —  with  the  chem- 
istry, physiology,  pathology  and  therapeutics.  This  class  of 
facts,  it  is  the  duty,  as  seems  to  us,  of  the  profession  to 
bring  before  the  public.  In  the  work  before  us  such  an  at- 
tempt is  made,  and   on  the   whole,  with  success. 

The  author  refers  to  the  able  and  more  scientific  work 
of  Dr.  Carpenter  on  "  The  Physiology  of  Temperance  and 
Total  abstinence,"  and  of  Dr.  Charles  Wilson,  on  "The 
Pathology  of  Drunkenness,"  as  excellent,  trustworthy  and  tell- 
ing; but  says  a  desire  has  been  expressed  to  have  a  more 
homely  exposition  of  the  matter,  and  one  more  accessible  to 
the  popular  hand  and  mind,  and  he  has  not  felt  at  liberty 
to   decline  the  task. 

He  takes  the  broad  ground,  but  the  only  one  at  all 
tenable  on  any  scientific  basis,  that  alcohol  is  a  poison  — 
that  in  Chemistry  and  Physiology,  this  is  its  proper  place 
—  quoting  the  highest  authorities  in  the  profession,  and  re- 
ferring to  well  known  facts  to  substantiate  his  position.  This 
is  by  no  means  inconsistent  with  the  fact,  as  he  plainly  shows, 
that  it  may  be  useful  as  a  medicine^  any  more  than  that 
arsenic,  morphine,  or  prussic  acid,  may  not  be  useful  because 
they  are  poisonous.  The  fact  is  that  all  these  articles,  inclu- 
ding alcohol,  in  whatever  combinations  or  mixtures  presented, 
should  be  placed  together,  so  far  as  the  question  of  poisons 
is  concerned; — regarded  as  disturbers  of  the  physiological  or 
healthy  actions,  and  beneficial  only  in  relation  to  morbid  con- 
ditions —  as  useful  only  in  modifying  diseased  actions.  What 
are  the  simple  facts?  All  these  articles  in  certain  quanti- 
ties, but  independently  of  bulk  or  any  mere  physical  or 
mechanical  qualities,  when  taken  into  the  animal  organ- 
ism, will  produce  death.  In  certain  diminished  quanti- 
ties, though  death  may  not  follow,  serious  toxicological  ef- 
fects are  manifest.  In  still  smaller  quantities,  less  decided, 
but  still  appreciable  de\iations  from  physiological  actions  are 
induced,  while  the  ^quantities  may  be  so  reduced  that  no  ef- 
fects are  perceptible.  In  each  of  these  particulars  all  the  ar- 
ticles agree  —  and  further,  those  especially  which  are  narcotic, 
agree,  under  certain  circumstances,  and  particularly  when  their 
■use  becomes  habitual,   in  rendering  the  sensations  more  agree- 


Editorial  Department.  681 

able,    and    causing    temporarily  some    of   the  functions  to  be 
more  actively  performed.     By  all  the  articles,  when  these  im- 
pressions are  habitually  made,   and  in  proportion   to  their  fre- 
quency and  profoundness,  will  the  powers  of  the   organism  be 
injured — exhausted  and  deranged.     All  are  capable   of  produ- 
cing   beneficial  effects    in  certain   diseases    to   which   they   are 
adapted  —  though  opium,   for  instance,   much    more   frequently 
than  alcohol,    and  arsenic,   perhaps,  than  prussic   acid ;   yet,  in 
all  particulars  relating  to  the  question  of  poisons,  they  agree, 
and  must  be   all  looked  upon  in  the  same  light  by  every  sci- 
entific  man.      These  are  simple  facts  impossible  to    be  denied, 
and  the  fair  inference   seems  to    be    that    the    articles  should 
be   avoided  in   the    healthy  or  physiological   condition,  and  in 
morbid  conditions  should  only  be    resorted  to  for  strictly  me- 
dical effects,   and   should    be   discontinued    the    moment    these 
effects  cease  to  bear  a  curative  relation    to   morbid   conditions 
existing.     Man  was  no  more   created  with  reference  to  the  use 
of  alcohol   than    to  that  of  opium  or  any    other    poison.     The 
use  of  any  of  these  articles  may  become  general  in  a  commu- 
nity or    habitual  with   an    individual,   under    the    influence    of 
fashion   or   custom ;  but  this  fact,   lamentable  as  it  is,  does  not 
interfere   with   the   other  fact,    that  the   articles  are  poisonous 
and  destructive. 

In  this  same  category,  we  might  and  should  have  included 
tobacco,  and  the  sad  history  of  all  these  articles  is  in  melan- 
choly accordance  with  the  principles  announced.  Disease  and 
misery  (though  in  different  degrees  in  the  different  articles), 
have  ever  followed  in  the  wake  of  their  habitual  use.  It 
would  be  an  imputation  upon  the  wisdom  of  the  Creator  .to 
suppose,  that  an  article  so  frequently,  yea,  so  constantly  in- 
flicting the  most  terrible  moral  and  physical  evils  upon  hu- 
manity, as  alcohol  does,  wherever  its  use  is  generally  indul- 
ged, should  be  made  necessary  for  the  highest  development, 
or  in  health  for  the  well  being  and'  permanent  comfort  of 
man.  It  is  not  so,  and  all  reason  and  all  experience  cries  out 
against  this  position. 

It  would  give  us  pleasure  to  follow  Prof.  Miller  through 
his  volume,  giving  some  of  his  arguments,  facts,  and  statistics, 
but  we  have  not  space,  and  can  only  commend  the  book  to 
our  readers. 


682  The  Peninsular  and  Independent. 

Before  leaving  the  subject,  we  cannot  refrain  from  refer- 
ring our  readers  to  the  article  in  our  January  number,  "On 
the  effects  of  the  use  of  Alcoholic  Liquors  in  the  Tuberculous 
Diseases,  or  in  Constitutions  Predisposed  to  such  Diseases"  — 
an  original  review  written  by  our  colaborator.  Dr.  M.  A.  Pat- 
TEESON,  but  by  mistake  placed  under  the  head  of  "  Selected 
Articles,  Abstracts,  &c.  In  the  Essay  of  Dr.  John  Bell,  of 
N.  Y.,  there  referred  to,  and  in  Dr.  P.'s  article  itself,  the 
modern  and  American,  but  as  we  for  some  years  have  be- 
lieved, the  erroneous  doctrine,  that  alcoholic  liquors  have  spe- 
cial tendencies  to  prevent  and  cure  consumption,  have  receiv- 
ed a  blow  from  which  it  Avill  not  readily  recover.  That  tu- 
berculosis is  better  treated  by  a  generous  diet,  tonics  and  out- 
door exercise,  than  by  low  diet,  digitalis,  mercury  and  anti- 
mony, with  confinement  to  a  chamber,  no  one  now  doubts  — 
even  though  under  the  new  plan  alcohol  be  indulged  in  —  but 
that  it  is  of  itself  especially  prophylactic  or  curative,  is  a  delu- 
sion sustained  neither  by  reason  or  facts.  We  believe  that 'al- 
cohol has  received  credit  due  to  the  concomitant  good  diet 
and  out-of-door  exercise.  A.  B.  P. 


Proceedings  of  Elgtatb  Annual  Meeting  of  Michigan  State  Medical  Society,  beld  at 

Coldwater,  January  IStb,  1860. 


The  Society  was  called  to  order  at  three  o'clock,  P.  M., 
Vice-President  Dr.  M.  Gunn  in  the  chair. 

The  Secretary  being  absent,  on  motion.  Dr.  Wm.  Brodie 
was  appointed  Secretary  pro  tern. 

On  motion,  the  reading  of  the  minutes  was  dispensed  with, 
they  having  been  printed  and  distributed. 

Members  present,  Dr.  M.  Gunn,  V.  P.,  Dr.  Wm.  Brodie, 
Secretary  P.  T.,  Dr.  S.  M.  Axford,  Dr.  J.  H.  Beech,  Dr.  S.  S. 
Cutter,  Dr.  A.  F.  Whalen,  each  of  whom  paid  the  annual  fee. 

On  motion,  the  Secretary  was  authorized  to  pay  the  ex- 
penses of  printing  notices  of  meeting  in  the  Detroit  daily 
papers. 

There  being  so  few  members  present,  owing  to  the  want 
'of  the  proper  notification  through  the  usual  channel,  it  was 
deemed  advisable  to  defer  all  business  pertaining  to  the  meet- 
ing," and  adjourn  to  some  other  place.  Therefore,  it  was  unani- 
mously 


Editorial  Department.  683 

Resolved^  That  the  Society  adjourn  to  meet  at  Ann  Arbor 
at  two  o'clock  of  Commencement  Day,  being  the  29th  day 
of  March,  1860. 

Wm.  Beodie,  &e(^y  pro  tern. 


A  Good   Appointment 

The  new  Medical  School  in  Chicago,  —  the  Medical  De- 
partment of  "Lind  University,"  noticed  in  our  last  number, 
has  secured  for  the  Chair  of  Anatomy,  Prof.  Titus  Deville, 
an  Englishman  by  birth  and  education,  but  who  has  been  en- 
gaged for  several  years  past  as  a  teacher  of  his  favorite  De. 
partment  in  the   School  of  Medicine  in  Paris. 

From  a  knowledge  of  Prof.  Deville's  reputation  in  Paris, 
as  well  as  ;  from  a  personal  acquaintance  with  him,  we  can 
heartily  congratulate  our  Chicago  friends  in  having  secured 
his  services,  feeling  assured  that  a  more  competent,  zealous, 
and  thorough  teacher  of  Anatomy  it  would  have  been  im- 
possible for  them  to  have  found,  searching  where  they  might. 
We  understand  he  is  winning  golden  opinions  of  his  col- 
leagues and  class  as  a  teacher ;  and  in  consideration  of  the 
many  kindnesses  shown  us  while  among  strangers  in  Paiiis, 
during  our  recent  sojourn  there,  we  have  great  pleasure  in 
bearing  this  testimony  to  his  merits,  and  in  hoping  him  a 
long  and  prosperous  career    in  the  home  of  his  adoption. 

A.  B.  P. 


To  the  Subscribers  of  the   Peninsular  and  Independent  Medical 

Journal. 

The  publishers  beg  leave  to  state  that  though  our  rule 
has  been  to  require  payment  of  yearly  subscription  in  ad- 
vance, yet  there  is  a  large  number  of  names  on  our  books 
to  whom  the  Journal  has  been  sent  regularly,  and  who  have 
not  yet  paid  the  fee  of  two  dollars  due  for  it. 

We%ave  sent  to  these,  out  of  respect  for  them  as  patrons  of  the 
former  Journals,  the  consolidation  of  which  formed  the  present 
one,  and  regret  to  say  that  the  payment  of  our  just  dues  from 
these  sources,  forms  a  poor  encouragement  indeed  for  us  to 
continue  the  publication  of  the  Jouen"AL. 

"We  hope  that  all  who  find  their  attention  called  to  this  by 
a  pencil  mark,  will  understand  that  this  statement  addresses  it- 


684  2  he  Peninsular  and  Independent, 

self  particularly  to   them,  and  that  they  will    immediately  res- 
pond by  paying  subscriptions  now  long  past  due. 

HiGBY  &  Steaens. 


Please  do  us  a  FaYor? 

HiGBY  &  Stearns,  the  publishers  of  this  Journal,  having 
recently  made  arrangements  whereby  they  will  hereafter  keep 
a  full  supply  of  the  Artificial  Teeth  of  Messrs.  Jones  &  White, 
in  addition  to  those  they  heretofore  have  kept  from  other 
makers,  wish  to  make  it  generally  known  to  the  Dental  pro" 
fession,  and  will  feel  obliged  if  the  readers  of  this  Journal 
throughout  the  State,  would  mention  the  fact  above  stated 
to   the   Dentists  residing  in  their  respective   neighborhoods. 

It  is  also  our  intention,  during  the  coming  season,  to  large- 
ly increase  our  stock  of  goods  required  by  Dentists,  in  the 
way   of    Instruments   and   appliances   for  mechanical   dentistry. 


The  Leaf  Sets  of  Furniture  Labels. 

We  have  received  from  Messrs.  Sage  &  Sons,  Lithograph- 
ers, Buffalo,  samples  of  their  new  furnitm'e  labels,  which  in 
point  of  novelty,  quite  surpass  anything  in  that  line  hitherto 
published. 

The  form  adopted,  is  the  shape  of  the  leaf  of  the  Twin- 
leaf  plant,  Jeffersonia  diphylla^  being  printed  on  dark  blue 
paper,  with  fine  bronze.  The  effect  is  quite  striking,  and  we 
trust  the  enterprise  of  the  publishers  will  meet  its  due  re- 
ward. 

^^They  also  issue  a  set  of  labels  expressly  for  physicians  and 
small  dealers,  less  complete  in  point  of  number,  and  of  small- 
er  size.     The  style,  however,   of  this  is  neat   and   quite  new. 

These  labels  may  be  had  in  Detroit  of  Messrs.  Higby  & 
Steaens. 


Correction. 

The   original  article  in  our  last  issue,  on  the  effects  of 
the  use  of   alcoholic  liquors   in  tuburcular  diseases,   or  in 
constitutions  predisposed    to    such  disease,  written  by  pur 


JEditoTial  Department.  685 

friend  Dr.  M.  A.  Patterson,  was  placed  by  an  inex- 
cusable oversight  on.  our  part,  in  the  department  of  selec- 
tions, usually  made  by  him,  and  without  due  credit  hav- 
ing been  given  him  for  it.     [Ed. 


tUtttli  ^xtitUs,  Jibstratts;,  &t. 


»»♦ 


ABSTRACTS  AND  SELECTIONS  for  the  PENINSllAK  AND  INDEPENDENT. 


By  M.  A.  Patterson,  M.  D.,  Tecumsoh. 


Gelsemlnum  Sempcrvlrens. 

At  the  request  of  the  editor  of  the  New  York  Medical  Press,  Dr. 
B.  Keith,  of  New  York,  has  furnished  that  Journal  (January  2)  with 
his  experience  of  the  utiHty  of  the  Gclsemin  in  certain  morbid  condi- 
tions of  the  human  organism.  For  controlhng  febrile  and  inflammatory 
affections,  we  have  found  its  action  less  prompt  and  reliable  than  the 
veratrum  viride.  We  are  certain,  however,  that  it  possesses  therapeutic 
properties  distinct  from  the  veratrum,  and  which  have  not  been  claimed 
for  that  article.  The  following  quotation  from  Dr.  Keiths'  remarks,  may 
serve  to  stimulate  some  of  the  readers  of  the  Journal  to  test  the  accu- 
racy of  the  writer's  views,  and  also  to  communicate  their  observations 
to  the  public  regarding  the  medical  powers  of  this  agent : 

"For  controlling  fevers  of  every  type  and  grade;  to  arrest  hemor- 
rhage from  the  lungs,  stomach,  bowels,  uterus  and  urinary  organs;  in 
dysentery  and  bowel  complaints ;  in  spermatorrhoea,  amaurosis,  deafness, 
catarrhal  affections,  hay -fever,  I  have  used  the  Gelsemin  successfully. 
A  single  half  grain  has  arrested  hemhorrhage  from  the  lungs,  when  all 
other  remedies  known  to  me  had  failed.  While  experimenting  with  it 
to  ascertain  its  power  for  arresting  hemorrhage,  I  gave  to  a  lady  who 
had  been  confined  two  days  previous,  one  and  a  half  grains  during 
twenty  -  four  hours,  which  amount  completely  arrested  the  hemorrhage. 
I  administered  two  grains  during  the  course  of  thirty  -  six  hours,  to  a 
lady  who  had  been  suffering  from  uterine  hemorrhage  for  two  months, 
and  that  small  quantity  completely  stopped  the  flow.  So  effectual  is  it 
in  this  form  of  hemorrhage,  that  I  consider  it  quite  a  specific.  In  dy- 
senteiy  and  bowel  complaints,  I  consider  it  the  most  valuable  article  in 
the  Materia  Medica.  From  one  -  tenth  to  one  -  eighth  of  one  grain  ad- 
ministered after  each  discharge,  will  shortly  stop  all  hemorrhage  and 
traces  of  the  disease. 

In  spermatorrhoea,  I  believe  the  Gelsemin  to  be  invaluable.  I  have 
administered  it  in  cases  of  five  years  standing,  without  a  single  instance 
of  recarrence  of  the  difficulty.  If  there  were  no  other  qualifications 
to"? recommend  the  Gelsemin  than  the  one  just  mentioned,  that  is  suffi- 
cient to  call  it  to  the  use  of  practitioners  of  medicine. 

I  rely  almost  entirely  upon  it  in  cases  of  amaurosis,  and  believe 
that  its  continued  use  would  result  in  a  cure  in  a  majority  of  cases. 

In  deafness,  the  efiects  of  the  Gelsemin  are   very  marked.     While 


y 


Selected  Articles^  Abstracts^  <S)c.  687 

under  its  influence  the  patient  can  hear  readily  common  conversation, 
and  even  the  ticking  of  a  clock.  When  that  influence  has  passed  off, 
the  deafness  returns.  The  medicine  should  be  continued  until  a  marked 
improvement  is  observed.     As  a  local  application,  I  use  the  following: 

^.   Gelsemin,  gr.  j. 
Aquae,  gts.  xl. 

Miscc. 
Put  on  a  little  cotton  and  apply  to  the  ear. 

I  have  found  very  beneficial  effects  follow  the  use  of  the  Gelsemin 
in  catarrhal  affections  and  hay -fever,  and  would  recommend  the  article 
to  the  medical  profession  for  use  in  those  cases.  In  dry  coughs,  de- 
pendent upon  irritation  of  the  throat,  it  is  the  most  prompt  agent  I 
have  ever  used.  In  nausea  and  vomiting  I  have  used  it,  many  cases 
yielding  to  a  single   dose  of  one  -  fourth  of  one  grain. 

I  would  here  remark,  that,  as  the  Gelsemin  is  a  medicine  of  great 
power,  caution  should  be  used  in  the  administration.  For  some  cause, 
which  I  am  unable  to  explain,  persons  of  lymphatic  temperament,  can- 
not bear  more  than  one -half  the  quantity  that  can  be  safely  adminis- 
tered to  adults  of  other  temperaments. 

The  following  prescription  I  have  used  in  epileptic  fits  with  favora- 
ble results: 

15.  Gelsemin  grs.  iv. 
Podophyllin,  gr.  viij. 
Misce. 
Divide  into  sixteen  powders,  and   administer  one  at  night. 

A  very  convenient  preparation  of  the  Gelsemin,  is  the  concentrated 
tincture,  dose  five  to  twent}'-  drops." 


Cannabis  Indica  In  Gonorrhoea. 

In  the  OglethoriJe  Medical  and  Surgical  Journal^  Dr.  M.  D.  Mooney, 
speaking  of  the  influence  of  cannabis  indica  in  the  affection,  remarks : 
*'  I  used  the  following  prescription  in  four  cases  of  gonorrhoea,  and 
was  successful  in  every   case,   in  from   five  to  seven  days : 

^.   Sugar  of  Milk,    |  ss. 

Ext.  Ind.   Cannabis,   20  grs. 
Mix  well  together  and  divide  into  sixty  powders,  one  to  be  taken  every 
three  or  four  hours.     This    prescription,    I  am  persuaded,  |will    relieve 
the  most  obstinate  cases  in  a  short  time."     The  extract  used   by  Dr. 
M.  was  prepared  by  Herrings   &   Co.,    London. 


Gout  and  Its  Remedy. 

In  the  London  Lancet  for  December  10th,  Mr.  L.  M.  Bennett, 
of  Winterton  Brigg,  England,  endorses  the  views  presented  by  Dr. 
Thomas  Garnett,  of  London,  in  1804,  respecting  the  cause  and  cure 
of  gout;  expressed  by  Dr.  Garnett  substantially  as  follows:  "I  be- 
lieve there  never   was  one  instance  of  a  person  having  the  gout   who 


688  The  Peninsular  and  Independent, 

totally  abstained  from  every  form  of  alcohol,  however  he  might  live 
in  other  respects ;  and  I  doubt  if  ever  the  gout  returned  after  a  per- 
son had  abstained  from  fermented  or  spirituous  liquors  for  two  years." 
Dr.  Bennett  says:  "Nearly  thirty  years'  experience  and  observation 
have  convinced  me  that  Dr.  Garnett  was  quite  correct  in  his  ob- 
servations as  to  the  cause  and  cure  of  the  painful  malady ;  and  my 
object  in  now  writing  is  to  inquire  if  any  of  your  numerous  readers 
can  inform  me  if  they  have  ever  met  with  a  case  of  gout  in  a  per- 
son who  totally  abstained  from  every  form  of  alcohol,  or  was  not  per- 
fectly cured  by  abstaining  from  the  same  for  two  years.  When  I  say 
gout  I  do  not  mean  rheumatism." 


Supulln  In  Delirium  Tremens. 

Dr.  D.  S.  Gloninger,  of  Philadelphia,  has  an  article  in  the  Medi- 
cal and  Surgical  Reporter  for  December  31,  highly  commendatory  of 
lupulin  in  delirium  tremens,  to  induce  sleep,  the  main  indication,  with 
the  least  possible  risk.  He  has  used  the  "brandy  hops''  a  favorite 
with  Dr.  M.  Hatfield,  made  by  saturating  hops  with  brandy,  and 
after  nine  weeks  it  is  fit  for  use,  but  prefers  "a  tincture  made  by 
displacing  the  lupulin  with  the  best  brandy."  He  regards  this  medi- 
cine as  perfectly  safe,  and  states  that  it  may  be  given  ad  libitum 
without  danger.  "  During  its  administration  the  patient  becomes  sat- 
urated with  it,  his  skin  adnata,  and  secretions  are  tinged  yellow ; 
this  condition  disappears  after  sleep."  He  says,  Dr.  Hatfield  told 
him  that  in  the  treatment  of  this  malady  "he  relies  solely  on  lupu- 
lin or  hops,  and  that  he  has  successfully  brought  patients  through 
their  thirty  -  second  attack,  which  he  thinks  impossible  under  the 
opium  method. 

As  a  diet,  we  know  of  nothing  better  than  "butter -milk.'*  It 
will  be  retained  on  an  irritable  stomach  where  lime  water  and  milk 
are  ejected." 


Treatment  of  Ingrowing  Toe -Nail. 

Dr.  N.  GiLMAN,  of  Hatfield,  Massachusetts,  (B6ston  Medical  and 
Surgical  Journal,  Dec.  29),  communicates  the  treatment  he  has  pur- 
sued in  these  cases  for  over  twenty  years.  Describing  his  mode  of 
proceeding  in  a  bad  case  of  long  standing,  he  says:  "I  put  a  very 
small  piece  of  tallow  in  a  spoon  and  heated  it  over  a  lamp  until  it 
became  very  hot,  and  dropped  two  or  three  drops  between  the  nail 
and  the  granulations.  The  effect  was  almost  magical.  Pain  and  ten- 
derness were  at  once  relieved,  and  in  a  few  days  the  granulations 
were  all  gone,  the  deceased  parts  dry  and  destitute^of  feeling,  and 
the    edge  of    the  nail  exposed  so    as  to  admit   of  being  pared  away 


Selected  Articles^  Abstracts^  chc.  689 

without  any  inconvenience.      The   cure  was   complete   and   the  trouble 
never  returned." 

Dr.  Oilman  has  tried  this  plan  repeatedly  with  uniform  success. 
If  Dr.  LoRiNSERs'  theory  of  this  affection  is  correct,  he  thinks  the  mo- 
dus operandi  of  his  treatment  quite  intelligible.  "  The  liquid  cautery 
insinuates  itself  into  every  interstice,  under  the  nail,  along  the  fistula 
into  the  ulcer  at  the  matrix  of  the  nail,  accomplishing  in  one  min- 
ute without  pain,  all  that  can  be  effected  by  the  painful  application 
of  nitrate  of  silver  for  several  weeks.  Let  this  simple  plan  be  tried 
before  resorting  to  the  barbarous  plan  of  pulling  out  the  nail,  or  any 
other   mode   of  torture." 


Achillea  MiUefoUam  In  rterlne  Conjestlon. 

Dr.  James  WniTEHEAD,  in  the  third  Report  of  the  Manchester 
Clinical  Hospital,  speaks  highly  of  the  efficacy  of  the  common  yarrow 
in  uterine  menorrhagia  and  leucorrhoea,  the  consequence  of  a  "  vas- 
cular or  spongeoid  hypertrophy  of  the  uterus."  He  reports  two  cases 
in  which  the  symptoms  were  urgent,  and  which  were  entirely  cured, 
the  patient  using  no  other  remedy.  In  one  it  was  given  in  tincture 
in  doses  of  a  dessert  spoonful  three  or  four  times  a  day ;  in  the 
other,  the  patient  took  the  decoction.  He  says,  "the  grounds  upon 
which  this  remedy  is  recommended  as  an  anti  -  hemorrhagic,  are  not 
limited  to  the  experience  above  cited,  I  have  used  it  pretty  freely  in 
private  practice  about  three  years,  and  the  results  now  stated  go  en- 
tirely to  confirm  those  of  previous  years"  — Boston  Medical  and  Sur. 
gical  Journal.  This  is  an  old  remedy  revived.  Milfoil,  or  common 
yarrow  for  many  years  was  as  favorite  a  domestic  remedy  in  some  sec- 
tions of  the  Union  for  hemorrhagic  and  lucorrhoeal  discharges,  as  was 
Trillium  Pendulum  or  bethroot  in  other  sections  for  similar  maladies. 
In  our  experience  the  yarrow  proved  superior  to  the  bethroot  in  men- 
orrhagia, and  the  latter  more  efficacious  than  the  former  in  leucorrhoea, 
and  also  in  cases  of  hemoptysis  arising  from  tubercles.  It  is  probable 
that  both  remedies  are  entitled  to  more  credit  than  they  have  received 
from  the  Profession. 


Oxide  of  Zinc  in  Cbronic  Intoxication. 

Dr.  Marcet,  of  Westminster  Hospital,  reports,  (London  Lancet), 
the  treatment  of  twenty -seven  cases  of  chronic  intoxication,  with 
Oxide  of  Zinc  in  doses  of  two  grains  twice  a  day,  gradually  increas- 
ed to  three  or  four  times  that  quantity  at  a  time.  Under  this  treat- 
ment, some  of  the  victims  of  slow  alcoholic  poisoning  were  cured 
and  others  much  improved.  Six  of  the  number  remained  under  treat- 
ment,   and  two  ceased  attending  after  one  or  two  visits. 

Vol.  II— 2T 


600  Selected  Articles^  Abstracts^  dbc. 

MURIATED  TINCT.  OF  IRON  IN  INTERMITTENT  FEVER. 

From  the  same  transactions,  we  learn  that  the  physicians  of 
Brooklyn,  N.  Y.,  and  vicinity,  have  been  greatly  embarrassed  by  the 
peculiar  obstinacy  of  the  intermittents  which  have  prevailed  there  du. 
ring  the  past  season.  Cases  of  masked  intermittents  popularly  known 
all  over  the  west  and  south-west  as  ^^damh  agues^^''  were  common. 
The  usual  anti  -  periodic  remedies  frequently  failed  to  interrupt  the 
paroxysms.  "Dr.  Bell  stated,  that  in  the  ^ficm'c  pernicieuse'  of  the 
American  tropics  where  the  congestive  stage  is  highly  dangerousi 
and  usually  fatal  on  the  second  or  third  recurrence  of  the  paroxysm* 
he  had  frequently  cut  it  short  on  the  eve  of  the  chill  by  quinine 
and  piperine  in  very  large  doses  —  a  drachm  of  quinine  and  a  scruple 
of  piperine,  given  at  one  dose.  But,  although  he  had  frequently  had 
his  ingenuity  taxed  to  the  utmost  in  the  treatment  of  these  severe 
forms  of  intermittent  in  various  regions,  he  had  generally  found  them 
•urable  —  which  teas  not  the  case  with  some  of  the  now  j)revailing  inter- 
mittents of  BrooHyn.  His  experience  had  been  like  that  of  others  in 
the  severe  forms  of  the  ordinary  type  of  this  disease,  viz. :  when 
quinine  failed,  by  combining  arsenic  or  piperine,  it  could  be  cured' 
But  there  were  cases  now  in  the  Brooklyn  City  Hospital  which  had 
been  repeatedly  arsenicated;  yet,  in  less  than  a  week  the  paroxysms 
would  recur,  and  most  of  them  would  run  three  weeks,  no  matter 
what   the   treatment,    while   others   would   last  twice   as   long." 

Dr.  Cook  stated  "when  the  ordinary  means  fail,  he  has  usually 
succeeded  by  giving  large  doses  of  muriated  tincture  of  iron,  one 
dose  of  a  fluid  drachm  just  before  the  time  of  the  expected  chill  and 
where  this  is  irregular,    the  same   quantity  several   times  a  day. 

Dr.  Dudley  had  also  used  the  same  remedy,  but  oftener  the  ci- 
trate  of  iron,   and  quinine  with   good  success." 

Intermittents  have  been  unusually  obstinate  in  most  sections, 
where  they  have  prevailed  in  Michigan,  during  the  summer  and  au- 
tumn of  the  past  year;  but  we  have  not  learned  that  they  have 
proved  as  unyielding  as  the  forms  encountered  by  our  Atlantic  friends- 
With  us  the  muriated  tincture  of  iron,  in  drachm  doses,  will  be  re. 
garded  as  novel  treatment.  To  prevent  the  return  of  the  paroxysms, 
we  have  found  the  pills  recommended  in  Eberle's  Practice,  composed 
of  Sulph.    Zinci  and  Capsicum,    of  equal  value. 

CLERICAL  QUACKERY,  bt  O.  C.  Gibbs,  M.  D.,  Frewsbcrgh,  N.  Y. 

There  are,  perhaps,  no  persons  who  exercise  more  influence  in  their 
respective  communities  than  the  clergy.  The  ignorant  and  vulgar  par- 
ticularly, look  up  to  their  minister  for  light  and  correct  opinions  upon  all 
matters,  whether  concerning  spiritual  or  temporal  things.  There  are  thou- 
sands and  tens  of  thousands  in  our  boasted  land  of  liberty  and  enlighten- 


Selected  Articles^  Abstracts^  &c.  691 

ment,  who  are  in  the  most  abject  mental  servitude — wearing  their  priestly 
chains  with  great  complacency,  voting  as  their  pastor  tells  them  is  right — 
and  trust  their  lives  in  the  hands,  and  gild  the  pockets,  of  such  quacks  who 
happen  to  be  fashionable  at  the  time  with  him  who  meekly  dispenses  reli- 
gious ceremonies.  Why  ministers  of  the  gospel  of  Christ,  who  should  be 
members  of  an  honest,  liberal,  high-mined,  and  learned  profession,  should 
see  it  their  duty  to  eschew  medical  literature,  science,  and  learning,  and 
give  their  influence  to  the  support  of  ignorance,  quackery,  and  the  most 
arrogant  pretenders,  is  beyond  human  comprehension.  There  are,  scattered 
over  the  land,  many  honorable  exceptions,  who  give  to  the  educated,  high- 
minded,  and  honorable  physician,  who  has  devoted  his  life,  and  all  his  men- 
tal and  physical  energies  to  the  welfare  of  the  race,  the  right  hand  of  fel- 
lowship and  encouragement. 

The  above  thoughts  were  suggested  on  listening  to  a  public  discourse 
by  a  talented  divine,  in  which  he  gave  expression  to  the  following  idea : 
"Physicians  are  a  useless  excresence,  an  expensive  vampire,  upon  society. 
"When  a  man's  time  has  come,  he  will  die  in  spite  of  all  the  physicians  in 
the  world  ;  and  when  his  time  has  not  come,  however  sick  he  may  be,  he 
will  recover  as  well  without,  as  with,  medical  aid."  Against  such  doctrines 
we  enter  our  decided  protest,  as  they  develop  the  most  objectionable  fea- 
ture of  fatalism. 

Why  does  not  their  advocate  act  honestly,  discontinue  his  ministerial 
labors,  and  relinquish  his  comfortable  salary?  It  is  a  legitimate  deduc- 
tion from  the  doctrine  to  say,  that  those  God  has  designed  to  save  will 
be  saved  without  preaching,  and  those  whom  he  has  not  designed  to  save, 
no  amount  of  ministerial  labor  can  affect  ?  If  his  child  should  fall  from  a 
bridge  into  the  river,  would  he  stand  composedly  upon  the  shore  and 
reason  thus?  "If  his  time  has  come  he  will  drown ;  in  spite  of  all  my 
efforts  to  save ;  and  if  it  has  not  come,  he  will  get  out  some  way,  without 
my  wetting  myself  to  accomplish  his  rescue."  The  parent  who  would 
reason  thus,  would  be  considered  a  brute,  or  a  fit  subject  for  a  mad-house. 
The  clergyman  that  will  use  his  ministerial  influence,  in  the  sacred  pulpit 
and  in  private  intercourse,  to  the  disparagement  of  medical  science  — who 
will  say  that  the  administration  of  medicine  is  always  worse  than  useless 
and  that  physicians  are  an  expensive  excrescence  upon  society,  we  consi- 
der either  a  knave  or  a  fool. 

There  are  thousands  of  deaths  annually  which  are  insultingly  ascribed 
to  the  providence  of  God,  that  are  really  attributable  to  the  foolishness  of 
of  man.  Christ,  our  great  exampler,  used  instrumentalities  for  the  cure 
of  the  afflicted :  the  eyes  of  the  blind  were  anointed,  and  the  leprous  were 
sent  to  wash  repeatedly  in  the  pool  of  Siloam. 

There  is  no  class  of  men  who  receive  so  many  gratuities  at  the  hands 
of  physicians,  as  the  members  of  the  clerical  profession ;  and,  according  to 
our  observation,  there  is  no  equal  number  of  intelligent  men  that  so  abuse 
their  influence  to  the  injury  of  regular  medicine. 


692  Selected  Articles^  Abstracts^  <bc. 

In  our  little  village,  we  support  four  clergymen.  One  of  them  gave  ex- 
pression to  the  quotation  given  above ;  one  is  a  Thompsonian,  one  a  Ilomoe- 
opathist,  and  one  a  believer  in  the  all-healing  virtues  of  cold  water.  Neither 
has  any  scruples  to  use  his  ministerial  influence  for  the  advocacy  of  his  own 
peculiar  doctrines. 

In  our  first  three  years  of  medical  practice,  we  were  followed  to  the  ^ 
bedside  of  almost  every  sick  one,  by  a  clergymen,  who  had  no  compunc- 
tions of  conscience  in  countermanding  our  orders,  and  advising  the  various 
uses  of  water  instead.  On  one  occasion,  he  called  on  a  good  sister,  and 
greatly  to  his  surprise,  found  her  laboring  under  great  pain  in  her  bowels. 
He  advised  her  not  to  delay  another  da}^,  but  to  go  to  the  Water  Cure 
(some  60  miles  distant),  where  a  perfect  and  permanent  cure  would  soon  be 
effected.  She  said  she  had  sent  for  her  physician,  in  whom  she  had  confi- 
dence, and  had  no  doubt  she  should  soon  be  better  without  the  necessity  of 
leaving  home.  He  urged  the  matter  still,  and  with  such  warmth  and  per- 
tinacity, that  one  of  the  good  mothers  was  obliged  to  inform  him  that  the 
lady  was  in  the  first  stage  of  labor,  and  that  her  physician  would  soon  be 
there,  and  that  his  visit  would  be  more  acceptable  at  some  other  time.  Two 
years  later,  the  clergyman's  lady  attempted  to  superintend  the  accouch- 
ment  of  this  same  woman ;  and  death  to  both  mother  and  child  was  the 
result. 

In  either  of  the  professions,  the  field  of  labor  and  of  study  is  wide 
enough  for  the  ambition  of  any  man,  however  extended  his  researches  or 
capacious  his  powers.  Having  a  common  origin  and  a  common  object — 
originating  in  sin,  and  having  for  their  object  the  amelioration  of  the  physi- 
cal, moral,  and  social  conditions  of  the  race — there  should  exist  in  the  pro- 
fessional trlo^  a  bond  of  union  and  of  sympathy,  surpassed  nowhere  else  in 
science  or  in  social  relations.  Man  can,  if  he  will,  deal  justly  with  his 
fellows,  in  which  event,  if  universal,  the  profession  of  law  would  be  a  su- 
perfluity; with  the  Divine  Law  and  God's  revealed  will  before  him,  he 
might  so  attune  his  actions,  in  conformity  with  the  healthy  existence  of  the 
soul,  as  not  to  require  the  services  of  doctors  of  divinity  ;  but  say  what  we 
will,  the  profession  of  medicine  is  a  necessity  that  cannot  well  be  dispensed 
with.  Man's  nature  gravitates  towards  the  grave,  and  disease  and  pain  are 
casualties  by  the  way,  depending  upon  causes  ever  at  work,  over  which  the 
human  judgment  has,  at  least,  but  limited  control.  Cuts  and  bruises,  dis- 
located joints  and  broken  bones,  no  human  foresight  can  wholly  prevent. 
The  poisoned  air  of  an  unhealthy  climate,  and  the  vicissitudes  of  an  unpro- 
pitious  season,  are  beyond  human  agency  and  control.  The  breeze  that 
brings  upon  its  wings  the  seeds  of  the  pestilence  and  the  plague,  can  only 
be  rendered  salubrious,  if  at  all,  by  such  instrumentalities  as  the  science  of 
medicine  has  only  made  known.  "Then  give  place  to  the  physician,  for 
the  Lord  hath  created  him :  let  him  not  go  from  thee,  for  thou  hast  need  of 
him,"  said  one  of  old;  and  that  need  has  andVill  continue,  so  long  as  chil- 
dren are  borne,  whose  very  cradles  rock  diseaseward,  and  whose  every  sub- 
sequent footstep  is  toward  the  grave. 


Selected  Articles^  Abstracts^  Sc.  693 

Our  clerical  friends  should  remember  that  physicians  have  had  no 
light  of  revelation  to  guide  them,  but  have  been  obliged  to  search  for  truth 
in  the  wilderness  of  ignorance;  their  very  way  hedged  in  by  prejudice,  su- 
perstition, legal  anactments,  and  penal  enjoinders.  If  they  see  us  giving 
countenance  to  what  they  suppose  to  be  errors,  let  them  check  their  vanity, 
by  inquiring  how  long  it  is  si  nee  women  were  hung  or  burned  for  witch- 
craft by  their  sanction.  [Buffalo  Medical  Journal. 


ON  MARSH  SELINUM  AS  A  REMEDY  IN  EPILEPSY,  &c.    Bt  Dr.  Th,  Hbrpin. 

In  the  July  number  of  the  Journal  de  PJiarmacie  et  de  Chimie  for  the 
present  year  there  is  an  article  on  the  above  substance,  in  which  it  is  recom- 
mended as  a  remedy  in  epilepsy  and  some  other  nervous  affections.  From 
this  paper  it  appears  that  this  remedy  was  first  discovered  in  1807  by  Dr. 
Trinius,  a  Russian  physician,  who  obtained  the  secret  from  a  peasant,  who 
had  employed  it  with  much  success  in  ep  ilepsy.  In  1818,  Dr.  Trinius  re- 
lated these  facts  to  the  Physico  Medical  Society  of  Moscow.*  In  1826,  it 
was  tried  with  success  in  epilepsy  by  some  Swiss  physicians,  who  reported 
the  same  to  the  Medico-Chirurgical  Society  of  Zurich.t  In  1827,  Peschier 
published  an  analysis  of  the  root  of  the  above  plant,  and  also  narrated 
several  cures  obtained  by  its  use.]:  From  1827  to  1852,  nothing  original 
appeared  regarding  it,  but  at  the  latter  date  Dr.  Herpin  published  a  Treatise 
on  epilepsy,  in  which  several  articles  were  devoted  to  it.§  Since  that 
period,  Dr.  Herpin  (the  author  of  the  present  paper)  states  that  he  has  had 
much  farther  experience  in  the  use  of  the  selinum,  having  employed  it  in 
a  great  number  of  cases,  and,  feeling  certain  that  the  remedy  does  not  de- 
serve the  oblivion  into  which  it  has  fallen,  he  has  now  made  known  his 
researches  upon  its  natural  history,  physiological  effects,  posology,  &c. 

JSfatural  History. — The  author  shows  that  the  marsh  selinum,  which 
belongs  to  the  Nat.  Ord,  TJinbellifercR.,  has  received  various  names  by  differ- 
ent authors.     Thus,  it  is  the 

Selinum  pahistre  (Linn.  De  Cand.) 

Selinum  syhestre  (Jacquin). 

Selinum  thysselinum  (Krantz). 

Thysselinum  pulustre  (Hoffman,  Koch.,  Gaudin). 

Thysselinum  Plinii  (Sprengel). 

Thpsselinum  syhestre,  pulstre  et  angustifolium  (Reichenbach). 

Thysselinum  sylvestre  (Vaucher). 

Peucedanum  sylvestre  (De  CandoUe). 

Peucedanum  palustre  (Moench,  Duby,  Oosson  et  Germain,  Grenier  et 
Godron,  Boreau  et  Godet). 

*  Memoires  de  la  Soc.  Phys.  Medic,  de  Moscou,  t.  iii.,  p,  86. 
t  Verhandl.  der  Medic.  Chirurg.  Gesellich  der  cant.  Zurich,  1826,  pp.  16  et  122. 
X  Actes  de  la  Societe  lielvetique  des  Sciences  naturells,  en  1827. 

§  Du  Pronostic  et  du  Traitement  curatif  de  FEpilepsie.    Paris,  1852,  Bailliere,  pp.  594  ei 
«uiv.,  642  et  suiv. 


694  Selected  Articles^  Abstracts^  c&c. 

The  author  then  shows  that  the  last  name  is  the  one  by  which  the 
plant  should  be  distinguished,  and  afterwards  gives  a  botonical  description 
of  it  under  that  name  {Peucedanum  pulstre),  and  then  makes  known  its 
habitats.  The  root  (the  part  used)  is  described  as  branched,  fleshy,  of  a 
deep  brown  color  externally,  white  and  milky  within,  having  a  strong  aro- 
matic odor,  and  an  acrid  and  piquant  taste. 

The  plant  is  common  in  the  north  and  east  of  France,  less  so  in  the 
centre  and  west,  and  apparently  wanting  in  the  south.  It  is  also  found  in 
certain  parts  of  Switzerland,  Germany  and  Russia.* 

Materia  Medica. — The  root  is  the  only  part  of  the  plant  which  has 
been  employed,  but  the  fruit  has  a  similar  taste,  and  hence  the  author 
supposes  that  it  would  possess  somewhat  analoguos  properties.  The 
dried  root  resembles  that  in  a  recent  state  in  its  odor,  taste,  and  color, 
although  in  the  latter  particular  the  brown  color  is  less  deep.  The  pow- 
der is  described  as  of  a  bright  yellow,  bordering  on  grey. 

According  to  Peschier,  the  root  contains  a  volatile  oil,  a  fatty  oil 
soluble  in  ether  and  alcohol  at  34*^  C.  (=  93°  Fahr.),  gummy  matter, 
a  yellow  coloi'ing  principle,  a  nitrogenous  mucoso-saccharine  principle,  a 
peculiar  acid,  which  it  is  proposed  to  call  selinic,  phosphate  of  lime, 
and  woody  matter.  The  oleo-resinous  matter  constitutes  an  eighth  or 
tenth  part  of  the  root,  and  hence  Peschier  recommends  an  alcoholic  ex- 
tract as  the  best  preparation.  The  author,  however,  says  that  he  has 
had  but  little  experience  in  the  use  of  such  an  extract,  but  judging 
from  his  own  experience,  he  prefers,  and  always  employs,  the  powdered 
root. 

Pysiological  Effects. — The  selinum  appears  to  act  principally  upon 
the  parts  connected  with  digestion.  In  seventy-nine  cases  in  which  it 
was  tried  by  the  author,  a  somewhat  purgative  effect  was  observed  in 
half  of  them,  and  in  a  few  instances  nausea,  gastralgia,  or  dyspepsia 
was  noticed,  although  in  a  trifling  degree  only.  In  no  case  was  any  in- 
jurious effect  produced  upon  the  general  health,  but,  on  the  contrary, 
its  use  appeared,  in  some  instances,  to  have  a  beneficial  influence.  In 
the  majority  of  cases  in  which  it  was  employed  it  exercised  a  very  fa- 
vorable influence  upon  menstruation,  and  the  disorders  incident  thereto. 

Posology. — In  the  treatment  of  epilepsy  the  author  was  accustomed 
to  administer  the  selinum  three  times  a  day ;  but  if,  in  the  course  of 
the  treatment,  the  patient  suffered  from  diarrhoea  or  colic,  the  number 
of  doses  was  reduced  to  two,  or  sometimes  to  one  in  a  day.  The  com- 
mencing weekly  dose  for  an  adult  was  30  grammes  (=463  grains), 
which  was  divided  into  20  doses,  and  administered  at  the  times  above 
stated.  This  dose  was  increased  weekly  by  15  grammes,  until  it  be- 
came 120  grammes,  which  qua^ntity  would  be  arrived  at  in  the  seventh 

*  This  plant  is  generally  known  in  England  under  the  above  name  of  Peucdanum  pul- 
usire.  It  is  a  rare  plant  with  us,  hut  may  be  occasionally  found  in  marshy  and  fenny  districts. 
— lEiD.Pharm.  Jotorn. 


Selected  Articles^  Abstracts^  <&g.  695 

week.  In  the  eighth  week  the  dose  was  increased  to  its  maximum, 
namely,  125  grammes;  and  this  weekly  dose  was  continued  for  six  weeks 
longer  in  those  cases  in  which  the  remedy  was  unsuccessful,  and  for  a 
much  longer  time  still  if  an  evident  remedial  effect  was  observed.  The 
dose  for  children  from  seven  to  fifteen  years  old  was  reduced  by  a  third, 
and  for  infants  by  two-thirds. 

Therapeutics. — The  author  states  that  in  1852,  with  his  then  limited 
experience,  he  arranged  the  four  medicines  which  had  succeeded  with 
him  in  the  treatment  of  epilepsy  in  the  following  order :  selinum,  oxide 
of  zinc,  ammoniacal  sulphate  of  copper,  and  valerian ;  but  with  his  pres- 
ent experience,  without  changmg  the  order  of  the  three  last,  he  would 
remove  the  selinum  from  the  first  to  the  fourth  rank,  but  at  the  same 
time  preserving  for  it  an  important  value. 

The  author  thinks  that  it  would  be  desirable  to  try  the  selinum  in 
wcher  nervous  affections,  as  hysteria,  chorea,  &c.  He  also  says  that  he 
has  recently  obtained  most  favorable  results  with  it  in  a  case  of  hypo- 
chondriasis and  in  three  cases  of  hoopingcough.  Dr.  Herpin  concludes 
his  communication  by  expressing  further  confidence  in  the  future  suc- 
cess of  the  selinum,  in  consequence  of  discovering  in  the  works  of  Di- 
oscorides  a  discription  of  a  Peucedanum,  which  had  very  many  analogies 
with  that  of  Peucedanum  'palustre^  and  which  was  stated  by  him  to  be 
useful  in  epilepsy  and  other  nervous  affections,  in  retention  of  the  menses, 
catarrah,  &c.  The  Peucedanum  of  Dioscorides,  however,  differs  from  the 
present  species  (P.  Palustre)  in  several  particulars ;  thus,  it  has  yellow 
instead  of  white  flowers,  and  is  found  in  mountainous  districts,  not  in 
marshes.  It  appears  to  the  author  to  be  the  F.  officinale  of  modern 
botanists.*  This  Peucedanum  is  mentioned  by  Pliny,  and  is  alluded  to 
also  in  most  of  the  treatises  on  Materia  Medica  until  the  close  of  the 
last  century,  but  it  has  since  fallen  into  disuse.  The  author  proposes 
again  to  try  its  effects.  [Fharm.  Journ. 


THE  USE  AND  PROPERTIES  OF  PERCHLORIDE  OF  IROIf. 

In  answer  to  several  correspondents  on  this  subject,  we  subjoin  the 
following,  which  has  appeared  in  the  medical  journals : — 

"The  solution  of  this  persalt  is  now  almost  universally  employed  to 
arrest  aterial  or  venous  haemorrhage,  resulting  either  from  accident,  or  as 
a  consequence  of  surgical  operations.  It  has  also  been  found  useful  in  in- 
testinal haemorrhage ;  in  one  case  in  particular,  M.  Demarquay,  of  Paris, 
administered  morning  and  evening,  enemata  of  seven  ounces  of  fluid,  with 
twenty  drops  of  the  concentratad  solution  of  perchloride  of  iron,  and  a 
tablespoonfal  of  the  perchloride  syrup  (five  or  six  drops  to  the  tablespoon- 
ful),  where  the  haemorrhage  from  the  bowels  was  considerable,  and  had 

*  The  P.  officinale  is  found  in  some  parts  of  England,  but  not  in  mountainous  distrlcs 
as  mentioned  above  by  the  author,  but  in  salt-marshes  in  Kent,  Essex,  &c. — Ed.  Phar.  Jour. 


696  Selected  Articles,  Abstracts,  <S;c. 

resisted  the  ordinary  remedies.  The  result  was  extremely  satisfactory. 
The  same  surgeon  relates  a  second  case  ef  extensive  abscess  of  the  shoulder 
where  an  injection  of  iodine  caused  severe  haDmorrhage.  This  was  arrested 
by  throwing  into  the  sac  a  lotion  composed  of  seven  ounces  of  water  and 
ten  drops  of  the  perchloride. 

"In  gonorrhoea  and  leucorrhcea,  injections  of  the  perchloride  have 
been  tried  with  success  in  weak  and  lymphatic  subjects,  the  proportion  of 
the  perchloride  being  twenty  drops  to  three  ounces  and  a  half  of  water. 

"As  A  HAEMOSTATIC. —  1.  As  a  local  or  external  ha3mostatic,  3  to  5 
parts  chloride  of  iron  to  100  parts  of  distilled  water.  Lint  soaked  in  this 
mixture  is  to  be  applied  with  more  or  less  pressure  on  the  seat  of  haemorrh- 
age. 2.  As  an  internal  haemostatic,  1  part  of  chloride  of  iron  to  500  of 
distilled  water,  sweetened  to  taste.  One  tablcspoonful  to  be  given  every 
hour,  or  oftener  if  necessary.  This  formula  suffices  to  check  the  fiercest 
haemorrhage  within  twenty-four  hours.  The  same  formula,  without  sugar, 
forms  a  useful  uterine  injection  or  astringent  lavement  in  cholera,  of  4 
to  15  parts  of  chloride  of  iron  to  30  of  axunge." 

In  a  letter  to  the  Medical  Gazette,  Aug.  27th,  Mr.  J.  Zachariah  Law- 
rence states  that  having,  a  few  months  ago,  drawn  the  attention  of  the  pro- 
fession to  the  powerful  local  styptic  properties  of  the  solid  perchloride  of 
iron,  he  has  since  that  time  foud  a  superior  method  of  employing  it.  "If 
the  solid  perchloride  of  iron  be  kept  in  a  bottle,  a  small  portion  of  it  after 
a  time  deliquesces  into  a  thick  brown  fluid,  which  is  constantly  kept  in  a 
state  of  super-saturation  by  the  uudeliquesced  portions  of  the  salt.  This 
liquid,  applied  by  means  of  a  spun-glass  brush  to  a  bleeding  surface,  arrests 
the  bleeding  almost  instantaneously.  This  mode  of  application  is  partci- 
ularly  valuable  in  applying  the  styptic  to  such  cases  as  excision  of  the  ton- 
sils, bleeding  from  the  deeper-seated  gums,  &c."  \^Phar.  Jour. 

QtJINIC  ETHER. 

M.  Eissen  has  recommended  in  the  Gazette  Medicale  de  Strasbourg, 
the  use  of  quinine,  introduced  into  the  air  passages,  for  the  treatment  of  in- 
termittant  fevers.  The  process  consists  in  the  inhalation  of  quinic  ether — 
a  combination  made  by  M.  Manette,  and  first  used  byM.  Pignacci,  of  Milan. 

The  substance,  still  incompletely  defined,  in  a  chemical  point  of  view, 
is  obtained  by  means  of  the  distillation  of  alcohol,  treated  by  sulphuric 
acid  (theory  of  ethers),  in  presence  of  the  quinate  of  lime.  The  product 
of  this  distillation  is  a  liquid  perfectly  limpid,  colorless,  of  an  agreeable 
odor,  less  volatile  than  sulphuric  ether,  but  still  sufficiently  volatile  to  evap- 
orate at  an  ordinary  temperature,  without  leaving  a  deposit.  It  deserves, 
then,  the  name  of  ether;  and  its  therapeutical  action,  besides,  seems  to 
justify  the  qualification  of  quinic  which  has  been  given  to  it. 

Quinic  ether,  says  M.  Eissen,  fills  all  the  necessary  conditions  of  a 
good  therapeutical  agent.      It  acts,  at  the  same  time,  tuto  cito  et  jucunde. 


Selected  Articles^  Abstracts^  etc.  697 

Inhaled  in  the  dose  of  a  few  grammes  (2  to  3),  as  chloroform  is  generally 
employed  upon  a  compress,  it  checks  a  commencing  access,  and  prevents  a 
return  of  subsequent  accesses.  In  all  the  cases  in  which  it  was  tried,  the 
mccess  gradually  yielded,  never  to  return,  when  the  fever  was  simple,  or 
Uttdei^  a  very  mild  form,  in  cases  of  decided  cachexia. 

Since  the  first  trial  upon  patients  in  Lombardy,  who  could  not  be  sus- 
pected of  being  slightly  affected,  other  trials  have  been  made  by  Prof. 
Groh,  at  Olmutz,  and  with  the  same  success.  The  results  have  been  the 
same — whether  the  inhalation  was  made  before  or  during  the  pyrexia,  the 
access  was  lessened  in  character  in  a  marked  degree,  and  the  next  antici- 
pated access  prevented,  in  the  majority  of  cases — the  tumefaction  of  the 
spleen  disappearing  at  the  same  time.  The  inhalation,  far  from  being  dis- 
agreeable, was  followed  by  good  results,  or  of  a  sensation  of  decided  ame" 
lioration.  We  may  add  that,  in  their  experiments,  our  learned  confreres, 
whose  names  we  have  cited,  were  careful  to  establish  negative  proofs  to 
confirm  their  judgment.  They  submitted  a  certain  number  of  fever  patients 
to  inhalations  of  pure  sulphuric  ether,  or  sulphuric  ether  holding  sulphate 
of  quinine  in  solution.  The  inhalations  of  pure  ether  produced  no  other 
effect  than  that  of  increasing,  in  an  insupportable  manner,  the  hot  stage } 
while  in  those  taking  the  ether  containing  the  quinine,  some  anti-periodic 
effects  were  observed,  after  large  quantities  of  the  remedy  were  absorbed; 
but  in  severe  cases  these  effects  were  so  slight,  after  long  trials,  that  the 
patients  themselves,  solicited  more  energetic  measures. 

[Amer.  Med.  Mon.  and  K  0.  Med.  News. 

GLYCERINE  OINTMENT  FOR  THE  ITCH. 

M.  Bourguignon,  so  well  known  in  Paris  by  his  successful  researches 
on  *'the  acarus  scabiei,"  has  published  in  the  Gazette  Medicale  the  follow- 
ing formula.  One  general  friction,  not  preceded  by  soap  ablutions,  is  suf- 
ficient:— Yolks  of  two  eggs;  essence  of  lavender,  lemon,  and  mint,  of  each 
seventy-five  drops;  essence  of  cloves  and  cinnamon,  of  each  120  drops; 
gum  tragacanth,  half  a  drachm :  well  pounded  sulphur,  twenty-six  drachms ; 
glycerine,  thirty-two  drachms.  Total  weight,  nearly  eleven  ounces.  Mix 
the  essences  with  the  yolks  of  egg,  add  the  gum  tragacanth,  make  a  good 
mucilage,  and  then  add  very  gradually  the  glycerine  and  sulphur.  Many 
cures  have  been  obtained  by  this  preparation,  which  has  the  advantage  of 
giving  no  pain.  The  well-known  Helmeric  |ointment  being  really  useful. 
M.  Bourguignon  has  modified  it,  and  substituted  glycerine  for  the  axung. 
In  the  altered  form  the  preparation  is  not  any  dearer,  as  efiicacious,  and 
less  painful  than  the  original  ointment.  It  does  not  grease  the  cloths,  and 
has  an  agreeable  perfume.  Gum  tragacanth,  fifteen  grains ;  carbonate  of 
potash,  thirteen  drachms ;  well  pounded  sulphur,  twenty-six  drachms  ;  gly- 
cerine, fifty-two  drachms ;  essence  of  lavender,  lemon,  mint,  cloves,  and 
cinnamon,  of  each  fifteen  drops.      Tolal  weight,  nearly  eleven  ounces: 


698  Selected  Articles^  Abstracts^  dbc. 

make  a  mucilage  with  the  gum  and  one  ounce  of  glycerine,  add  the  carbon- 
ate, mix  until  it  is  dissolved,  and  then  gradually  add  the  sulphur  and  gly- 
cerine ;  lastly,  pour  in  the  essences.  With  this  compound,  M.  Bourguig- 
non  advises  two  general  frictions  of  half  an  hour,  within  twelve  hours  of 
each  other,  and  followed,  twenty-four  hours  afterwards,  by  a  simple  warm 
bath,  as  the  glycerine  is  soluble  in  water.  Two-thirds  of  the  preparation 
should  be  used  for  the  first  friction,  the  other  third  for  the  second. 

Lancet^  and  Phar.  Jour. 


TESTS  FOR  THE  PURITY  OF  CHLOROFORM. 

M.  Berthe  gives  the  following  directions,  in  the  Moidteur  des  Iloin- 
taux: — Chloroform  may  contain  chloride  of  elaidine,  alcohol,  various  chlor- 
ides, amylic  and  methylic  combinations,  and  aldehyde.  By  adding  caustic 
potash  to  chloroform  containing  chloride  of  elaidine,  the  compound  is  trans- 
formed into  chloride  of  acetyle,  the  fator  of  which  is  immediately  noticed. 
Tn  order  to  ascertain  the  presence  of  all  the  other  compounds  which  may 
b©  mixed  with  the  chloroform,  especially  alcoholic  compounds,  pound  a 
small  quantity  of  bichromate  of  potash  in  a  little  chloroform,  and  add  to 
this  mixture  a  few  drops  of  sulphuric  acid.  If  the  chloroform  is  pure,  a 
reddish-brown  precipitate  of  chromic  acid  is  formed ;  if  not  pure,  the  acid 
is  reduced,  whilst  the  precipitate,  or  sometimes  the  liquid  itself,  assumes  a 
green  color,  dependent  on  the  presence  of  the  sesquioxide  of  chrome. 

[Lond.  Lancet. 

ARSENIC  IN  MENORRnAGIA,  LEUCORRHiEA,  Sec. 

In  the  October  number  of  the  American  Journal  of  the  Medical 
Sciences^  Dr.  Bukns,  of  Ellicotfs  Mills,  Md.,  speaks  of  ''the  great 
powers  of  arsenic  in  menorrhagca,  leucorrhtea,  hemorrhage  in  threa 
ened  abortion  and  after  delivery,  and  excessive  loechial  discharge." 
He  says,  "  My  usual  plan  of  treatment  has  been,  in  monorrhagia,  if 
called  to  the  patient  during  the  hemorrhage,  to  give  immediately  ten 
to  twenty  drops  of  Fowler's  solution  according  to  the  severity  of 
the  case,  and  repeat  it  in  doses  of  ten  drops  every  fifteen  to  twenty 
minutes,  until  the  hemorrhage  is  checked.  I  have  never  had  occa- 
sion to  push  it  to  a  dangerous  extent.  Care  must  be  exercised  in 
its  administration,  or  it  will  entirely  suspend  the  menstrual  secretion. 
I  then  give  five  to  ten  drops  three  times  a  day  during  the  menstrual 
period,  and  in  the  interval  three  to  five  drops,  three  times  a  day. 
In  leucorrh^ea,  I  give  three  to  five  drops  of  Fowler's  solution  three 
times  a  day." 

A  NEW  VEHICLE  FOR  IODINE. 

Dr.  Heller,  and  before  him  Arneth,  Pelikan  and  Zdekauer,  has  made 


Selected  Articles^  Abstracts^  Se.  699 

the  observation,  that  as  long  as  the  color  of  the  ointment  of  iodide  of  pot- 
assium is  white,  not  a  trace  of  iodine  is  found  in  the  urine,  which  is  the 
case  after  it  has  turned  yellow,  and  contains  free  iodine ;  he  concludes  that 
preparations  of  iodine  for  external  use  must  be  more  active  if  they  contain 
free  iodine.  Tincture  of  iodine,  after  a  continued  use  for  some  time,  has 
various  disadvantages,  and  Dr.  Heller  has  therefore  tried  to  employ  it  in  a 
solution  in  oil  of  juniper. 

The  solution  of  iodine  in  the  oil  must  be  effected  with  great  care  by 
introducing  it  gradually  in  small  quantities  into  the  oil  to  avoid  explosion. 
The  solution  at  first  is  brown,  but  gradually  decolorizes  and  corresponds 
with  the  formula  Ojo  Hi,  I4.  It  shows  no  reaction  on  starch,  has  no  odor 
of  iodine,"but  smells  of  juniper  berries,  and  does  not  color  or  destroy  the 
skin.  After  its  use,  iodine  is  found  in  the  urine,  the  saliva  and  the  mucus 
of  the  nose.  [Zeitsch,  d.   Wiener  Aerzte.  1858,  and  Am.  Jour.  Phar. 

A  NEW  METHOD  OF  APPLYING  CHLOEIDE  OF  ZINC. 

The  following  formula  is  recommended  by  Dr.  G.  W.  Spence,  of 
England,  for  a  chloride  of  zinc  paste.  Dissolve  fifty  grains  of  prepared 
chalk  in  two  drachms  (by  measure)  of  commercial  muriatic  acid  ;  dissolve 
one  hundred  and  fifty  grains  of  sulphate  of  zinc  in  two  fluid  drachms  of 
boiling  water.  When  required  for  use,  mix  the  two  solutions,  and  the  re- 
sult will  be  a  paste  weighing  near  an  ounce,  and  containing  about  one-sixth 
of  pure  chloride  of  zinc.  [^Lond,  Lancet^  and  Bost.  Med.  Jour. 

GOLDEN  SULPHURET  OF  ANTIMONY  IN  PNEUMONIA. 

At  a  meeting  of  the  Medical  Society  of  Kings  County — proceedings 
published  in  the  same  Journal  —  "Dr.  Simms  stated  that  he  had  used 
this  remedy  with  signal  success  in  a  case  of  consolidated  lung  remaining 
after  pneumonia.  The  case  was  obstinate  and  resisted  treatment,  until 
he  prescribed  powders  composed  of  "  G.  S.  of  antimony,  gr.  i,  with  can- 
nabas  indica,  grs.  v."  The  lung  under  its  use  rapidly  regained  its 
functions." 

NEVER  SAY  FAIL. 

The  following  literary  curiosities  deserves  to  be  preserved.  A  gentle- 
man, resident  somewhere  on  the  western  continent,  was  hurriedly  passed 
through  a  steam  doctor  mill,  and  come  out  a  Doctor  as  slick  as  an  onion. 
He  afterwards  got  some  Doctor  books,  determining,  he  said,  to  learn  "both 
systems."  After  practicing  "both  ways,"  and  "all  sorts  of  ways,"  some 
years,  he  determined  to  get  a  diploma  from  a  regular  medical  college,  and 
made  application  in  due  form  for  the  honorary  degree.  He  was  told  that  he 
must  write  out  a  thesis,  that  the  Faculty  might  be  able  to  judge  of  his  pre- 


700  Selected  Articles^  Abstracts^  c6c. 

liminary  qualifications,   when  he  immediately  dashed  off  the  following  in 
very  good  chirography : 

"  Ginral  simptoms  of  congistive  feavour.  small  Deprexed  pulce,  cold 
Extrematis,  cule  Dry  skin,  frecant  bateing  or  palpatation  over  the  Kitneys 
or  the  back  or  lunges,  in  this  deseaze  we  sildem  ar  vomit,  the  treatemint 
Must  Be  agreeabe  To  the  strenth  and  Habit  of  the  patint  let  yure  obgect 
Be  To  oppurate  will  on  the  kitney  and  liver  and  Blead. 

Billis  feavour. 
full  high  pulce  pane  in  the  heade  and  Back  Grate  sickniss  of  the  stomack 
chiles  Bleade,  vomit,  and  use  Carthickes  frealy. 

fevoitr  and  Ague. 
pane  in  the  head  Back  and  shakink  vomrait  purge  dont  Bleade.     use  stima- 
lating  stimilating  Medison  To  Brake  the  ague,     use  Musturd  Plastur. 

Plurisee. 
Pane  in  the  Right  side  cough  spitting  Blood  Depresed  pulce  some  feavour 
and  thirst  cule  feet  some  Times  pane  in  the  head.     Bleade  frealy  use  car- 
thickes and  Expcpturants  llaxsead  Tea  Blistering  ScQ. 

inflamatory  plurisee. 
pane  m  the  Left  side  palpatation  of  the  hart  high  feavour  Read  spoets  on 
the  cheak  at  Times,     theris  But  little  diference  Between  this  and  what  is 
genarly  cald  wintur  feavour. 

act  on  the  Liver  use  Experants  ilax  seade  Tea  Elum  warter  Blistur 
sweating  Tea  &C.  use  for  Experants  1  Grane  quinine  2  Granes  Epacack  3^ 
Grane  Morphen  &C  &  &C. 


The  above  is  an  absolute  fact.  We  make  the  present  printed  copy 
from  the  original,  only  suppressing  the  signature. 

It  is  unnecessary  to  say  that  of  course  he  failed  to  secure  the  "  honor- 
ary degree ;"  but  he  is  this  day  in  large  practice,  his  patrons  contending 
with  Patrick  Henry,  that  "Nateral  abilities  is  far  better  than  the  gography, 
trignomtry  and  gomtry  of  reglar  edecation."  [Xashtille  Journal, 


A  deputation  of  citizens  of  Dublin  having  waited  on  the  Lord  Lieutenant 
to  submit  to  him  the  necessity  of  providing  the  city  with  fountains  of 
drinking  water,  the  Medical  Press  of  that  city  profits  by  the  occasion  to 
demand  public  urinals,  a  very  logical  reasoning — the  more  water  people 
drink  the  greater  need  of  facilities  for  passing  it.  [^Med.  Reporter. 


Ijarmat^utial  ^t^utmnt. 


-•♦♦- 


Extracts   from   the  Eeport   on   Progress  of  Pharmacy,  to  the  Am. 
Phar.   Asoc.  1859: 

French  Salep. — Salep  is  prepared  in  France  from  the  tuhers  of 
orchis  mascula,  by  washing,  rubbing  off  their  epidermis,  and  then 
plunging  them  into  boiHng  water  until  they  begin  to  swell,  to  burst 
the  starch  granules,  and  to  rid  them  of  a  volatile,  disagreeable  princi- 
ple existing  in  the  recent  tuber,  when  they  are  strung  on  a  string 
and  dried.  —  (Repertoric   de  Pharm.,  1858.) 

Caffein. — M.  Vogel  (Journal  de  Chimie  Med.,  1858)  gives  a  pro- 
cess for  extracting  caffein  from  ground  green  coffee,  by  the  aid  of 
benzole,  which  quickly  dissolves  the  caffein  and  fixed  oil.  The  sol- 
vent is  then  distilled  off,  and  the  residue,  by  treatment  with  boiling 
water,  filtering  and   concentrating,  affords  the  caffein  in  crystals. 

Buckwheat  considered  as  Food.  —  M.  Isodore  Pierre  has  investi- 
gated the  value  of  this  cereal,  as  an  alimentary  substance,  and  finds 
that  the  finest  bolted  flour  contains  much  less  nitrogen  and  phosphates 
than   the   course  —(Am.    Jour.   Pharm.,    1858,  p.  426.) 

New  Grenada  Barh.  —  Hekr  Karsten,  by  numerous  analyses  of 
the  bark  of  Cinchona  lancifolia,  made  at  its  place  of  growth,  has 
shown  that  the  proportion  of  alkaloids  varies  exceedingly,  owing  to 
climate  and  soil,  especially  the  former.  He  considers  the  average 
yield  of  the  bark  to  be  2.5  per  cent,  of  sulphate  of  quinia,  and  from 
1  to  1.5  per  cent,  of  the  cinchonia  salt;  and  that  while  it  sometimes 
yields  none,  at  others  it  affords  4.5  per  cent.  The  bark  of  the  little 
branches  yielded  little,  if  any,  when  the  trunk  bark  afforded  1.5  per 
cent,  of  alkaloids.  He  also  believes  that  the  alkaloids  perform  some 
function  in  the  growth  of  the  plant,  whereby  their  amount  is  liable 
to  decrease  at  certain  seasons.  Observation  renders  it  probable  that 
a  uniform  climate,  with  due  proportions  of  cloudy,  rainy,  and  sunny 
weather,  is  most  favorable  to  their  development.  —  (Pharm  Jour., 
Lond.,  Sept.,  1858,  from  Bericht  der  Akad.  der  Wissench.  zu  Berlin, 
1858.) 

Alkaloids  in  Nux  Vomica. — M.  Schutzenberger  (Comptes  Rendus 
and  Amer.    Jour.    Pharm.,    1858,    p.    535,;   has    made    researches    on 


702  The  Peninsular  and  Independent. 

these  alkaloids,  which  load  him  to  believe  that  he  has  established 
the  existence  of  mne  new  alkaloids,  which  are  all  colorless,  have  a 
very  bitter  taste,  and  an  action  on  the  animal  economy  analagous 
to  that  of  strychnia.  They  are  all  soluble  in  boiling  water,  all  con- 
tain six  or  eight  equivalents  of  water  of  crystallization,  all  colored 
red  by  nitric  acid  like  brucia,  and  none  of  them  fuse  by  heat.  The 
author  regards  them  as  products  of  transformation  under  the  influ- 
ence of  vital  forces. 

7he  Thorn  Apx^le.  —  Schlectendal  refers  the  nativity  of  Datura 
Stramonium  to  Southern  Russia.  —  (Amer.   Jour.  Pharm.,   Nov.,  1858.) 

Podopliyllin. — Harvey  Allen  (Amer.  Jour.  Pharm,,  1850,  p.  206,) 
corroborates  the  results  of  John  Cadbury,  noticed  in  the  report  of 
last  year,  that  it  is  the  resin  soluble  in  ether  which  is  the  most  ac- 
tive  constituent   of  the  root. 

Cetonia  Aurata. — Dr.  Eulenburo  (Wittstein's  Vierteljahrs,  and 
Amer.  Jour.  Pharm.,  July,  1859,)  states  that  this  insect  is  used  as  a 
remedy  for  hydrophobia,  in  Russia,  with  considerable  success.  It  be- 
longs to  the  family  scarahmides  of  Latr.,  is  flat,  has  a  strong  metallic 
lustre,  body  copper -colored,  upper  part  golden  green.  The  powdered 
insect  in  doses  of  a  teaspoonful  is  said  to  be  sufficient  for  men  and 
dogs. 

Powder  of  decayed  Wood.  —  M.  Devergie  (Bui.  de  Therap. ,  March, 
1859),  recommends  the  powder  of  decayed  wood  as  a  substitute  for 
lycopodium,   as  a  siccative  astringent  in   certain   skin   diseases. 

Oxonized  Oils.  —  Dr.  Theophilus  Thompson,  in  a  communication 
to  the  Royal  Medical  and  Chirurgical  Society  of  Edinburgh,  states 
that  when  fixed  oils  are  charged  with  oxygen,  and  then  exposed  to 
the  sun's  direct  light,  and  so  become  oxonized,  they  are  endowed  with 
properties  not  before  possessed,  as  they  reduce  the  pulse  as  much  as 
24  beats  a  minute  in  some  cases.  The  oils  particularly  tried  were 
cocoanut  oil,  sun  -  flower  oil,  and  cod  -  liver  oil,  and  Dr.  Thompson 
thinks  that  they  may,  from  their  tendency  to  abate  the  pulse,  be 
found  useful   in   phthisis.  —  (Pharm.  Jour.    Aug.,    1859). 

Nicotiana. — John  Le  Conte,  (Journal  Acad.  Nat.  Sci.,  Philad. 
has  investigated  the  species  of  nicotiana,  yielding  commercial  tobacco, 
and  he  arrives  at  the  conclusion  that  all  the  so-called  varieties  are 
traceable  to  three  species,  N.  tabacum,  N.  rustica,  N.  fruticosa;  the 
first  yielding  the  United  States  tobacco  proper,  the  second  affording 
the  tobacco  of  East  India  and  Persia,  and  the  last,  that  of  Cuba.  — 
(Amer.   Jour.   Pharm.,  Sept.,   1859). 

Carlonate  of  Lithia.  —  The  London  correspondent  of  the  Drug- 
gists^ Circular.,  in  his  letter  published  in  the  August  number  of  that 
Journal,   states  that    carbonate  of  lithia  has    recently  come  into   use 


Pharmaceutical  Department.  YOB 

as  a  solvent  for  uric  acid  calculi,  owing  to  its  great  solvent  power 
for  that  acid.     Its   great  expense  will  limit  its  use. 

Volatile  Oil  of  the  seeds  of  the  Cicuta  Virosa. — Julius  Trapp, 
(Buchner's  Ke porter,  and  Amer.  Jour.  Pharm.,  May,  1859),  has  shown 
that  this  oil  is  identical  with  the  oil  of  cummin  seed,  and  it  is  also 
probable  that  the  identity  holds  good  with  the  oil  of  our  indigenous 
cicuta  maculata,  described  by  Joseph  E.  Young,  in  the  Amer.  Jour. 
Pharm.,  1855,  p.    239. 

Decolorizing  Power  of  Seeds.  —  M.  Harms,  noticing  the  fact  that 
wine  of  colchicum  and  other  wines  of  seeds  are  lighter  colored  than 
the  wines  from  which  they  are  made,  attributes  the  change  to  the 
decolorizing  property  of  the  seeds. — (Jour,  de  Pharm.,   June,  1859.) 

Oxide  of  Silver  Pills.  —  It  is  believed,  (Amer.  Jour.  Pharm., 
Sept.,  1858,)  that  the  intumescence  which  occurs  in  these  pills  at 
times,  is  due  to  the  presence  of  grape  sugar  in  some  form,  as  the 
honey  in  conserve  of  roses.  I.  Faeis  Moore,  of  Baltimore,  believes 
this  occurrence  to  be  due  to  tannic  acid,  or  some  other  vegetable 
acid.  —  (Maryland  Jour,  and  Trans.) 

Liniment  of  Iodide  of  Potassium.  —  T.  S.  Wiegand,  (Amer.  Jour. 
Pharm.,  1858,  p.  406),  recommends  the  following  formula :  Take  of 
sapo  vulgaris,  U.  S.  P.,  3  xiv.,  alcohol  95  per  cent,  |  viiiss.,  iodide 
of  potassium,  |  iss.,  oil  of  garden  lavender,  3  ss.  The  soap  is  dis- 
solved in  alcohol  by  heat,  the  oil  added,  the  iodide  dissolved  in  the 
water,  and  all  mixed  warm  in   a  suitable  bottle. 

New  form  of  Sii'p'positories. — Dr.  Pfeiffer  (Jour,  de  Pharm., 
March,  1859),  recommends  butter  of  cacao  to  be  cast  in  moulds, 
with  a  longitudinal  cavity  in  the  larger  end,  into  which  the  medici- 
nal substance  is  introduced  and  then  closed  in.  This  enables  the 
apothecary  to  medicate  the  previously  prepared  suppositories  extem- 
poraneously. 

Oiled  Pajper.  —  Dr.  James  McGhie,  of  the  Glasgow  Royal  Infirma- 
ry, recommends  oiled  paper  as  a  cheap  substitute  for  oiled  silk  in  sur- 
gical dressings.  It  is  prepared  by  saturating  thin  strong  paper  by 
means  of  a  brush  with  linseed  oil,  which  has  been  boiled  with  lith- 
arge, acetate  of  lead,  and  sulphate  of  zinc,  and  burnt  umber,  in  the 
proportion  of  from  one  to  two  ounces  of  each  to  the  gallon  of  oil,  and 
dried  without  heat.  —  (Pharm.  Jour.,  Feb.,  1859,  and  Amer.  Jour. 
Pharm.,   May,    1859). 

Distilled  Water.  —  William  S.  Thompson,  of  Baltimore,  has  ascer- 
tained that  water,  which  has  had  its  organic  impurity  destroyed  by 
means  of  permanganate  of  potassa  before  distillation,  will  afford  a  dis- 
tilled water  that  will  keep  without  depositing  the  flocculent  matter 
that  is  usually  found  in  that  liquid  when  kept  some  time.  —  (Maryland 
Jour  Pharm). 


704  The  Peninsular  and  Independent. 

Glycerole  of  Tar.  —  This  preparation,  made  of  30  parts  of  glyce- 
rin, 5  parts  of  starch  and  2  of  tar,  is  a  glycamyl  imbued  with  tar. 
It  will  be  recollected  that  starch,  heated  to  to  about  300°F.  in  gly- 
cerin expands  into  a  jelly,  and  gives  a  consistence  that  has  rendered 
it  a  substitute   for  simple   ointment.  —  (Jour,   dc   Pharm). 

Hydroscojnc  I^xtracU.  —  M.  LAcnAxiBKE  recommends  keeping  the 
jars  containing  these  extracts,  each  in  a  larger  jur,  with  quick  lime 
beneath   to   absorb  moisture  from  the  enclosed  air,  and  thus  dry  them. 

Bontigntfa  Fumigating  Powder  and  Paper.  —  The  powder  con- 
.sists  of  55.09  bisulphate  of  potassa,  and  44.31  of  nitrate  of  potassa, 
with  peroxide  of  manganese  q.s  to  color.  It  is  used  by  projecting 
small  portions  on  a  red  hot  surface.  The  paper  is  made  by  dipping 
unsized  paper  in  a  solution  of  one  part  of  nitrate  of  potassa  and  two 
parts  of  sugar  in  six  parts  of  water  and  drying. — Jour,  de  Chem. 
Med.,  Feb.,  1819). 

Conimn  Leaves.  —  According  to  a  writer  on  the  new  Belgian 
Pharmacopa^ia,  (Druggists'  Circular,  Aug.,  1850),  conium  gradually  d  e 
teriorate  by  keeping,  and  that  the  mere  effect  of  drying  is  to  dete- 
riorate them. 


ADJOURMD  MEETIXG  OF  THE  MICUIGAN  STATE  MEDICAL  SOCIETY. 

In  accordance  with  a  Resolution,  passed  at  the 
regular  meeting  held  at  Coldwater,  January  18th,  an 
adjourned  Meeting  will  be  held,  at  Ann  Harbor,  on 
Commencement  Day,  being  Wednesday,  29th  March. 
A  full  attendance  is  desired. 

E.  P.  Christian,  Secy. 

TEE  AMERICAN  MEDICAL  ASSOCIATION. 

Will  hold  its  Thirteenth  Annual  Meeting,  at  New 
Haven,  on  the  first  Tuesday  of  June.,  1860.  The 
Secretaries  of  local  Societies,  Colleges  and  Hospitals, 
are  requested  to  forward  the  names  of  delegates  as 
soon  as  they  are  appointed,  to 

Stephen  G.  Hubbard,  M.D.,  Secretary, 

New  Haven,    Ct 


THE 

PENINSULAR  and  INDEPENDENT 

MEDICAL  JOUPiML 

Vol.  II.  DETROIT,  MARCH,  1860.  No.  12. 

(SixxfiMl  (Iammitnitati0ns  aitir  %XMShtxtiU. 


ART.  XLI.— On  Turning  the  Foetus  in  Utcroby  External  Manipulations. 

By  J.  H.  Beech,  M.  D. 


Dr.  E.  NoEGGERATH  lias  contributed  to  the  N.  Y.  Jour- 
nal  of  Medicine  a  very  valuable  paper  on  the  subject  of 
"Turning  the  Fgetus  in  Utero  by  External  Manipu- 
lations/' of  which,  as  it  may  not  have  reached  all  of 
the  readers  of  your  Journal,  I  propose  to  sketch  some  of 
the  lending  points,  and  finally  to  add  a  few  practical  sug- 
gestions. 

Dr.  N.  thinks  the  operation  of  turning  by  external 
manipulations  too  little  thought  of,  and  too  little  prac- 
ticed by  American  practitioners.  This  he  attributes  to  the 
neglect  the  subject  has  received  from  the  obstetric  author- 
ities whose  writings  have  been  most  disseminated  in  this 
country. 

Vol.  XL  — 2U. 


706  The  Peninsular  and  Indepeyideyit. 

He  cites  distinguislied  authority  in  favor  of  external 
manipulation  and  auscultation  as  means  of  diagnosis  of 
presentation,  and  declares  his  own  preference  for  external 
instead  of  internal  examination,  were  he  obliged  to  dis- 
pense with  either,  except  in  case  of  excessive  thickness 
of  the  abdominal  walls,  or  the  tenderness  of  the  womb. 
He  says :  "  It  was  the  combination  of  these  two  circum- 
stances, viz. :  the  established  fact  of  spontaneous  version, 
and  the  perfection  of  external  diagnosis,  which  induced 
accouchers  to  try  turning  by  external  manipulation,  and 
bring  this  operation  to  a  scientific  standing/' 

We  shall  not  attempt  to  follow  the  historical  part 
of  Dr.  N.'s  paper,  which  shows  much  research  and  ex- 
tensive resources,  commencing  with  the  spontaneous  ver- 
sion mentioned  in  Genesis,  chapter  xxxiii.  v.  28,  in  which 
Zarah,  with  a  brightness  sufficient  for  a  Yankee  lad,  put 
out  his  hand  to  receive  the  badge  of  birthright,  and  then 
modestly  retired  in  favor  of  Pharez.  The  authority  of 
Hippocrates  is  acknowledged,  whose  operation  was  rather 
a  version  than  manipulation  of  the  woman ;  a'nd  the  chief 
honor  is  conferred  upon  Dr.  Justus  H.  Wigand,  of  Ham- 
burg,  Germany. 

It  is  further  stated  that  German  medical  literature 
abounds  with  treatises  commendatory  of  turning  by  exter- 
nal manipulation. 

In  this,  as  in  other  articles.  Dr.  N.  has  done  good 
service  in  presenting  us  with  the  treasures  of  the  ^^  old 
world." 

To  illustrate  the  principles  and  practice  contended 
for,  [he  has  detailed  several  cases,  the  important  points 
of  which  we  will  make  use  of,  A  lengthy  extract  from 
an  article  by  Dr.  Mattei  is  given  on  pages  336,-340  of 
the  November  No.  of  the  N.  Y.  Journal,  in  which  is 
inculcated   that   breech  presentations  are  not  physiological, 


On  TufYiiug  the  Foetus  in   Utero^  <hs,  Y07 

and  sliould  be  changed  in  all  cases  of  normal  pelvis, — 
that  the  most  suitable  time  is  from  the  ^sixth  to  the 
middle  of  the  ninth  month,  —  provided  that  the  nates 
have  not  engaged  in  the  pelvis.  ^^  He  directs  the  woman 
to  be  placed  horizontally  on  the  back,  the  pelvis  elevated. 
The  cubital  border  of  one  or  both  hands  placed  between 
the  edge  of  the  os  pubis  and  the  presenting  part  of 
the  foetus,  which  is  to  be  pressed  upward  and  laterally, 
while  the  head  is  brought  downward  in  the  direction  of 
natural  flexion  of  the  foetus,  until  it  arrives  at  the  pelvic 
brim,  where  it  must  be  retained  "for  some  time,  in  order 
to  get  the  extremities,  and  the  entire  body  to  become 
thus  nicely  encased  in  the  uterine  cavity,  and,  if  neces- 
sary, an  abdominal  bandage  applied  to  prevent  return  to 
the  mal-position."  A  very  fully  reported  case  exemplifies 
the  above  teachings,  but  we  do  not  discover  anything 
which  would  not  naturally  be  observed  as  palpation  and 
auscultation   are   usually   practiced. 

Case  1st,  of  version  during  labor,  occurred  in  a  prim- 
apara  22  years  of  age ;  "  the  os  uteri  was  found,  on 
examination,  dilated  to  a  diameter  of  one  inch  and  a 
half,  the  membranes  unruptured,  and  an  arm  presenting." 
The  head  could  be  distinguished  as  a  round  hard  mass 
in  the  left  iliac  region.  Dr.  Elliot  (the  reporter  tried 
by  gentle  friction  to  push  the  head  upwards,  and  really 
the  head  began  to  move.  This  was  therefore  continued 
with  the  right  hand  during  the  cessation  of  pains  while 
the  feet  were  pressed  downward.  During  the  pains,  the 
position  gained  was  retained,  and  in  about  twenty  min- 
utes the  feet  presented  at  the  os  uteri.  "  During  all 
this  time  the  patient  kept  her  recumbent  position.''  These 
are   all  the   material  points. 

Dr.  Elliot's  second  case  was  also  a  primapara  —  a  cross 
presentation   of  the   child  in   the  mesogastic  region,  while 


708  2  he  Peninsular  and  Independent, 

the  hypogastric  region  seemed  empty,  the  amniotic  bag 
presented  in  a  large  extent,  but  was  empty,  and  no  por- 
tion of  the  foetus  could  be  detected  by  internal  exam- 
ination." Pelvis  natural;  pains  strong.  In  one  hour  noth- 
ing changed. 

The  foetus  was  now  pushed  ujDward,  leaving  the  ver- 
sion to  chance,  situation  of  the  several  parts  of  the  foetus 
could  not  he  made  out.  In  fifteen  minutes  the  "  head  pre- 
sented through  the  os  uteri,  but  it  was  directed  somewhat 
towards  the  right  side.  Accordingly,  the  woman  was  or- 
dered to  lie  on  her  left  side,  and  the  above  manipulations 
continued  for  another  hour.     Success  complete. 

Case  3d.  Eeported  by  Dr.  Spengler,  of  Berlin.  Pp, 
Shoulder  presentation  by  vaginal  examination.  Externally, 
the  head  was  found  towards  the  left  iliac  region,  and  the 
nates  higher  up  towards  the  right  side,  the  woman  being 
placed  on  her  left  side,  with  a  cushion  underneath  that 
part  where  the  head  could  be  recognized.  The  os  was 
dilated  to  the  size  of  a  quarter,  the  water,  discharged. 
Gentle  frictions  were  at  first  commenced  on  the  place  which 
corresponded  with  the  pelvis  of  the  foetus,  and  subsequently 
both  hands  were  used  in  proj)er  manijDulations,  until  a 
proper  cephalic  presentation  was  attained,  followed  by  de- 
scent into  the  pelvis,  when  the  woman  was  placed  on  her 
back  with  successful  result. 

Case  4,  from  Prof  Genser.  The  os  was  a  very  little 
opened,  and  the  right  elbow  presented.  The  head  was  dis- 
tinctly felt  in  the  left,  and  the  breech  in  the  right  iliac 
fossa.  "  The  woman  lying  on  her  back,  it  was  attempted 
in  the  intervals  of  the  pains  to  push  the  head  downwards, 
and  the  back  upwards,  whilst  in  the  acme  of  the  pains 
the  uterus  was  merely  compressed  on  either  side. 

In  half  an  hour  the  patient  was  made  to  lie  on  the 
left  side,  and  in  the  place  where  the  head  was  felt  a  hard 
pillow  was  pressed.     Success  was  complete. 


On  Turning  the  Foetus  in   Titer o^  c§c.  '709 

Case  5th,  by  De  Shnetter,  of  N.  Y.  city.  The  pa- 
tient had  been  delivered  of  a  dead  child  by  Dr.  S.,  in 
consequence  of  a  cross  presentation  which  had  been  turned 
by  the  feet,  and  the  body  extracted  by  the  attending  phy- 
sician. At  the  time  reported,  no  foetal  part  could  be 
felt  internally  through  the  os  dilated  to  about  one  inch. 
Upon  this,  four  fingers  were  introduced  into  the  vagina, 
and  now  it  was  easy  to  detect  the  left  shoulder  down- 
most,  back  forwards.  The  woman  was  now  placed  on  her 
left  side,  j)ressure  was  made  upon  the  foetal  head,  forcing 
it  downwards,  while  the  trunk  was  raised  towards  the 
mesial  line.  This  was  effectual,  but  on  the  patient's 
being  left,  the  head  returned  to  its  former  position,  al- 
though the  patient  was  kept  on  her  left  side.  The  afore- 
said manipulation  was  repeated  successfully,  and  the  mem- 
branes ruptured  to  make  sure  of  the  head.  A  portion 
of  the  funis  now  escaped,  which  was  returned  and  secured 
by  placing  the  patient  in  the  position  proposed  by  Dr. 
Thomas  (upon  the  knees,  with  the  shoulders  low)  for  a 
quarter  of  an  hour,  when,  as  the  funis  did  not  again 
present,  she  was  placed  on  her  left  side.  The  head  now 
rested  strongly  upon  the  symphisis  pubis  from  excessive 
inclination  of  the  maternal  pelvis,  and  the  delivery  was 
completed  with  forceps.  Child  full  grown,  "in  the  most 
desirable  state  of  life.'' 

Case  6th,  by  Dr.  Noeggerath  himself,  who  thus  sums 
it  up :  "  Suffice  it  to  say  that  it  was  a  shoulder  pre- 
sentation, and  the  child  turned  by  external  manipulation. 
It  was  born  alive  in  a  vertex  presentation." 

The  advantages  named  by  Dr.  N.  are  safety  to  mother 
and  child  —  freedom  from  fear  and  from  pain.  He  claims 
for  it  freedom  from  the  necessity  of  using  chloroform,  but  we 
do  not  see  why  chloroform  may  not  be  a  valuable  assist- 
ant in  cases  in  which  the  manipulations  are  not  other- 


710  The  Peninsular  and  Independent. 

wise  well  borne.  We  can  not  say  from  experience  in 
turning,  but  speak  knowingly  in  regard  to  its  influence 
when  the  head  has  been  slow  to  descend  from  weak  or 
tender  abdominal  walls,  and  we  have  been  desirous  of 
adding  manual  aid  externally. 

Tlie  indications  appear  to  be  all  those  cases  in  which 
it  is  desirable  to  change  the  position  of  the  foetus  ;  when 
the  possibility  of  failure  would  not  involve  the  mother  in 
danger  from  any  delay.  Hemorrhage,  convulsions,  and 
pelvis  very  much  contracted,  are  named  as  requiring  more 
expedition  than  can  be  confidently  relied  on  by  external 
manipulation,  and  we  would  add  that  extreme  exhaustion 
may  occur  where  a  mal- position  has  retarded  labor  for 
many  hours,  and  a  skillful  operator  might  save  the  mother 
and  child  by  an  immediate  internal  manipulation,  which 
would  be  less  probable  by  external.  For  ourself,  we  have 
looked  upon  the  '^operation  of  turning  by  the  feet"  as 
we  have  on  a  "too  handy"  pair  of  forceps — liable  to  be 
used  to  deliver  the  doctor  of  a  swell,  when  the  patient 
might  get  along  easier.  Dr.  Noeggerath  remarks  that 
turning  by  the  feet  never  fails  to  have  a  striking  effect, 
but  if  external  manipulations  fail  (in  ordinary  cases)  noth- 
ing is  lost,  except,  perhaps,  a  little  time. 

The  following  are  Dr.  N.'s  directions  for  "^7ie  perform- 
ance of  the  operation''  "  The  correct  diagnosis  of  the 
situation  of  the  foetus  in  utero  by  external  examination, 
is  the  preparatory  step,  and  an  intrinsic  part  of  the 
operation.  Before  attempting  to  perform  it,  the  operator 
must  have  in  every  single  case  a  distinct  idea  of  the  pre- 
sentation of  the  child  in  his  mind,  to  the  confirmation 
of  which  repeated  inspection,  palplation,  and  auscultation, 
must  be  called  to  aid  ;  internal  examination  will,  in  the 
great  majority  of  cases,  yield  only  negative  results. 

"  This   done,  the  woman  is  ordered  to  lie  on  her  back, 


On  Turning  the  Foetus  in   Titer o^  dbc.  711 

while  the  physician  takes  his  position  on  the  side  of  the 
bed  opposite  that  where  the  head  was  located.  Suppose 
the  head  is  felt  in  the  left  iliac  fossa,  the  operator  places 
his  right  hand  upon  the  cranial  protuberance,  while  his 
left  hand  is  placed  on  that  portion  of  the  uterus  where 
the  nates  are  situated. 

"Now,  gentle  frictions  are  made  upon  the  points  in- 
dicated, and  and  at  once  a  pressure  effected  upon  the  head 
with  a  tendency  to  push  it  downwards  and  towards  the 
mesial  line,  while  the  breech  is  gently  pushed  upwards 
and  towards  the  opposite  side.  All  this  is  done  during 
an  interval  of  the  pains.  As  sooii  as  another  pain  be- 
gins, both  hands  keep  their  place,  and  the  woman  is  or- 
dered  to  turn  on  her  left  side. 

"With  the  remission  of  the  pain,  the  same  manoeuvre 
must  be  repeated,  and  continued  until  a  change  of  pre- 
sentation is  effected.  This  having  been  ascertained  by 
internal  examination,  the  woman  has  to  continue  the  pos- 
ture on  her  left  side,  and  a  small  hard  pillow  is  to  be 
placed  just  underneath  that  portion  of  the  abdomen  where 
the  foetal  head  was  at  first  situated.  If  after  a  number 
of  pains  the  head  is  found  to  have  retaken  its  former 
situation,  the  manipulations  must  be  repeated,  and  after 
turning  has  been  effected  again,  it  is  advisable  to  rup- 
ture the  membranes,  in  order  to  keep  the  head  from 
returning  to  where  it  was  formerly  imbedded. 

"  The  most  suitable  time  for  the  performance  of  the 
operation  is  from  the  beginning  of  labor  to  perfect  dila- 
tation of  the  OS." 

The  idea  that  the  profession  in  this  country  has  no 
knowledge  of  the  art  of  changing  the  position  of  the 
foetus  in  utero  by  external  manipulation,  would,  we  think, 
by  very  incorrect. 

I  am  not  aware   of  any  written   authority  in  our  Ian- 


712  The  Peninsular  and  Independent. 

guage  on  the  subject^  although  it  may  exist^  but  I  well 
remember  that^  when  a  student^  one  of  my  private  in- 
structors (Dr.  H.  E.  PiNKNEY,  of  Scoharie  Co.,  N.  Y.,) 
said  to  me:  "A  great  deal  can  be  done  in  correcting 
improper  presentations  by  proper  management  through  the 
walls  of  the  abdomen/'  and  he  proceeded  to  give  similar 
directions  to  those  in  Dr.  N.'s  paper.  We  have  also 
seen  other  physicians  apply  their  hands  to  the  abdomen 
of  patients  under  consultation  in  a  systematic  manner, 
with  successful  efforts  to  change  the   position  of  the  foetus. 

As  some  important  facts  in  regard  to  position  and 
treatment  are  not  alluded  to  in  Dr.  N.'s  paper,  I  will  ven- 
ture to  mention  them,  although  most  of  them  may  be 
familiar  to  the  readers  of  the  "Peninsular  and  Inde- 
pendent," as  we  also  had  supposed  that  the  whole  art 
of  external  manipulation  had  long  been.  There  are  ^nq 
classes  of  patients  upon  whom  it  is  frequently  difficult  to 
manipulate,  so  as  to  change  the  presentation  of  the  foetus 
in  utero  in  either  of  the  positions  named  for  the  patients^ 
i.  e.,  upon  the  back  or  side,  viz. :  the  very  fat,  the  dropsi- 
cal, when  the  bowels  are  very  flatulent,  when  the  liquor 
amnii  is  superabundant,  and  in  the  very  lean.  In  the  first 
class,  the  thickness  of  the  abdominal  walls  prevents  the 
application  of  any  warrantable  amount  of  force  reaching 
the  uterus  with  force  enough  to  change  the  foetal  pre- 
sentation. 

This  is  rendered  still  more  difficult  from  the  relative 
weight  of  the  gravid  uterus,  carrying  it  below  the  intes- 
tines and  epiploon  thickened  by  adipose  deposits.  Any  con- 
siderable degree  of  flatulence  also  hinders  in  the  manner 
last  mentioned  by  the  intestines  riding  above  the  uterus, 
thereby  presenting  a  mechanical  difficulty,  and,  perhaps, 
rendering  palpation  painful.  We  have  used  the  term  drop- 
sical^ referring  to  cases  in  which  ascites  and  anasarca  exist. 


On  Turning  the  Foetus  in   Titer o^  Sc.  TIS 

If  anasarca  only  exists,  dorsal  decubitus  is  most  favorable. 
But  as  the  gravid  uterus  sinks  below  peritoneal  effusion,  it 
would  be  unfavorable  in  that  case,  and  tbe  anasarcous  pa- 
rieties  would  increase  the  difficulty  of  transposition.  In 
very  large  parturients,  the  bodies  of  the  vertebrge  project 
so  far  above  the  muscles  on  either  side  that  the  foetal 
head  or  body  is  not  easily  lifted  upon  or  over  the  column. 
Take,  for  instance,  a  lean  patient,  with  well  expanded  ossa 
ilii,  with  a  presentation  of  any  lateral  portion  of  the  body 
or  head,  especially  if  the  abdomen  is  a  little  tender,  and 
it  will  be,  sometimes,  very  difficult  to  turn  the  foetus  by 
external  manuplation  with  the  patient  either  on  the  back 
or  side.  But  in  either  of  the  aforesaid  instances,  let  the 
patient  be  placed  on  her  knees  upon  a  pillow  or  cushion, 
so  that  she  may  endure  the  posture,  with  the  shoulders 
resting  upon  a  well  pillowed  chair  or  stool,  so  that  they 
may  be  elevated  or  depressed,  as  may  be  found  necessary; 
let  the  operator  kneel  upon  one  knee,  using  the  other 
as  a  fulcrum  for  the  elbow,  in  order  that  he  may  con- 
tinue his  efforts  for  considerable  time,  if  required,  or,  if 
convenient,  sit  upon  a  low  stool,  and  he  will  find  that 
the  foetus  is  much  easier  movedj  for  reasons  which  will 
be  obvious  to  every  reflecting  mind.  In  the  obese,  the 
dropsical,  and  the  flatulent,  as  also  in  excess  of  liquor 
amnii,  diagnosis  is  more  clear  in  this  position  for  reasons 
before  intimated,  ^.  e.,  the  relative  weight  of  the  foetus. 
I  think  that  I  have  never  performed  turning  by  the  feet 
except  for  hemorrhage  in  placenta  praevia,  in  19  years 
of  practice,  of  which  a  respectable  portion  has  been  ab- 
stetric,  and  (previous  to  seeing  Dr.  Noeggerath's  paper) 
supposed  that  the  possibility  of  turning  by  external  mani- 
pulation was  fully  understood  by  a  large  majority  of  prac- 
titioners. 

Since   the  foregoing  was  written,   the   January  number 


'714  The  Perdnsuiar  and  Independent. 

of  the  N.  Y.  Journal  of  Medicine,  has  published  another 
paper  prepared  by  Dr.  Noeggerath,  from  an  article  by 
Prof  EsTERLE,  of  Trentj  on  "turning  by  external  mani- 
pulation/' which  contains  additional  ideas.  The  author 
declares  that  "a  considerable  number  of  children  presented 
in  a  transverse  position  at  the  seventh  and  eighth  month 
of  pregnancy,  and  although  formerly  nothing  was  done  to 
rectify  this  cross-position  (in  the  Instituto  D'elle  Laste), 
most  of  them  presented  with  the  vertex  at  the  time  of 
delivery/'  and  still  he  advises  interference  "as  soon  as  the 
accoucher  detects  the  transverse  presentation.*'  Notwith- 
standing the  high  authority,  we  are  convinced  that  no 
such  manipulation  is  warrantable  until  some  inconvenience 
is  felt  by  the  mother,  or  until  labor  is  at  hand,  and 
that  premature  labor  will  sometimes  be  induced  when,  if 
the  case  were  left  alone,  spontaneous  version  would  occur 
without  harm. 

When  the  bowels  are  obstructed  by  the  transverse 
foetus,  giving  rise  to  colic  pains,  etc.,  the  foetus  may  be 
changed  with  great  advantage.  In  changing  a  position  or 
condition  which  has  not  produced  any  unfavorable  symp- 
toms, we  are  liable  to  excite  irritation,  which  may  be- 
come mischievous,  while  the  same  changes  to  relieve  a 
pathological  condition  would  be  tolerated  because  a  sensi- 
ble cause  of  irritation  was  removed.  Our  author  mentions 
the  following  "means  by  which  nature  effects  spontaneous 
version": 

"1st.  The  constantly  increasing  dilatation  of  the  lower 
section  of  the  womb,  by  which  the  long  diameter  of  the 
uterus  gains  over  the  lateral  diameter,  so  that  the  grow- 
ing foetus  is  compelled  to  change  its  situation  in  order  to 
adapt  itself  to  the  shape  of  the  womb.  This  very  rarely 
occurs  before  the  seventh  month  of  gestation. 

"2.    The  partial  contractions  of  the  womb  which  set  in 


On  Turning  the  Foetus  in   Titer o^  c&c.  715 

very  often  long  before  the  beginning  of  labor,  and  which 
by  lateral  pressure  upon  the  most  prominent  points  of  the 
foetal  body,  compel  it  to  occupy  the  fundus  with  either 
the  head  or  nates. 

"3.  The  regular  contraction  of  the  uterus  at  the  be- 
ginning of  labor,  do  very  often  promote  the  rectification  of 
a  cross-position. 

"4.  The  most  efficient  cause  of  spontaneous  version  is 
the  united  action  of  the  active  movements  of  the  foetus 
and  of  its  gravitation,  inasmuch  as  the  point  of  gravitation 
in  the  foetus  is  situated,  if  not  in  the  head  itself,  at  least 
near  by  it.  To  these  must  be  added  a  sufficient  quantity 
of  the  liquor  amnii." 

The  power  of  the  abdominal  muscles,  in  correcting 
transverse  positions  seems  to  have  been  ignored;  but  who 
that  has  ever  performed  an  easy  turning  by  external  mani- 
pulation, can  doubt  that  the  abdominal  muscles  may  of 
themselves  exert  sufficient  force  to  effect  it. 

In  labor,  the  abdominal  muscles  usually  contract  imme- 
diately after  the  uterus  begins  each  effort,  which  tends  to 
bring  the  axis  of  the  foetal  body  in  line  with  that  of  the 
maternal,  the  contraction  of  the  diaphragm  follows  quickly 
upon  that  of  the  abdominal  muscles,  and  complete  the  ex- 
pulsive effort.  We  believe  that  cross-positions  occur  more 
frequently  in  females  of  feeble  abdominal  muscles,  or  in 
those  whose  ilii  are  excessively  expanded,  so  that  the  foetus 
has  too  much  scope  by  the  breadth  between  the  attach- 
ments of  the  muscles. 

Dr.  EsTERLE  considers  it  ^^unnecessary  and  dangerous 
to  change  a  breech  into  a  vertex  presentation,"  and  advises 
to  bring  the  head  or  nates  down,  as  either  may  happen  to 
be  nearer  the  pelvic  entrance. 

Where  there  is  probability  that  the  foetal  head  is  so 
large   as   to   render    its   passage    through    the   pelvis    slow 


716  The  Peninsular  and  Independent. 

or  doubtful,  there  can  be  but  little  doubt  of  the  pro- 
priety of  using  all  reasonable  effort  to  turn  by  external 
manipulation  a  breech  presentation  to  a  cephalic,  inasmuch 
as  the  prospect  of  delivery  by  the  natural  powers  would 
be  increased,  and  the  chances  of  further  obstetric  opera- 
tions, if  necessary,  would  not  be  impaired.  In  instances 
in  which  the  foetal  head  is  of  normal  proportions,  it  would 
appear  officious  to  turn  by  external  manipulation,  as  it 
is  liable  to  delay,  and  even  defeat,  which  prevents  its 
remedial  value  in  emergencies.  Our  author  adds  to  his 
manipulations  by  pressure  ^'gentle  knocks  applied  alter- 
nately upon  both  ends  of  the  ovum.''  If  by  this  is  meant 
sudden  forcible  pressure,  without  removing  the  hands  from 
the  surface,  similar  to  the  succession  in  ballottement,  we 
are  agreed  ;  but  if  the  hand  were  removed  from  the  ma- 
ternal body,  and  forcibly  brought  against  it,  as  we  under- 
stand the  word  knock,  we  believe  its  effect  would  be  in- 
jurious to  the  maternal  tissues,  and  that  the  greater  part 
of  the  force  would   be  lost  before  it  reached   the  foetus/ 

We  understand  most  of  the  authorities  cited  by  Dr. 
NoEGGERATH  as  Condemning'^  efforts  at  turning  by  exter- 
nal manipulation,  ofter  the  membranes  are  ruptured.  Dr. 
EsTERLE  says :  ^^After  the  discharge  of  the  water,  the 
operation  has  been  successful  only  in  a  few  instances." 
But  are  not  obstetric  records  full  of  cases  of  spontaneous 
version  after  the  rupture  of  the  membranes,  and  even 
while  the  arm  has  been  pulled  by  the  anxious  or  ambitious 
midwife,  the  head  has  been  forced  into  the  pelvic  entrance 
by  the  natural  expulsive  efforts. 

We  insist  that  external  manipulations  are  proper,  and 
promise  success,  whenever  any  portion  of  the  foetus  is  well 
defined,  varying  from  its  normal  position  at  any  period  of 
parturition. 

It  has  been  objected  in  our  presence   that   such   mani- 


Poisonous  Symptoms  from  Tartar  Emetic  IVl 

pulations  might  induce  inflammation  of  the  peritoneum  or 
uterus,  but  we  think  not  from  any  reasonable  force.  We 
have  seen  considerable  force  used  upon  the  abdomen,  but 
have  never  been  able  to  trace  serious  results  to  it.  In  or- 
der to  diagnose  satisfactorily,  or  effect  turning,  the  hands 
must  be  applied  to  the  skin  without  the  intervention  of 
any  skin  or  covering,  as  the  elasticity  of  the  skin  is  lost 
by  the  thinnest  fabric,  and  the  salient  points  may  pass 
undetected.  It  is  also  true  that  the  elasticity  of  the  ab- 
dominal parieties  is  increased  by  inunctions  of  warm  ole- 
aginous substances  and  by  protracted  inunction,  patients 
are  enabled  to  bear  a  degree  of  pressure  at  first  intolerable. 
By  such  friction,  also,  much  of  the  fluid  in  anasarca  can 
be  forced  out  of  the  cellular  tissue  of  the  abdominal  walls, 
thereby  facilitating  diagnosis  and  manipulation.  Such 
manipulations  are  compatible  with  the  utmost  delicacy  in 
regard  to  personal  exposure  of  the  patient,  which  is  never 
to  be  lost  sight  of  by  the  high-minded  accoucher. 
CoLDWATEB,  January  20,  1860. 


•  ♦  • 


ART,  XLII.— Poisonons  Symptoms  from  Tartar  Emetic. 
Twenty  Grain  Doses. 


By  Charles  Rynd,  M.  D. 


I  contribute  the  following  account  of  an  accident 
which  occurred  in  my  practice  a  short  time  since,  for 
two   reasons  : 

First.  Because  of  its  interest  in  a  Toxicological  point 
of  view. 

Second.  Because  important  deductions  may-  be  drawn 
therefrom. 

Mrs.    H.,    aged   24,  widow,    mother   of  three   children, 


718  Ihe  Peninsular  and  Independent. 

charwoman,  was  employed  to  perform  some  labor  on  July 
5,  1859,  which  exhaustad  her  very  much.  She  caught  a 
bad  cold,  which  was  followed  by  a  violent  attack  of 
acute  rheumatism,  suppression  of  menstrual  discharge,  dc, 
dc. 

In  the  absence  of  proper  treatment,  —  aided  much, 
no  doubt,  by  the  miseries  of  poverty  —  these  conditions 
became  chronic,  and  the  patient  was,  ere  long,  crippled, 
anasmic,  —  in  fact  reduced  to  the  very  verge  of  the  grave. 

December  7th,  1859,  was  called  in  for  the  first  time 
to   visit  this   patient,   and  found   her  as   stated   above. 

Kheumatism  and  the  complications  had  well  -  nigh  ex- 
tinguished the  ^Wital  spark,"  and  my  patient  was  in  a 
pitiable   condition. 

I  found  a  torpid  and  inactive  state  of  the  kidneys, 
and  to  remedy  this  evil,  depurate  the  blood,  and  thus 
counteract   the   rheumatic   diathesis,    I   prescribed: 

Pot.  Acct.,    3  ss. 
Aq.  Dist.       3  vj. 
M.  S.  a  tahlespoonful  morning  and  evening  in  a  glass  of  water.'''' 

It  will  be  seen  that  each  dose  contained  about  twenty 
grains  of  the  salt,  which  was  the  manner  in  which  I 
designed  it  should  be  used  to  fulfill  existing  indications. 
Tonics,  depuratives,  &c.,  were  being  used,  also,  with  all 
the   care   and  discrimination   of  which   we   were   master. 

A  full  dose  was  taken  about  10  P.  M.,  which  was 
followed  in  about  forty  minutes  by  vomiting,  purging,  a 
burning  pain  in  the  epigastrium,  and  great  prostration 
of  strength. 

But  the  patient  and  friends  were  determined  to  carry 
out  their  instructions,  and,  therefore,  another  half  ounce 
of  the  solution  was  taken  in  the  morninof,  about  half 
past  seven  o'clock. 


'OJ 


Poisonous  Symptoms  of  Tartar  Emetic.  719 

This  was  followed  in  about  thirty  -  five  minutes  by 
the  most  alarming  vomiting  and  purging;  blood  was 
found  in  the  matters  vomited,  as  also  in  the  dejections, 
I  was  called  in  at  12  M.,  to  see  my  suffering  patient, 
and  discovered  immediately  that  I  had  a  case  of  Poison^ 
ing  by  Tartar  Emetic. 

All  the  symptoms  of  acute  poisoning  by  Tartar  Emetic 
were  present ;  —  a  peculiar  metallic  taste  ;  tongue  coated 
with  a  heavy  yellow  fur,  the  tip  and  edges  being  intensely 
red ;  small,  contracted,  and  accelerated  pulse ;  respira- 
tion slow  and  labored ;  nausea ;  copious  vomiting ;  vio- 
lent purging  ;  hiccough ;  burning  pain  in  the  epigastrium; 
tenesmus  ;  skin  cold  and  covered  with  a  clammy  perspi- 
ration ;  a  shrivelled  condition  of  the  extremities  ;  occa- 
sionally cramps  in  the  legs,  alternated  with  extreme  re- 
laxation  of  the  muscular  fibre.  =^ 

The  Sedative  action  of  the  antimonial  was  particu- 
larly conspicuous.  From  a  careful  examination  of  the 
symptoms,  we  were  led  to  think  that  the  tendency  was 
to  death  by  asthenia.  There  was  no  time  to  be  lost, 
for  if  nothing  was  done  to  counteract  the  effects  of  the 
poison,  and  resuscitate  the  [sinking  energies  of  |^the  sys- 
tem,  a  fatal   result   seemed  inevitable. 

I  administered  a  drachm  of  laudanum  immediately, 
followed  in  a  few  minutes  by  ten  grains  of  tannic  acid. 
Decoction  of  green  tea  was  also  given  freely,  and  the 
laudanum  and  tannic  acid  was  repeated.  A  mustard  sin- 
apism was  applied  to  the  epigastrium,  and  heat  |to  the 
extremities.  In  this  manner  we  endeavored  to  counter- 
act the  effects  of  the  poison  and  equalize  the  circula- 
tion. But  there  was  a  tendency,  as  before  stated,  to 
sink,  —  to  die  by  the  gradual  cessation  of  the  heart's 
action,  —  and  to  counteract  this  tendency,  we  had,  as  the 
more  urgent   symptoms   of    irritation   passed,   off,   recourse 


720  The  Peninsular  and  Independent. 

to  gentle  stimulation.  This  was  done  with,  great  caution, 
and  in  a  few  hours  I  had  the  satisfaction  to  see  my 
patient   in   a   comparatively   comfortable  condition. 

I  watched  the  case  carefully,  but  abstained  from  fur- 
ther medication  for  two  or  three  days,  when  my  pre- 
determined course  was  carried  into  effect.  The  prostra- 
tion of  strength  was  evident  for  nearly  a  week,  but  no- 
thing particularly  unfavorable  presented.  At  the  next 
menstrual  "period  the  discharge  re  -  appeared  ;  the  rheuma- 
tic condition  gradually  gave  way; — health  is  now  being 
restored. 

In  this  case,  we  had  forty  grains  of  Tartar  Emetic 

ADMINISTERED     WITHIN     A     PERIOD     OF    TEN    HOURS  ;     violent 

symptoms  presented,  and  yet  we  had  a  speedy  recovery 
from   its    prostrating   effects. 

It  may  be  remarked,  also,  that  the  salt  dissolved  al- 
most wholly  in  the  water.  According  to  the  experiments 
of  the  Brandes,  and  the  opinion  of  the  Dr.  Perceval, 
of  Dublin,  a  good  article  will  dissolve  in  about  twelve 
parts  of  water  ;  it  is  probable,  therefore,  that  in  this  in- 
stance we  had  an  article  which  was  nearly,  if  not  al- 
together pure.  Or,  the  solution  may  have  became  warm, 
as  it  was  placed  on  a  table  near  to  the  stove.  At  any 
rate,  when  I  examined  the  solution,  I  found  that  the 
salt  had  been  almost  entirely  dissolved,  and  it  follows, 
therefore,  as  a  legitimate  inference,  that  forty  grains  were 
really   taken   as  stated  above. 

The  inference  to  the  operation  of  the  antimonial,  I 
am  almost  certain  that  its  use  (or  abuse,  if  you  please,) 
was  attended  with  beneficial  results.  This  case  had  been 
treated  by  several  able  practitioners  with  little  or  no  be- 
nefit,—  indeed  the  patient  grew  worse.  We  had,  pre- 
vious to  the  operation  of  the  antimonial,  a  deficiency  of 
the   secretions  ;  a  torpid    condition  of  the   liver.     Many  of 


Poisonous  Symptoms  of  Tartar  Emetic.  721 

the   symptoms   of   indigestion,    and   a    peculiar   depression 
of  nervous   force. 

After  the  operation  of  the  antimonial  —  during  con- 
valescence —  we  have  an  improvement  of  the  secretions 
generally ;  a  more  active  condition  of  the  liver ;  the  di- 
gestive organs  became  more  vigorous  ;  and  the  dormant 
nervous   energies   seemed   very   much   aroused. 

I  was  forced  to  believe  that  the  operation  of  the  an- 
timonial had  produced  a  powerful  Alterative  effect  on  the 
system,  which  proved,  under  the  circumstances,  decidedly 
beneficial.  Nor  is  this  view  inconsistent  with  the  most 
correct   principles  of  medical   science. 

What,  it  may  be  asked,  is  our  duty  in  reference  to 
our  relations  with  Apothecaries.^  Is  it  a  fact  that,  even 
in  our  cities,  we  must  run  the  most  fearful  risks,  and 
thus  j)lace  in  jeopardy,  every  day,  the  lives  of  our  fel- 
low -  creatures  ?  Must  our  patients'  safety  and  our  own 
comfort  and  reputation,  too,  lie  at  the  mercy  of  every  care- 
less boy  ?  Should  every  egotistic  pretender  be  permitted 
to  dispense  drugs  and  imperil,  by  so  doing,  the  safety 
of  the    sick  in   all  classes   of  society  ? 

The  dispensing  Apothecary,  in  this  instance,  when  in- 
terrogated, rendered  "  Po^  Acet^'  '^  Antimoniate  of  Potash. 
For  the  credit  of  that  Profession,  however,  I  would  say 
that  several  other  clerks  in  the  locality  had  no  difficulty 
in  rendering  us  ''  Acetate  of  Potassa/'  and  not  '^  Anti- 
moniate  of  PotasJi,"  which  being  interpreted,  means,  of 
course,  "  Tartar  Emetic  J' 

Now  the  qiiestion  arises,  how  is  the  Profession  to  be 
protected  from  these  blunders.?  Druggists  complain,  and 
sometimes  justly,  of  the  carelessness  of  Physicians,  but 
have  we  no   ground  for  complaint   at   all  ? 

"  In  the  writing  of  prescriptions,"  says  Prof  Parish, 
"the    chief  desideratum  is   to   secure   accuracy   without  an 

Vol  II.-2V 


722  The  Peninsular  and  Independent. 

unnecessary  and  cumbersome  phraseology,  and  for  this 
purpose  the  officinal  names  of  all  medicines  are  to  be 
preferred  to  either  of  their  common  and  changing  syn- 
onyms. *  •'^'  *  *  *  Many  medicines  are  called  by 
very  different  names  in  different  parts  of  the  country,  and 
the  same  name  is  liable  to  be  applied  to  either  of  seve- 
ral drugs.     *     *•'■     *     *     '••■  ' 

This  able  pharmaceutist  further  says  :  '^  There  can  be 
no  comparison  between  the  names  sugar  of  lead  and 
plumbi  acetas,  white  vitriol  and  zinci  sulphas,  liver  of  sul- 
phur and  potassa  sulphuretum,  salt  of  tartar  and  potassi 
carbonas.  The  name  which  expresses  the'chemical  compo- 
sition of  a  substance,  is  generally,  of  all  that  can  be  de- 
vised, the  best ;  and  hence,  even  in  common  language,  most 
familiar  chemical  substances  are  beginning  to  be  called 
by  their  proper  names.  Although  there  is  little  difference 
between  the  English  and  Latin  chemical  names,  the  lat- 
ter has  the  advantage  for  use  in  prescription ;  it  is  easier 
of  abbreviation,  or  its  abbreviations  are  more  familiar; 
while  the  omission  of  the  connecting  preposition  of  between 
the  two  parts  of  the  name,  reduces  it  to  a  single  compound 
word,  rendering  it  shorter  and  more  quickly  written." 

Now,  from  what  study  we  have  been  able  to  bestow  on 
this  matter  —  one  pregnant  with  importance — we  cannot 
go  in  for  the  sweeping  changes  advocated  by  some  Mem- 
bers of  our  Profession.  We  believe  weighty  objections 
may  be  raised  against  them ;  we  refer  to  the  writing  of 
all  prescriptions  in  English.  We  can  see  the  force  of 
Pkofessor   Parrish's  ideas   as  given  above. 

Professor  Palmer   says  : 

"The  Latin    names  of  the    diflferent    medicines,  and  the  few  words 
ndicating  their  preparation  can  be  very  readily  learned." 

In  fact,  any  person  of  ordinary  ability  can,  in  a  short 


Hypnotism,  '^2S 

time,  with  diligence  and  application,  acquire  sucli  a  know- 
ledge of  the  Latin  language  as  will  enable  him  to  write 
prescriptions   with  neatness,    or   read    them  with   accuracy. 

The  Profession  should,  in  duty  to  itself  and  the  pub- 
lic, avoid  patronizing  those  Houses  where  either  ignorance 
or  carelessness  is  manifested,  and  strenuously  insist  on 
having  prescriptions  made  up  where  care  and  attention 
are   bestowed   on  the  matter. 

In  the  absence  of  Legislation  this  would  be  a  salut- 
ary check,  and  employers  would  find  it  to  their  advantage 
to  retain  such  employees,  and  such  only,  as  possessed 
the  requisite   qualifications. 

Adrian,   January,    1860. 


»»  »• 


ART.  XIIII— Hypnotism. 

By  0.  D.  Palmer,  Zelienople,  Pa. 

A  profound  sensation  has  been  made,  in  the  scientific 
world  of  Paris  of  late,  by  the  announcement  of  a  new 
method  of  efiecting  anesthesia,  to  which  they  have  given 
the  name  heading  this  article.  The  circumstances  of  its 
discovery,  its  marvelous  history,  and  enthusiastic  recep- 
tion in  the  metropolis  of  civilization  and  science,  will  all 
transpire  in  the  translation  appended  below,  which  has 
bee*  made  from  the  "  Gazette  Hehdomadaire "  of  Decem- 
ber 9th,   1859: 

"The  society  of  surgery  heard  at  its  last  session,  on  December 
Tth,  a  communication  certainly  interesting,  but  the  future  of  which  it 
is  impossible  to  calculate,  at  present.  We  mean  the  manner  of  pro- 
curing anesthesia  by  a  very  simple  manoeuvre,  which  consists  in  in- 
ducing and  continuing  for  some  time,    superior   convergent  strabismus, 

A  young  provincial  surgeon,  M.  the  doctor  Azam,  assistant  pro- 
fessor at  the  secondary  school  of  Bordeaux,   has  introduced  to  us  this 


724-  The  Peninsular  and  Independent. 

singular  method,  as  the  fruit  of  prolongned  studies,  and  results  of 
numerous  experiments,  patiently  instituted  during  a  long  period.  On 
his  arrival  at  Paris,  Dr.  Azam  imparted  his  observation  to  our  excel- 
lent friend.  Dr.  Broca,  and  to  ourself.  Dr.  Bkoca,  convinced  like  Dr. 
Azam,  that  practical  surgery  could  reap  benefit  from  these  marvelous 
experiments,  hastened  to  make  trial  in  practical  surgery,  under  the 
direction  of  Dr.  Follet.  In  a  case  which  vre  will  summarily  repro- 
duce hereafter,  the  success  was  so  perfect,  as  to  induce  Dr.  Bkoca 
to  reduce  it  to  paper,  which  M.  Velpeau  deigned  to  communicate  to 
the  institute   on  Monday. 

We  do  not  wish  to  dissemble  either  the  obscurity  of  the  subject, 
or  the  imperfections  of  the  experiments;  we  are  ignorant  what  fortune 
may  be  reserved  for  this  discovery,  we  suspect  even  that  the  initia- 
tive taken  at  this  time,  will  be  variously  judged,  in  our  own  ranks, 
and  elsewhere;  but  we  may  be  permitted  the  remark,  that  a  fact  in- 
troduced into  science,  or  at  least  patronized  at  its  debut,  by  such  men 
as  the  Messieurs  Azam,  Bkoca,  Follen,  and  Yelpeau,  merits  examina- 
tion, to  say  the  least,  and  should  not  be  assailed  under  any  pre- 
text, by  incredulity,  or  even  by  obstinate  doubt.  The  proud  disdain 
of  the  learned,  for  extraordinary  facts,  has  been  reproached  for  a  long 
time,  and  with  reason.  We  live  in  an  epoch  in  which  all  that  is 
announced  under  a  serious  mien,  and  which  proceeds  scientifically, 
merits  examination.  In  short,  we  live  in  a  time,  when  it  would  be 
unreasonable  to  turn  away  our  eyes,  from  any  thing  wished  to  be 
shown  us,  merely  because  it  is  improbable  or  prodigious.  Besides 
the  best,  and  in  fact  only  manner  of  judging  any  thing,  consists  in 
viewing  it  first,  and  this  is  what  has  been  done  by  the  grave  men  we 
have  cited.     This  is  M^hat  we  ourselves  have  undertaken. 

Moreover,  this  thing  is  not  entirely  new,  and  Dr.  Azam  has  him- 
self put  us  in  mind  of  the  series  of  circumstances,  which  led  him  to 
the  discovery,  or  exhumation  of  this  order  of  facts.  Eighteen  months 
since  he  had  occasion  to  attend  a  young  hysterical  patient,  in  sponta- 
neous catalepsy.  We  observed  in  her  facts  the  most  curious,  which  it 
does  not  come  within  our  province  to  relate  here.  A  professor  in  the 
Academy  of  Sciences,  a  man  of  great  distinction.  Dr.  Bazin,  was  made 
acquainted  with  these  experiments.  He  advised  Dr.  Azam  to  consult,  at 
this  time,  an  English  work  published  in  1842.  by  M.  Braid,  and  in 
which  is  indicated,  a  means  of  producing  catalepsy,  and  artificial  anes- 
thesia. Dr.  Azam,  having  procured  the  work,  an  analysis  of  which  an 
eminent  physiologist,  M.  Carpenter,  had  given  in  the  Cyclopedia  of 
Todd  &  Bowman  (article  sleep),  instituted  upon  this  cataleptic,  and  not 
less  than  thirty  other  subjects,  numerous  experiments.  He  proved  that 
a  greater  part  of  Mr.  Braid's  assertions  were  seriously  true ;  among 
others,  that  catalepsy  and  anesthesia,  could  be  obtained  at  will,  by  pro- 
ceeding  in  the  following  manner 


Hypnotistn.  725 

The  subject  is  seated,  or  lying,  in  a  convenient  position,  the  opera- 
tor placed  either  before  or  behind  him,  places  before  his  eyes,  at  a  few 
inches  distance,  but  generally  within  the  point  of  distinct  vision,  a 
bright  object,  on  which  the  eyes  are  to  be  directed,  and  constantly 
fixed.  The  bright  body  should  be  so  placed,  that  in  order  to  see  it, 
the  eyes  are  directed  and  attracted  strongly  upward,  by  the  rectus  su^ 
perior  muscle  of  each  eye,  contracted  to  its  utmost.  In  this  action, 
there  is  a  forced  contraction  of  the  levatores  palpebrarum^  and  of  the 
recti  supeiHores,  that  produces  con'cergent  strabismus. 

Scarcely  has  this  attitude,  fatiguing  at  least,  been  persevered  in,  but 
two  or  three  minutes,  till  we  observe  the  pupils  to  contract,  and  then 
to  dilate;  the  palpebrae  rapidly  to  oscillate,  and  then  fall  down,  and 
immediately  the  subject  slumbers.  Two  symtoms  are  then  manifested 
pretty  constantly,  more  or  less  emphatic,  and  more  or  less  durable,  1st, 
catalepsy,  in  all  analogous  to  classical  descriptions,  and,  2d,  anesthesia, 
which  endures  from  three  to  fifteen  minutes,  either  complete  or  imper- 
fect, but  which  generally  permits  "pinching,"  "pricking,"  and  "tick- 
ling," without  the  least  trace  of  apparent  sensibility,  in  the  subject,  and 
without  having  these  excitations  modify  in  any  particular,  the  cataleptic 
state.  This  anesthetic  condition  is  usually  followed  by  a  hypersesthetic 
state  of  an  entirely  difi'erent  character,  in  which  the  ordinary  senses,  the 
sensations  of  temperature,  and  of  muscular  action,  attain  a  degree  of 
impressibility,  altogether  unaccustomed.  At  any  moment  of  the  experi- 
ment, the  symtoms  can  be  made  to  cease  suddenly,  by  making  frictions 
on  the  eyelids,  or    by  directing  on  these  organs  a  current    of  cold   air. 

The  subject  brought  to  himself,  preserves  no  remembrance  of  what 
has  passed  during  the  preceeding  time. 

We  will  not  insist  at  present,  on  all  the  particularities  of  these 
facts,  infringing  on  the  marvelous,  and  of  which  at  present,  we  only 
desire  to  be  the  faithful  historian;  we  will  report  no  farther  the  experi. 
ments  made  by  Drs.  Bkoca  and  Follet,  and  those  made  by  ourself ;  we 
will  merely  state  that  Dr.  Azam  has  arrived  at  Paris,  fully  persuaded 
that  surgery  is  in  possession  of  a  new  anesthetic.  Readers  may  judge 
from  the  following  report,  the  value  of  this  impression. 

Case.  Woman  aged  twenty  -  four  years,  vast  burn  of  the  back  and 
right  limbs,  abscess  voluminous  and  extremely  painful  of  the  margin  of 
the  arms,  exhausted  by  pain  and  otherwise  being  very  pusillanimous, 
she  greatly  fears  the  lancing ;  she  was  informed  that  she  was  to  be  put 
into  a  sleep.  A  copper  cylinder  is  placed  15  centimetres  anterior  to 
the  root  of  the  nose.  The  patient  was  obliged  to  squint  strongly,  in 
order  to  see  this  object;  the  pupils  were  directly  much  contracted.  The 
pulse  rapid,  previous  to  the  experiment,  was  first  a  little  accelerated 
then  soon  after  becoming  much  more  feeble  and  slow.  At  the  end  of 
two  minutes  the  pupils  begin  to  dilate;  [the  left  arm,  raised  nearly  ver- 


726  The  Peninsular  and  Independent. 

tically  above  the  bed,  remains  immovable  in  this  attitude ;  towards  the 
fourth  minute,  the  answers  were  slow  and  laborious,  otherwise  per- 
fectly sensible,  respiration  slightly  affected.  At  the  end  of  five  minutes 
Dr.  FoLLET  pricked  the  flesh  of  the  left  arm,  constantly  remaining  in 
the  vertical  position  —  no  movement,  no  effect  —  pricked  anew,  so  as  to 
give  rise  to  a  drop  of  blood,  passed  equally  unperceived ;  the  right  arm 
was  placed  in  the  same  attitude,  as  the  left ;  the  scat  of  the  abscess 
was  laid  bare,  the  patient  permitting  all,  but  constantly  saying  indiffer- 
ently, that  we  were  going  to  injure  her.  In  short  seven  minutes  after 
the  debut  of  the  experiment.  Dr.  Follet  made  a  large  opening  into  the 
abscess,  which  gave  issue  to  an  enormous  quantity  of  pus,  very  fetid. 
A  light  cry,  lasting  less  than  a  second,  is  the  sole  sign  of  feeling  made 
by  the  patient.  Other  ways,  not  the  least  twinge  in  the  muscles  of  the 
face,  or  limbs,  the  arms  preserving  the  attitude  in  which  they  had  been 
placed,  without  the  least  motion.  Two  minutes  later  the  position  the 
same,  the  eyes  ever  remaining  wide  open,  a  little  injected,  the  counte- 
nance open  and  free,  the  subject  constantly  insensible,  pulse  as  before 
the  experiment,  respiration  easy  and  free,  the  left  heel  was  raised,  and 
remained  suspended  in  air,  the  cataleptic  state  of  the  superior  members 
persistent. 

Dr.  Broca  removed  the  bright  body,  which  had  remained  all  this 
while  before  her  eyes ;  he  used  friction  to  the  eyelids,  and  sufflation  of 
cold  air.  The  patient  made  some  little  movements.  She  was  asked  if 
any  thing  had  been  done  to  her;  she  answered,  she  knew  of  nothing. 
The  three  limbs  still  remain  in  the  same  attitude,  first  given  them. 
Pricking  anew,  on  the  left  arm,  was  unperceived.  Eighteen  minutes 
after  the  commencement  of  the  experiments,  twelve  minutes  after  the 
operation,  again  friction  and  sufflation  of  the  palpebra,  sudden  awaking 
of  patient.  The  cataleptic  limbs  all  fall  at  once.  The  subject  rubs  her 
eyes,  and  resumes  her  consciousness.  She  remembers  nothing,  and  is 
astonished  to  find  herself  the  subject  of  an  operation.  Her  state  is 
similar,  in  a  certain  degree,  to  that  of  individuals  coming  out  of  an  or- 
dinary anesthetic  sleep.  Every  time  the  waking  has  been  much  more 
prompt  and  without  agitation  and  loquacity." 

The  anesthesia  reported  in  the  above  case  has  lasted 
from  12  to  15  minutes  at  least,  interrupted  only  by  pro- 
voked waking.  We  understand  that  Dr.  Azam  has  suc- 
ceeded under  the  auspices  of  Dr.  Trousseau  in  anesthesi- 
zing  very  promptly,  a  young  girl,  and  all  seems  to  con- 
spire to  give  the  belief,  that  experiments  will  be  multi- 
plied abundantly.     We   presume  merely  to  anticipate,  that 


N'otes  on  some  Cases  of  ITeart  Diseasei,  12*1 

some   subjects   may   show  themselves   altogether  refractory 
to   Hypnotism. 

We  wish,  in  conclusion,  to  forewarn  our  colleagues  against 
a  too  sudden  enthusiasm,  and  equally  against  a  skepti- 
cism too  ultra.  We  are  still  ignorant  of  the  conditions 
for  the  most  part,  essential  to  make  one  individual  vary 
in  results  from  another.  We  are  even  not  sure  of  having 
found  out  the  best  mode  of  procedure  to  be  followed. 
It  is  enough  to  say,  that  it  is  indispensible  to  study  the 
question  with  calmness,  patience,  and  coolness.  The  pro- 
moter of  this  discovery,  and  those  who  seek  to  propogate 
it,  do  not  wish,  ^^  thank  God,"  either  to  deceive,  or  to 
be  deceived;  they  seek  the  naked  truth.  Happy  if,  as 
all  leads  us  to  predict,  they  draw  some  useful  knowledge 
from  an  order  of  novel  facts  by  means  of  which  phy- 
siology and  even  psychology  will  reap,  without  doubt, 
more  immediate  advantage  than  therapeutics.  To  know 
how  to  await,  to  examine,  and  to  deny  nothing  to  in- 
stinct, such  are  our  parting  words  and  our  formal  in- 
tentions. 

[Editorial  BemarTc.  —  We  have  repeatedly,  since  the 
announcement  of  Hypnotism,  made  the  suggestion,  and 
we  now  again  express  the  belief,  that  the  same  number, 
and  the  same  class  of  persons  will  yield  to  it,  that  prove 
susceptible  to  the  so  -  called  mesmeric  influence.  It  is  but 
another   phase   of  that  wonder.  Gr. 


• » • 


ART.  ILIY.— Notes  on  some  Cases  of  Heart  Diseases, 


By  Peof.  a.   Sagee,  M.  D. 


Notwithstanding  the  numerous  and  excellent  monagraphs 
upon  the  physiology  and  pathology  of  the  heart,  there  still 


728  The  Peninsular  and  Independent, 

remain  some  points  that  require  elucidation.  Many  cir- 
cumstances moreover  greatly  modify  the  action  of  this 
organ,  and  the  ever -varying  combination  of  pathological 
conditions  render  the  faithful  record  of  cases  particularly 
important,  as  exjoerimeuts  furnished  by  nature  in  illustra- 
tion of  the  normal,  no  less  than  the  abnormal,  physiology 
of  the  heart.  In  this  view  the  following  cases  present 
some  points   of  considerable   interest. 

The  symptomatology  of  the  first  case  was  furnished 
in   a   letter   from   Prof  Z.  Pitcher.     He  writes  : 

Detroit,  December  11,  1859. 

My  Dear  Sir  :  I  send  you  by  express,  a  piece  of  mor- 
bid anatony,  obtained  to  -  day,  from  a  body  that  had 
been  only  two  days  under  my  observation.  The  case  was 
so  near  its  termination  when  I  first  saw  it,  that  it  was 
very   difficult   to    catch   the   distinctive   morbid    sounds. 

The  surface  of  the  body  generally  was  livid  and  bloat- 
ed, not  really  cedematous.  Ees2)iration  exceedingly  embar- 
rassed, more  particularly  the  .effort  to  inhale  atmospheric 
air.  The  impulse  of  the  heat  was  felt  over  a  large  space 
and  w^ith  the  force  characteristic  of  hypertrojihy  of  the 
left  ventricle,  at  the  same  time  there  was  no  pulsation 
in  the  radial  arteries.  Only  one  of  the  sounds  of  the 
heart  could  be  distinguished  ;  but  whether  the  first  or  the 
second  could  not  be  determined.  The  violent  movement 
of  the  heart  enabled  me  to  detect  the  presence  of  a  fluid 
in  the   pericardium. 

Before  the  patient  came  to  the  Hospital  he  had  been 
seen  by  a  very  intelligent  physician  by  whom  he  had 
been  bled  for  the  relief  of  pleuritic  symptoms,  traces  of 
which  (pleuritis),  as  well  as  of  Pericarditis  were  found 
after  death.  The  lungs  were  much  engorged  and  the  liver 
hypertrophied  as   in   valvular   disease    of  the  heart. 

I   was    enabled   to   determine   that  the    heart   was  the 


JVotes  on  so7ne  Cases  of  Heart  Diseases.  729 

primary  seat  of  disease,  but  not  what  part  of  its  struc- 
ture was  first  involved  in  the  morbid  change.  "When 
you  shall  have  made  use  of  the  specimen  I  shall  be 
glad   to   hear  from  you.  Very  truly  yours, 

Z.  Pitcher. 
Prof.  Sager. 

Divested  of  the  pericardium  the  heart  weighed  16  oz. 
avoir.  The  walls  of  the  right  ventricle  varied  in  thick- 
ness from  2  lines  at  the  apex  to  5  lines  at  the  base  of 
the  cavity.  The  average  thickness  of  the  right  auricle 
was  about  1  line.  The  left  ventricle  was  but  one  line 
at  the  apex,  6  lines  in  the  middle  and  2  lines  at  the 
base  of  the  organ  (average  normal  4  1-2,  5  1-6  and  4  2-3  lines 
at  the  base,  middle  and  apex  respectively).  The  septum 
of  the   ventricles  was  4  lines   in   average   thickness. 

The  mitral  valve  was  indurated,  rigid,  and  completely 
adherent  by  the  margins,  forming  an  infundibular  cavity  ; 
the  orifice  contracted  to  4  lines  in  diameter,  the  margins 
of  which  were  about  1-^  lines  in  thickness.  This  orifice 
therefore  did  not  exceed  one  -  tenth  of  its   normal    area. 

Left  auricle  was  considerably  dilated  but  without  at- 
tenuation of  its  parietes.  The  left  ventricle  was  of  normal 
capacity.  The  sigmoid  valves  were  normal.  The  right 
auricle  and  ventricle  were  much  dilated,  the  circumference 
of  the  tricuspid  orifice  full  5  inches  (normal  3  in.  and  10 
lines). 

In  the  great  mitral  obstruction  and  the  right  auricular 
regurgitation  we  find  the  essential  conditions  of  the  respi- 
ratory embarrassment  and  lividity  of  surface.  The  general 
hypertrophy  with  dilitation  explain  the  extent  of  impulse, 
but  the  absence  of  a  radial  pulse  is  inexplicable  from  the 
anatomical  conditions  of  the  organ,  if  it  be  not  due  to  the 
smallness  of  the  mitral  aperture.  The  rigid  immobility  of 
the   mitral   valve    would   explain    the   absence  of  a  mitral 


730  The  Peninsular  and  Independent. 

first  sound,  but  as  the  mobility  of  the  tricuspid  was  un- 
impaired  the  ventricular  systolic  or  first  sound  should  have 
been  audible  over  the  situation  of  that  valve,  if  the  pre- 
Tailing  hypothesis  relative  to  the  origin  of  that  sound  be 
correct.  Would  regurgitation  through  deficiency  of  the 
tricuspid  inteifere  with  the  production  of  a  systolic  sound. 

Case  2d.  I  was  called  in  haste  to  visit  a  young  lady; 
on  arrival,  a  frothy  serum  was  flowing  abundantly  from  the 
mouth.  The  surface  was  warm  and  livid.  Respiration  and 
circulation  had  completely  ceased.  The  following  meagre 
details  of  facts  comprise  all  that  enquiry  of  the  friends 
could  elicit  of  the  history  of  the  case.  About  8  years  pre- 
vious, she  had  suffered  from  an  attack  of  acute  articular 
rheumatism,  since  which  period  she  had  never  been  quite 
well,  choreic  symptoms  had  also  for  a  time  been  manifest- 
ed. Eecently  she  had  been  subject  to  paroxysms  of  dys- 
pnoea on  taking  even  moderate  exercise.  The  cardiac  ori- 
gin of  this  symptom  did  not  appear  to  have  been  suspect- 
ed. About  an  hour  previous  to  the  last  and  fatal  paroxysm 
she  had  returned  on  foot  from  a  visit  to  a  friend  in  a  dis- 
tant part  of  the  city. 

Autopsy.  A  good  degree  of  embonpoint  proved  that 
there  was  no  impairment  of  nutrition.  The  pleural  cavities 
contained  each  about  half  a  pint  of  transparent  serum  ;  no 
adhesion  or  recent  plastic  effusion.  Lungs  purple,  congest- 
ed, and  when  incised  a  frothy  sero- mucus  flowed  out  freely. 
Heart  evidently  hypertrophied  and  the  left  cavities  distend- 
ed with  blood,  mitral  valves  adherent,  the  orifice  being 
just  sufliicient  to  admit  the  point  of  the  finger.  The  state 
of  the  tricuspid  in  regard  to  insufficiency  was  not  observed, 
but  in  all  other  respects  it  was  quits  normal.  The  arterial 
valves  were  also  healthy.  The  pleural  effusion  and  pulmo- 
nary oedema  will  illustrate  the  usual  mode  of  death  from 
mitral  obstruction  conjoined  with  hypertrophy,  and  indicate 


Notes  on  some  Cases  of  Heart  Diseases.  731 

the  danger  under  such  circumstances  of  any  sudden  and 
violent  augmentation  of  the  action  of  the  heart. 

Case  3d.  A  young  man  aged  20  years  had  suffered  for 
Bome  years  from  dyspnoea,  which  was  regarded  as  asthma- 
tic. Some  two  or  three  months  previous  to  his  death  the 
dyspnoea  had  become  much  more  severe,  and  the  renal  ex- 
cretion was  both  deficient  in  quantity  and  depraved  in  quality. 
The  test  tube  and  the  microscope  revealed  a  highly  albu- 
minous condition  of  the  urine,  together  with  blood  discs, 
epithelial  scales  and  tube  casts.  Anasarca  of  the  inferior 
extremities  supervened,  and  some  pleural  effusion  was 
diagnosed.  A  distinct  endocardial  blowing  sound  was  audi- 
ble near  the  apex,  replacing  the  first  sound  at  this  point; 
near  the  base  of  the  heart  no  murmur  was  audible,  and 
the  double  or  tic  tac  sound  was  unusually  distinct.  The 
impulse  of  the  apex  was  felt  below  and  posterior  to  the 
left  nipple,  indicating  enlargement  of  the  organ.  The 
remedies  employed  afforded  great  relief  to  the  renal  symp- 
toms, but  the  symptoms  referrable  to  the  thoracic  organs 
steadily  progressed  to  a  fatal  termination. 

Autopsy.  The  right  pleural  sac  contained  about  24 
ounces  of  serum,  but  the  pulmonary  lobes  were  not  col- 
lapsed. The  left  pleural  sac  was  obliterated  by  chronic 
adhesions.  No  pericardial  f  effusion,  nor  ordema  of  the 
lungs.  General  hypertrophy  of  the  heart  with  dilitation 
of  the  right  cavities  and  also  of  the  left  auricle.  Left 
cardiac  valve  thickened,  indurated,  and  so  far  ossified  as 
to  be  nearly  inflexible,  the  ossification  not  uniform,  but 
in  thick  angular  patches  the  surfaces  presenting  numerous 
sharp  points,  the  friction  of  which  upon  the  opposite 
ventricular  wall,  had  given  rise  to  a  small  ulcerated  spot 
with   margins  much   thickened   and    ulcerated. 

The  orifice  contracted  to  a  narrow  fissure  with  the 
margins   covered   with   vegetations.      The  free  margins    of 


732  The  Peninsidar  and  Independent, 

the  aortic  valves  were  miicli  liypertrophied,  but  not  in- 
flexible, and  probably  not  insufficient.  Left  auricular 
endocardium  opake,  thickened  and  rough  from  subjacent 
deposit.  !No  material  lesion  observed  in  the  right  cavities, 
or  the  valves  of  that  side.  The  kidneys  were  not  hyper- 
trophied  and  presented  no  organic  lesion.  The  left  one 
alone  was  somewhat  congested.  In  this  interesting  case, 
we  find  a  normal  first  sound  at  the  base  of  the  heart 
synchronous  with  a  systolic  murmur  near  the  apex,  and 
as  the  latter  sound  was  undoubtedly  due  to  the  morbid 
condition  of  the  mitral  valve,  the  former  must  have  had 
its   origin   in   the   closure    of  the   tricuspid. 


-•-♦♦- 


ART,  XLV.— Keport  of  an  Austrian  Trial  for  Kapc. 


By  0.  D.  Palmer,  Zelicnoplc,  Pa. 


In  rendering  into  English,  the  report  of  a  trial  for  vio- 
lation, published  in  the  Vienna  Medical  Journal,  named 
below,  the  translator  has  been  influenced  by  considera- 
tions, that  need  perhaps  to  be  intimated.  The  trial  in 
itself  has  j^oints  of  interest,  both  novel  and  suggestive. 
A  female  is  ravished  whilst  unconscious,  and  therefore 
defenseless  ;  she  makes  information  under  the  influence  of 
animal  mac^netism,  and  knows  nothing:  of  either  informa- 
tion  or  violation,  when  in  her  proper  natural  senses. — 
The  accused  confesses  to  the  truth  of  her  dej^ositions, 
thus  obtained;  I  am  not  aware  of  any  thing  analogous 
to  this,  unless  it  may  be  found  in  the  revelations  made 
in  a  trial  at  Montreal,  sometime  since  published  in  the 
P.  and  I.  Journal,  by  which  we  may  infer,  that  ether- 
ization, in  some  females,  leaves  sexual  imjoressions  behind, 
liable   to   be   referred   to   the   operator.      This   is    only   ac- 


Report  of  an  Austrian  Trial  for  Rape.  V33 

counted  for  by  the  supposition,  that  in  the  reproductive 
^  organization,  the  sensibility  is  exalted  by  anesthetic  agency, 
in  the  same  proportion  as  sensation  is  depressed  in  the 
remaining  organisms.  Even  then,  to  perfect  the  analogy 
in  the  two  cases,  we  should  be  obliged  to  range,  cata- 
lepsy, etherization,  ecstacy,  somnambulism,  hypnotism,  mag- 
netism, spiritualism,  &c.,    in   the   same   category. 

Another  motive  in  this  translation  is,  to  exhibit  the 
systematic  manner,  in  which  medical  science  is  made  to 
further  the  ends  of  even  handed  justice  in  the  imperial 
government  of  Austria  ;  and  also  the  important  participa- 
tion in  its  administration,  that  medical  men  are  made  to 
assume.  I  refer  to  this  the  more  willingly  as  Prof.  Beck 
has   commended   the  Austrian   system.     He   says, 

"In  reference  to  iwst  mortem  examinations  by  physicians  in  all 
cases  of  death  under  suspicious  circumstances,  that  'in  England,  the 
country  from  which  we  derive  our  laws,  I  believe  I  may  say  with 
perfect  accuracy,  that  there  is  no  statuary  provision  to  be  found  on 
this   subject.' " 

He   remarks,   also : 

"That  in  Austria,  though  a  despotic  country,  this  subject  is  far 
better  arranged." 

But  in  our  country,  it  requires  no  remarkable  acu- 
men to  perceive,  which  of  the  professions  has  been  pre- 
ponderate in  the   construction   of  our  laws. 

It  was  a  significant  remark  of  DeWitt  Clinton,  made 
in  addressing  a  graduating  class  of  Union  College,  on  the 
choice  of  a  profession,  that  of  the  three  learned  profes- 
sions, the  preachers  have  the  most  friends ;  the  lawyers 
have  the  most  money ;  and  the  doctors  have  the  most 
learning.  We  are  not  willing  to  suppose,  that  this  great 
jurist  intended  by  this  aphorism,  any  sacrifice  of  sincer- 
ity to   civility,    for   the   purpose  of  assigning   to  each  pro- 


'734  The  Peninsular  and  Independent. 

fession    the    desideratum,   most    devoutly   wished    by   the 
same. 

Whatever  opinion  may  prevail,  as  to  the  policy  of 
this  divorcement  'of  the  largest  amount  of  learning  from 
remuneration,  the  fact  of  their  being  separated,  in  our 
courts  at  least,  is  so  potent,  as  not  to  need  ventilation. 
It  is  well  known,  that  Medical  Jurisprudence  pertains 
equally  to  law  and  to  medicine.  On  this  ground  it  is 
the  two  professions  meet.  The  jurist  and  physician  oc- 
cupy the  same  platform  in  Medico -legal  science.  But 
whilst  the  legal  gentleman,  on  the  bench  or  at  the  bar, 
is  remunerated  for  debiting  his  professional  knowledge,  the 
medical  witness  is  enforced  to  mount  the  stand,  and  sur- 
render the  fruits  of  his  professional  studies  and  researches, 
gratuitiously ;  being  constrained  to  answer,  without  time 
for  reflection,  all  manner  of  queries,  on  all  manner  of 
subjects.  And  these  answers  often  are  to  decide  between 
life  and  death,  horror  or  infamy  to  a  human  being.  It 
is  not  to  be  wondered,  this  testimony  is  frequently  of 
as  little  value  as  its  pay.  And  yet  it  is  in  Medical 
Jurisprudence  that  American  authorship  has  obtained  its 
greatest  triumph, — a  real  ovation.  Dr.  J.  Romeyn  Beck 
was  the  first  American  author  that  ever  attained  to  the 
honor  of  furnishing  for  the  schools  of  France  and  Eng- 
land a  medical  text  book  ;  one  which  would  enable  Ame- 
rican physicians,  when  officially  appointed  to  judicial  station, 
as  in  Continental  Europe,  to  render  written  oj^inions  on 
medico-legal  questions,  that  we  [trust  would  not  compare 
unfavorably   with   those  there   given. 


REPORT  OF  AN  AUSTRIAN  TRIAL. 

["^^  In  the  0 ester reichisdie  Zeitschrift  fuer  Praktisclie  Heil- 
hunde;  anglice,   Austrian   Gazette  for   Practical   Medicine, 


Report  of  an  Austrian  Trial  for  Rape.  735 

is   the   report   of  a   trial,   continued  through  ^nq.  numbers, 
an   abstract   of  which   I   propose   to   give  below. 

An  unmarried  female,  A.  M.,  age  not  given,  was  treated 
some   nine   months   in   a  hospital,  and  dismissed   uncured. 
She  returned  to   the   place  of  her  nativity,  to  reside  with 
an  aunt,  where   she   placed  herself  under  the  medical  care 
of  Surgeon  A.,  a  practitioner  of  experience  and  skill,  highly 
esteemed  for  integrity  and  honor.     Surgeon  A.  made  him- 
self acquainted  with  her  paroxysmal  attacks,  variously  de- 
signated  as    catalepsy,   ecstacy,   and    "  anto  -  somnambulis- 
mus."      In   consequence   of    the   repetition   of   these   spas- 
modic  paroxysms,    the   surgeon,  after  long   resistance,   ac- 
ceded  to   the   wishes   of    his    patient   to   have   used,   as   a 
remedial  means,   the   application   of  animal  magnetism,   a 
knowledge   of  which  he  professed   to  have   obtained  from 
books.     After  his  repeated   magnetization.    Dr.  A.  thought 
he  could   perceive   some  amelioration  of  his   patients   sym- 
toms,  and  a  less  frequent  recurrence  of  the  attacks.     This 
means    had    been   continued    for   some   months,   when   she 
predicted    some    inpending  misfortune.      ^^And  in   truth," 
says  A.,    "I   found   her  a  few   days   afterwards   in   a  vio- 
lent  fever,    the   understanding   disturbed,    tremulousness  of 
the   extremities,  and   these  symtoms  increasing  for  a  week^ 
delirium   supervened.      She   would    lie  for  hours   together, 
in  a  state   of  stupor,  with  entire  relaxation  of  the  nerves. 
On  a  Saturday,  she  had  a  lucid  interval,  and  the   sacra- 
ment  for   the   dying   was   administered.      At   6^  p.   m,    of 
the   same   day,   I   found  her  perspiring    freely,   heavy  res- 
piration, unintelligible  mutterings,  and  not  sensible  enough 
to  answer  my  questions.     I   magnetized   her,   in   the   hope 
that   she  would   obtain   same   rest.     In  her  magnetic  sleep 
she   commenced   weeping  bitterly,   and    at    the  same  time 
informed  me   that  a  strange    man    had   shortly  since   en- 
tered her  room,   and  misused  her  in  a  shocking  manner. 


736  The  Feyiinsular  and  Independent, 

At  first  I  thought  this  the  effect  of  a  disturbed  imagin- 
ation or  false  impression,  though  under  the  influence  of 
magnetism,  but  as  she  named  a  person  known  to  be  in 
the  vicinity,  I  made  an  examination  of  her  sexual  orga- 
nization, and  found  there  were  truly  suspicious  indications 
that  she  had  been  violated,  as  alleged.  The  piihescencQ 
of  the  labia  pudcndi  was  made  adlicrent  by  a  viscid  fluid, 
resembling  a  seminal  secretion  ;  whilst  a  turbid  sangui- 
neous matter,  exuded  from  the  entrance  to  the  varjina^ 
The  labia  externa  were  remarkably  irritated  and  reduced. 
Patches  and  stains  were  visible  on  her  body  linen.  She 
stated  that  the  person  held  a  handkerchief  in  his  hand, 
which  he  left  in  her  bed.  When  she  came  from  this 
magnetic  sleep,  she,  whilst  feeling  for  something  to  wipe 
away  the  perspiration,  found  the  strange  pocket  handker- 
chief, and  manifested  much  surprise  at  its  presence,  in- 
quiring  if  it   was   not   mine. 

By  this  I  recognized  her  ignorance  in  her  waking  hours, 
of  what  she  has  just  informed  me  in  her  magnetic  state. 
On  my  inquiry  of  the  aunt  what  had  passed  in  my  ab- 
sence, and  whether  any  strange  man  had  been  with  my 
patient ;    she   answered   as   follows : 

^^A  son  of  N.  was  here  twice.  He  came  first  at  two 
p.  M.  The  sister  of  A.  M.  was  here  then.  He  said  the 
Brewer's  wife  had  informed  him  of  a  sick  girl,  and  that 
he  had  come  to  visit  her.  At  his  first  coming  A.  M. 
was  senseless.  He  talked  to  "[us  about  her  complaint,  took 
her  hand,  and  looked  at  it.  He  said,  ^Hhat  gal  will 
live  but  a  few  days,''  ^  her  hands  are  the  color  of  wax 
now.'  It's  a  great  pity  for  she  is  so  handsome.''  When 
she  came  to  herself,  he  joked  with  her  and  said,  "  if 
she   would   only   get   married   she   would   be   well." 

He  staid  with  her  a  short  [time  after  we  went  out 
of  the   room.     She   told   me   afterwards   when  I    came   in, 


Report  of  an  Austrian   Trial  for  Rape,  1S1 

that  N.,   before  leaving  her,    pinched   her   chin,    and   that 
she   was   offended   and   turned  away.     I  staid  in  my  room 
the   rest   of    the   day,    leaving   the    door    leading    to    her 
room   ajar.      About    six    in    the    evening   N.    came   again. 
He   rapped   on   the  stair  and  I  came  down.     The  girl  was 
then  out  of  her   senses.     N.    seeing  her  in  this  state,  said 
I   had   better  leave,  and   he  would  watch   the   patient  till 
she  waked  up,  as   he   liked   to  talk  with  her.     So  I  went 
up   to   my   room,    not    having    the   least   suspicion ;    some 
time   after   I   heard   a   noise,    as  the  moving  a  stool  back- 
wards.    I    run   down  stairs   in   a  fright.     Here  I  found  N. 
setting   on  a  stool   at   the  foot  of  the  girls  bed,  with  his 
hands    still   on    the  coverlet,  and  buried  as  if  covering  her 
feet,  —  then   he   put  his    feet    together   quick,    and   pulled 
the   skirts    of  his   coat   around  before,   and   holding   them, 
so   as   to   make   me  suppose   his   pants  were  open,  and  he 
wished   to   hide  them,  —  the  soup -dish   sitting   beside   the 
bed   was   upset,   the    stool   standing   before   the   bed   when 
I  left,    was    now   at   its   foot,' — the    girl   still   senseless.     1 
scolded  him  for  upsetting  the  soup  dish,  and  as  I  laid  hold 
of  something  ;  he   left  saying  '^  God  defend  you.''     I  con- 
cluded, from   these   circumstances,    that  he  had  abused  the 
girl  sexually.     I  did  not  look  him  in  the  face,  and  there- 
fore  can    not   say,  whether   he  appeared   frightened  at  my 
sudden  appearance.      I   did  not   see   the   handkerchief  left 
in   her  bed. 

In  pursuance  of  the  information  made  by  surgeon  A. 
on  Septamber  5th,  185 — ,  a  judicial  commission  was  ap- 
pointed, consisting  of  the  Examining  Judge,  the  sworn 
Protacal  bearer ;  two  doctors,  as  experts,  the  attending 
surgeon  A.,  and  two  judicial  witnesses,  to  meet  on  the 
7th  of  the  month,  at  9  A.  m.,  at  the  place  and  residence 
of  A.  M.,  and  proceed  to  an  examination  under  their 
oath.     All   was   to   proceed   according  to  law,  in  the  mean 

Vol.  II.— 2W 


738  The  Peninsular  and  Independent. 

time   ascertaining   in   regard    to    the   previous  moral  stand- 
ing of  the  accusor  and  deliver  their  finding  to  the  protacal. 
A.  M.  was   found   lying  in  a  bed  in  a  room  even  with 
the  ground;  the   four   windows    of  which   were   covered  b;^ 
curtains.     She   is    of  middle   size,    slenderly   and   regularly 
formed,   the  expression  of  her  pale  countenance  indicating 
religious    enthusiasm,    face    well    formed,    regular   and   at- 
tractive,   abundant    brown   hair,    dark  blue    eyes,    respira- 
tion   somewhat    hurried,    the    abdomen,    especially   in   the 
epigastric  region,    distended,    tympanitic,   very  sensitive   to 
pressure,    below     the    umbilicus,    the    common  teguments, 
cool,    dry,     tender,    and     on   the    hands,   j)ale,    the   pulse 
small,   at   first   hurried,    afterwards   more   quiet.     Her  un- 
derstanding,   unclouded,    she     answers   the    questions   pro- 
pounded correctly   and   without  afi'ectation.     Questioned  in 
regard  to   her  former    lovers,    and   whether    she   had   per- 
mitted  them   liberties,  she    appeared   much   ashamed,    but 
gave  a   decided    negative.      She    knows    what   passed   be- 
tween her   and   the   accused,  only   through  the  medium  of 
the   surgeon.       She   has   a   dark    recollection,    quite    indis- 
tinct,   that   the   man  N.  had  visited  her  on  Saturday,  that 
during  his   presence,   she   fell  into  a   state  of  long   insen- 
sibility,   and   that   she   saw   N.  again  on   awaking  from  it. 
On   this  day   the   pain   in   the  abdomen   was   so   increased 
that   she   had   to  apply  to   surgeon   A.     She   would  know 
N.  by   sight,  but    has    no   more    intimate    relations    with 
him.      On   the   intimation   of    A.   that    he   would   not  be 
able   to   put   her    into    a    magnetic    sleep    in   presence   of 
the    commission,   the   members    retired,   but   were   directly 
recalled,  and   put    en   rapport    with   the   magnetized   girl. 
That'^  is,  the    surgeon    touched   the   subject   with  his  left 
hand,  whilst    he   extended    the    right   towards   the  assem- 
blage  present.     The   girl   lay    in    a   bed,     motionless,   and 
as  if  sleeping.     By   separating  the  23alpebra,  the  eyes  were 


Report  of  an  Austrian  Trial  for  Rape.  739 

V 

observed  unsteady,  and  rolling,  directed  internally ;  tlie 
pupils  dilated.  On  pressure  of  the  abdomen,  there  was 
no  expression  of  pain  manifested.  She  did  not  recoil  at 
the  flies  alighting  on  her  face.  Her  respiration,  some- 
what quickened.  The  genital  organs  were  examined,  (here 
the  non- medical  portion  of  the  committee  withdrew)  and 
found  not  more  developed  than  those  of  a  female  of 
fifteen  years,  (the  translator  will  he  excused  for  render- 
ing the  German  into  latin,  for  the  following).  Labia  ex- 
terna, raripilosa,  hene  clausa,  non  tumentia,  capillis  ad- 
herentihus,  nymphae  coarctantur,  color  roseus,  clitoris  et 
urethra  naturalis.  The  remains  of  the  hymen  were  seen 
on  each  side  in  a  state  of  nearly  perfect  cicatrization. 
The   whole   parts,  and   vagina,   irritated   and   reddened. 

A.  M.  was  questioned  at  length  by  the  commission, 
in  regard  to  the  act  of  violation.  Her  answers  accurately 
given,  detailed  the  circumstances  of  the  attack,  on  the 
part  of  the  accused.  We  gather  from  these  answers,  that 
N.,  having  been  left  alone  with  her,  whilst  in  a  defense- 
less state,  removed  the  feather  bed  that  covered  her,  in- 
troduced himself  into  her  bed,  and  by  the  same  act, 
both  violated  and  deflowered  her.  That  she  experienced 
neither  pain  nor  voluptuousness  from  ipso  actu.  That, 
in  her  natural  waking  state,  she  has  not  the  least  re- 
collection of  what  happened  to  her,  and  only  testifies 
under  the  influence   of  animal  magnetism. 

Her  evidence  as  taken  by  the  examining  of&cer,  whilst 
in  her  artificial  magnetic  state,  was  delivered  over  to  the 
judicial  physicians,  with  a  demand  for  their  written 
opinions,   in  answer  to  the   queries  following,  viz  : 

Query  1.  Has  there  been  according  to  the  finding  of 
the  commission,  committed  on  the  body  of  A.  M.,  a  rape, 
was  it  attempted,  or  perfected  ? 

Query  2.     If  in    the    affirmative,    are    there    sufficient 


740  The  Peninsular  and  Independent. 

grounds,  deduceable  from  the  appearances  on  examination, 
to  decide  with  certainty,  or  with  probability,  that  this 
rape    was   committed   on  her  in  a  virgin  state  ? 

Query  3.  Can  it  be  decided^  according  to  your  exami- 
nation, with  certainty  or  with  probability,  that  the  viola- 
tion was  accomplished,  during  a  state  of  unconsciousness 
on  the  part  of   A.   M.  ? 

Query  4.  Was  the  sexual  abuse  of  A.  M.,  attended 
with  injurious  consequences  for  her,  and  in  what  respects  ? 

Query  5.  Are  the  statements  of  A.  M.,  and  those 
of  her  witnesses,  in  regard  to  her  symptoms,  and  respect- 
ing her  diseased  state,  contradictory  to  scientific  experi- 
ence, on  the  subjects  of  somnambulism,  and  of  animal 
magnetism  ? 

(In  answer  to  these  queries  each  of  the  two  judicial 
physicians  gave  a  written  opinion  in  his  'own  words  and 
where  they  correspond  in  opinion  I  have  endeavored  to 
comprehend  the  sentiments  of  both  in  one  answer.  Where 
they  appear  to  entertain  opinions  somewhat  different,  I 
have  permitted   each   to   answer  for   himself). 

Ans.  1.  The  appearances  on  examination,  (repeated 
as  heretofore  given  by  surgeon  A.)  would  indicate  that 
there  had  been  a  coitus  on  the  body  of  A.  M.  either  at- 
tempted or  perfected  at  time  designated.  That  emission 
resulted  from  this  coition,  cannot  be  affirmed  with  cer- 
tainty or  probability,  in  as  much  as  the  chemical  analysis 
of  the  stains  found  on  the  chemise  of  A.  M.,  showed 
them  to  be  caused  by  mucous  and  not  by  seminal  con- 
tact. 

Ans,  2.  The  lack  of  prominence  in  the  labia,  the  close 
union  and  perfect  opposition  of  the  labia  and  nymphae, 
indicate  a  seldom  practice  of  coitus  with  A.  M.  The 
cicatrization  of  the  rents  in  the  ruptured  hymen,  are  in- 
consistant  with  a  belief  in    her  virginity   on    the    day   of 


Report  of  an  Austrian  7 rial  for  Rape.  741 

September  2dj  as  it  is  not  usual  for  this  rupture  to  heal 
in  five  days.  The  exhibition  as  detailed  by  surgeon  A., 
unless  the  effect  of  a  menstruation  at  the  time  would  be 
favorable  to  her  being  in  a  virgin  state.  The  presence  of 
blood  however,  cannot  always  be  taken  as  a  proof  of  the 
virgin  state,  as  it  does  not  always  accompany  defloration, 
for  all  females  do  not  loose  blood  at  the  first  coitus,  and 
likewise  those  who  are  no  longer  virgins  may  exhibit  this 
token  of  previous  chastity,  by  a  disproportion  in  the  sexual 
organs,  or  when  coitus  is  effected  with  impetuosity. 

Ans.  3.  By  Dr.  a.  It  is  manifested  by  the  concurrent 
testimony,  with  probability  that  the  coitus  was  effected 
when  A.  M.  was  in  a  state  of  insensibility.  The  aunt  had 
just  left  her  in  such  a  state.  Her  moral  reputation,  the 
almost  virgin  condition  of  her  genital  organs,  the  recent 
venesection  she  had  need  performed,  all  conspire  to  render 
it  improbable,  that  she  had  surrendered  herself  to  the  lusty 
embraces  of  a  stranger,  yet  the  known  artfulness,  and 
love  of  deception,  together  with  the  weakness  of  hysterical 
females,  render  it  difficult  to  determine,  whether  she  was 
really  unconscious. 

Ans.  3.  By  Dr.  h.  It  cannot  be  asserted  with  cer- 
tainty, nor  with  probability,  that  A.  M.  was,  according  to 
the  finding,  in  a  state  of  insensibility,  at  the  commence- 
ment of  the   coition,  as  this    was  -manifested  to  four  eyes. 

Ans..  4.  The  sexual  abuse  of  A.  M.,  was  succeeded  ac- 
cording to  surgeon  A.,  by  increased  difficulty  of  respira- 
tion, by  local,  spasmodic,  distention  of  the  bowels,  and  by 
debility.  Whether  these  symptoms  increased,  or  vanished, 
and  what  other  injurious  effects  were  developed;  later  and 
repeated  examinations  of  A.  M.'s  state,  would  be  neces- 
sary,  to   determine   with  any  degree   of  accuracy. 

Ans.  5.  By  Dr.  a.  The  testimony  of  A.  M.  and  that 
of  other  witnesses  touching  her   diseased  state,  is  not  in 


742  The  Peninsular  and  Independent, 

contradiction  with  the  received  medical  experience,  on  the 
subject  of  somnambulism,  and  animal  magnetism.  Her 
sensitive,  nervous  constitution,  the  large  venesection,  re- 
cently made,  for  a  traumatic  inflammation  of  the  stomach 
and  bowels,  her  subsequent  attack  of  catelepsy,  all  assist 
in  making  a  predisposition  to  an  extatic,  and  magnetic 
state ;  the  present  medico -legal  witness  had  an  oppor- 
tunity, a  fortnight  earlier,  to  observe  her  in  such  a  par- 
oxism of  exstacy,  when  her  eyes  were  so  fixedly  and  im- 
movably directed  above,  that  she  was  sensible  to  no 
change  of  light,  or  other  excitant,  the  pupils  remaining 
the  same.  Her  attendant  surgeon,  is  a  talented,  learned, 
and  prudent  gentleman  ;  formerly  a  disbeliever  in  animal 
magnetism.  He  has  not  as  yet  discovered,  after  long- 
continued  daily  obsrvation,  any  traces  of  simulation  in  her. 
He  has  been  made  a  believer  only  after  her  revelation  of 
secrets,  known  to  bim  alone,  during  her  magnetic  sleep. 
Besides,  she  seeks  to  avoid  every  ostentation  herself,  and 
ordered  her  physician  to  admit  no  one  to  her,  unless 
absolutely  necessary  to  her  assistance,  as  heretofore  when 
with  her  sister,  the  crowd  of  visitors  greatly  annoyed  her 
(she  was  later  taken  to  St.  S.  hospital).  These  are  all 
significant  facts,  that  speak  loudly  for  the  reality  of  her 
present  extatic,  and  magnetic  excesses,  yet  not  sufficient 
to  remove  all  doubts,  which  indeed,  nothing  but  long- 
continued  critical  observation,  would  be  able  to  remove. 
For  this  purpose  it  would  seem  necessary,  furthermore, 
to  have  an  undoubted  confirmation,  of  not  only  the  char- 
acter of  her  extatic  magnetic  state,  but  also  of  her  life, 
together  with  a  reliable  history  from  the  hospital,  and 
from  her   physician. 

Ans.  6.  By  Dr.  h.  As  the  existence  of  animal  mag- 
netism, is  as  yet  not  a  fact  established,  it  is  not  strange 
that  it  is   denied  by   not   a   small  number  of  physicians. 


Report  of  an  Austrian  Trial  for  Rape,  743 

Without  wishing  absolutely  to  call  in  question  its  exis- 
tence, we  must  openly  confess  that  its  manifestationSj  as 
exhibited  in  A.  M.,  are  not  such  as  necessarily  to  enforce 
the  conviction  that  she  was  actually  in  a  state  of  mag- 
netic sleep. 

After  the  surgeon  had,  during  our  retirement,  (for 
he  said  he  could  not  in  our  presence),  put  her  in  a 
magnetic  sleep,  the  commission  found  her  lying  motion- 
less in  bed,  with  closed  eyes.  She  answered  such  ques- 
tions only  as  were  put  by  the  surgeon.  To  dissemble 
such  a  state,  with  such  symptoms,  requires  indeed,  no 
great  artificial  training,  no  very  vivid  imagination.  But 
that  hysterical  females  are  often  disposed  to  exhibit  such 
freaks,  and  that  these  exhibitions  have  frequently  been 
dismasked,  is  a  matter  of  well  known  history.  In  fact, 
it  is  easier  to  suspect  such  dissimulation  than  to  estab- 
lish it.  The  physician,  that  now  considers  the  existence 
of  animal  magnetism,  in  the  light  of  a  ^  foregone  conclu- 
sion,' will  esteem  the  evidence  of  A.  M.,  and  that  of 
her  witnesses,  touching  the  morbid  statej  and  symptoms 
of  the  former  in  perfect  unison  with  the  experience  and 
teachings   of  science. 

In  an  opposite  category,  will  be  found  the  physician, 
who  is  a  disbeliever  in  animal  magnetism.  Should  a  con- 
tinuous and  attentive  observation,  lead  to  confident  results, 
this  observation  must  be  made  in  a  house  consecrated 
to  the  sick  alone.  In  conclusion,  I  learn  that  A.  M.  can 
no  longer  be  brought  in  a  magnetic  state  by  the  attend- 
ant surgeon   A.     {Since  declared  untrue   hy   the  surgeon). 

As   given  voluntarily   to   the  board,  here  follows  : 

THE  FIRST  STATEMENT  OF  THE  ACCUSED. 
He   was   aware    that  the    public    held    him    guilty   of 
misusing  A.   M.,  but  is  conscious  of  his  innocence.    Came 


744  The  Peninsular  and  Independent. 

to   the   town  of  S.,   the   residence  of    A.    M.    on   Septem- 
ber 1st,   and  then  first  heard  of  her  diseased  state,  could 
tell   all   that   was   passing  in   the   town    without   stepping 
out  of  the  house.     He  called   the  other  day  to  see  A.  M. 
and  found   her  in   bed  and   sleeping,  but  she  soon  awoke. 
She   spoke  to   the  sister  and  waiter  (aunt)  and  they  again 
left   the   room,    the   latter   soon   returned.     He   took   leave 
soon   and   A.    M.    who    appeared   in    good   spirits    invited 
him   to   call   again   and  relapsed   into   a    drowsy  state   be- 
fore  he  left.     He   called  again   in  the   afternoon,   he   can- 
not  say   at    what  hour.      When    the   waiter    opened    the 
'  door  for  him,    A.  M.  was    sleeping,  but    soon   awoke.     As 
the   waiter  soon  afterward  absented  herself  he    immediate- 
ly  expressed    his   desire   to    her    and    she    answered  in   a 
distinct  voice  ja.     Directly  after  the  coitus  inceptus  he  re- 
marked  that   she   again   fell  into  a  somnolent   state  which 
caused   him   to   be  seized  by   an  aversion  which  compelled 
him   to  desist  before    emission.      He   adjusted   his    clothes 
and   in    a   few   minutes    after   withdrew    without   speaking 
to   the   attendant   who   entered  just  before.     He  must  give 
a   decided    denial   to  the   statement  of  A.  M.  that  he  had 
abused  her  in   her    insensible   state.      He    denies     sending 
away  the  waiter  for   the    purpose   of    realizing   his    object 
and   also  of  being  disturbed   at   her   return. 

N.  is  unmarried,  is  31  years  of  age,  measures  5\  feet, 
is  well  proportioned,  but  slender,  appears  robust,  and  with 
the  exception  of  a  rupture  is  mentally  and  corporeally 
sound. 

THE  SECOND  STATEMENT  OF  THE  ACCUSED. 

It  having  been  repeatedly  represented  to  N.  in  his 
appearances  before  the  judge  that  it  was  difficult  to  be- 
lieve that  A.  M.  who  had  always  born  a  good  character, 
so  shortly  after  taking  the  dying   sacrament   could   volun- 


Report  of  an  Austriaii  Trial  for  Rape.  745 

tarily  submit  to  such  an  immoral  transaction  whereupon 
N,  proceeded  to  a  public  confession,  remarking  that  if 
he  had  known  of  this  circumstance  before^  he  would  not 
have  burthened  her  with  this  voluntary  crime.  After  the 
first  visit  he  had  not  the  most  remote  idea  of  making  such 
a  proposition  to  A.  M.  He  was  on  his  way  returning  from 
the  residence  of  the  latter,  when  his  dog,  that  he  led  by 
a  cord  broke  loose  and  returned  toward  N.  He  hastened 
after  the  dog  and  then  came  again  to  the  residence  of  A. 
M.  Here  he  remembered  the  invitation  of  A.  M.  for  him 
to  call  again.  Just  as  he  entered  the  room,  the  aunt  Y. 
G.  also  entered,  remained  a  short  time  and  left  the  room, 
leaving  him  alone  with  A.  M..  He  found  her  in  a  sleep- 
ing state,  in  which  she  remained  so  long  as  he  was  there. 
Now  first  was  awakened  in  him  a  desire  to  use  her  car- 
nally. She  lay  in  bed  on  her  back  and  was  motionless 
with  her  head  raised  somewhat,  her  eyes  as  he  believed 
closed.  The  feet  were  outstretched,  position  of  her  hands 
not  remembered.  She  was  dressed  in  night  gown  and 
chemise,  and  covered  by  a  feather  bed.  He  gently  raised 
her  linen,  shoved  the  covering  one  side  and  but  partially 
effected  a  penetration,  when  he  conceived  a  disgust  or 
fright,  which  must  have  been  occasioned  by  a  conscious- 
ness of  the  injustice  of  his  action  and  he  voluntarily  ab- 
stained from  the  consummation  of  the  inceptus  coitus  be- 
fore any  ejaculation  and  without  any  cause  on  the  side  of  A. 
M.  who  lay  constantly,  motionless,  speechless  and  insensible. 
The  foregoing  proceedings  of  the  Examining  Court, 
were  delivered  over  to  the  K.  K.  {Konigliche  Kaiserlishe, 
royal  imperial)  court  of  the  realms  and  this  court,  in 
view  of  the  importance  of  the]  case,  presented  to  the  K. 
K.  College  of  Physicians,  three  queries  for  solution.  The 
questions  and  answers  given  at  length  though,  exhibiting 
much   eradition,   would    extend   this   report,    already   long, 


746  The  Peninsular  and  Independent. 

to  a  tedious  length.  I  may  in  future,  if  required,  give 
these  queries  and  their  responses  in  extensOj  but  at  the 
present,  must  content  myself  with  merely  indicating  their 
import. 

Query  1.  Is  there,  according  to  the  medical  experi- 
ence of  the  past,  such  a  state,  simulating  sleejD,  in  which 
a  person  may  receive  impressions,  that  cannot  be  recalled 
in  the  natural  awaking,  but  may  be  remembered  and  im- 
parted  in   the   return   of  the  sleep   resembling   state  ? 

Ans.  1.  There  is  no  proof  of  such  a  state,  as  described 
in  query  1st.  But  it  is  known,  that  individuals,  affected 
with  periodical  insanity,  can  remember  in  one  paroxism, 
the  acts  of  a  previous  attack,  although  they  have  no  re- 
membrance  of  these,  in  a  moral  sound  state  of  the  mind. 

Query  2.  Can  it  be  admitted,  that  the  accuser  A. 
M.,  was  in  such  a  state,  at  the  time  the  act  was  per- 
petrated, and  again  when  she  testified   to  the  commission  ? 

Ans.  2.  The  two  conditions  referred  to,  were  not 
identical.  The  fact  was  spontaneous,  and  the  effect  of 
disease.  The  other  artificial  and  superinduced.  In  the 
first,  she  could  not  speak,  in  the  second  she  could.  As 
this  last  is  itself  problematical  testimony  all  taken  in  it, 
could  be   received   only   in   the  absense   of  all   other. 

Query  3.  Provided  it  is  not  established,  that  A.  M. 
was  insensible,  might  she  not  be  considered  as  defense- 
less, from  her  idosynacrasy   and  the  state  of  her    disease  ? 

Ans.  3.  Animal  magnetism  is  discredited.  It  is  charac- 
terized as  a  magic  circle,  into  which  courts  cannot  be 
drawn,  without  involving  themselves  in  endless  difficulties. 
Her  pretended  state  of  magnetism  is  esteemed  a  ruse,  a 
hysterical  trick,  pardonable  in  as  much  as  it  brought  the 
accused  to  a  confession,  of  which  her  aunt,  her  medical 
attendent,  and  more  than  all,  her  own  local  sensations, 
convinced   her  must   be  true,  and  which  her  moral  reputa- 


Malpractice^  &q,  747 

tion  should  corroborate  with  the  court.  The  whole  reason- 
ing on  this  point  is  a  chef  d'ceuvre,  of  medical  logic  and 
learning,  and  vindicates  the  title  obtained  for  the  K.  K. 
Faculty  of  Vienna,  the  "Doctoren  Collegium/'  as  of 
the  very  highest  order  of  intellectual  culture  to  have 
been  justly   acquired. 

The  accused  was  convicted  of  the  crime  of  ravishment 
and  underwent  the  punishment  provided  by  law  in  such 
cases. 


-♦-♦-^ 


ART.  XLVI.— Malpractice— Suits  for  — Tlieir  Influence  upon  Physi- 
cians and  the  Community. 


Eds.  Pen.  &  Ind.  —  I  solicit  a  small  space  m  your  columns, 
not  merely  because  I  feel  myself  aggrieved  —  not  only  be- 
cause I  have  suffered  gross  injustice,  and  wish  to  make  a 
truthful  statement  of  the  facts  that  my  professional  reputation 
may  not  suffer  more  than  it  deserves,  but  because,  I  still 
cherish  the  profession  of  medicine  and  surgery,  and  desire  to 
express  my  regrets  that  such  powerful  arguments  should  be 
brought  to  bear  to  discourage  from  the  necessarily  long  and 
toilsome  course,  those  individuals  who  are  otherwise  posses- 
sed of  sufficiently  strong  sympathies  to  induce  them  to  spend 
years  of  constant  study  and  observation,  in  order  to  become 
qualified  to  administer  to  the  relief  of  their  suffering  fellow 
mortals. 

Because  the  power  of  the  surgeon,  like  that  of  other 
mortals,  is  limited, — because  he  can  not  at  all  times  render 
a  broken  limb  as  near  perfect  as  the  creator  made  it  in  the 
first  place,  —  because  there  are  destructive  processes  entirely 
beyond  his   control, — he  must  needs  be  prosecuted. 

Such  treatment  is  "very  poor  pay"  for  sympathy  bes- 
towed, and  services  rendered,  besides  being  somewhat  dis- 
couraging. 

This    inevitable    result  will    and    should   be    to    deter  all 


748  The  Peninsular  and  Independent. 

educated  physicians  (and  hence  all  who  feel  the  weight  of 
their  responsibility)  from  rendering  any  assistance  whatever 
(except  perhaps  to  relatives  and  intimate  friends),  in  that 
class  of  cases,  which  above  all  others  (accidents),  calls  for 
the   prompt   attendance   of  the   surgeon. 

Permit  me,  in  this  connection,  to  make  a  truthful  state- 
ment of  some  of  the  most  important  facts  in  relation  to  a 
particular  case,  (the  case  tried  at  Mason,  in  December  last, 
and  to  which  many  of  the  readers  of  this  article  undoubt- 
edly listened)  after  which  I  will  advert  to  the  necessary  in- 
fluence of  this  and  similar  cases  upon  physicians  and  the  com- 
munity  at  large. 

On  Saturday  afternoon,  the  twenty  -  fifth  day  of  April,  a. 
L).  1857,  I  was  summoned  to  visit  Franklin,  infant  son  of 
Isaac   C.   Drew,  a   child   of  four   or  five   years   of  age. 

I  found  him  with  the  tibia  (larger  bone  of  the  leg) 
broken  at  about  an  inch  or  an  inch  and  a  half  above  the 
ankle  joint. 

The  boy  was  pale,  puny,  and  considerably  emaciated,  not 
having  entirely  recovered  from  a  severe  and  protracted  pneu- 
monia,*  or   inflammation   of  the   lungs. 

I  know  this  of  my  own  personal  knowledge,  as  I  attended 
upon  the  child  through  this  sickness,  and  but  a  few  weeks 
prior  to  th(^  date  of  the  occurrence  of  the  accident  at  pre- 
sent under   consideration. 

At  the  time  of  the  sickness  the  parents  neglected  to  send 
for  a  physician  until  they  nearly  despaired  of  the  life  of 
their  child  (the  attack  was  violent,  and  the  inflammation  ra- 
pid in  its  course),  so  that  when  I  first  saw  him,  both  lungs 
were  severely  and  extensively  inflamed,  in  one  of  which  the 
inflammations  progressed  to  the  third  stage,  or  that  of  sup- 
puration. 

Every  physician  knows  that  where  a  patient  in  this  situ- 
ation recovers  at  all,  the  convalescence  is  necessarily  greatly 
protracted.  At  the  time  I  set  the  broken  limb,  the  mother 
of  the  child  remarked  that  ^he  was  very  unfortunate,  as  he 
had  but  just  sufiiciently  recovered  to  be  permitted  to  play 
out  of    doors.     By   some   circumstance,    a  pole    from  four  to 

*The  fact  of  this  sickness  was  proved  upon  the  witness  stand. 


Malpractice^  etc.  749 

six  inches  in  diameter,  and  from  twenty  to  twenty  -  five  in 
length  was  placed  with  one  end  upon  the  fence  and  the  other 
upon  the   ground. 

Straddling  this  pole  at  near  its  middle,  the  boy  commenced 
to  teeter.  The  end  slipped  from  the  fence  and  came  down 
across  his  leg  at  the  place  of  the  fracture  with  such  force 
as  to  leave  the  impression  of  his  foot  and  ankle  in  the 
ground. 

The  soft  parts  were  of  course  considerably  bruised  and  to 
all  appearance  somewhat  lacerated  internally,  though  the  frac- 
ture was  not  a  compound  fracture^  that  is  to  say,  the  ends 
of  the  broken  bone  did  not  entirely  pierce  through  the  skin. 
Appropriate  splints  were  carved  out  and  the  limb  pro]perly 
set  and   dressed. 

As  the  testimony  in  relation  to  the  handaging  of  this 
limb  was  more  distorted  from  the  truth  than  most  of  the 
other  testimony,  it  may  not  be  inappropriate  to  relate  the 
method  adopted   in   detail. 

A  many -tailed  bandage  (not  a  roller  or  long  bandage,  as 
Geo.  TV.  Wilson  testified),  made  of  old  slazy  cotton  cloth, 
was  first  applied  to  the  leg,  and  the  ends  folded  successi- 
vely upon   each   other  from  the  anhle  to  the  hnee. 

During  the  time  that  I  attended  upon  the  hoy  there  was 
never  a  bandage  of  any  description  applied  to  his  leg^  either 
external  or  internal  to  the  splints,  in  the  direction  of  from 
ABOVE  DOWNWAKDS,  the  testimony  of  the  Messrs.  Wilson  to 
the  contrary  notwithstanding. 

After  being  thoroughly  wadded,  the  splints  were  next  ap- 
plied, and  retained  in  place  by  another  many -tailed  bandage. 
This  bandage,  external  to  the  splints,  was  used  instead  of 
strings,  because  from  some  little  experience,  I  believe  it  to 
answer,  a  much  better  purpose.  By  coming  in  contact  (even 
slight  though  it  be),  with  the  splints  throughout  their  entire 
length,  and  extending  over  their  extremities,  the  probability 
of  their  being  displaced,  by  contact  with  the  bed  -  clothes,  or, 
from  other  cause,  is  much  less  than  when]  their  extremities 
are   merely  tied  with   strings. 

This   bandage  was    made   of   new    cotton   cloth,    and   teas 
.applied  in  the   direction  of  from   the  ankle  towards  the  knee. 

These  facts   are    not  material    to    the  case,  but   are  men- 


750  The  Peninsular  and  Independent. 

tioned    here,   because,   upon   the    trial    (to   use   a  mild  term), 
they  were  unduly   emphasized. 

Had  the  testimony  in  relation  to  the  direction,  in  which 
this  bandage  was  applied,  been  tnie^  it  would  have  been  of 
no  account,  as  was  shown  upon  the  stand  by  rehable  medi- 
cal testimony.  As  this  bandage  did  not  come  in  contact  with 
the  leg  it  must  appear  plain  to  every  one,  that  the  direction 
of  its  aj)plication  could  not  have  the  least  i)ossible  influence 
upon   the   circulation. 

For  the  j^urj^ose  of  reudcringi  the  necessary]^  pressure  uni- 
form, as  well  as  to  guard  against  changes  of  temperature, 
the  dressing  was  completed  by  applying  an  ordinary  bandage 
(roller)  to  the  foot  in  the  direction  of  from  'Xhc  ankle  to 
the  toes. 

"With  such  a  dressing  as  this,  it  is  obvious  that  the  leg 
could  be  entirely  exposed  witliout  raising  it  from  tlie  pillow, 
or  disturbing  its   position  in  the   least. 

Isaac  C.  Drew  being  away  from  home  at  this  time,  the 
ordinary  general  directions  were  tlien  given  to  his  wife,  and 
her  sister-in-law  wlio  was  residing  upon  the  premises,  and 
in  the   same   house,   I  think,  at    the   tune. 

I  stated  that  in  case  certain  symjjtoms  should  arise,  which 
I  fully  explained  to  her  (Mrs.  Drew),  and  among  wliich  I 
dwelt  upon  severe  p>ai7i  as  one  of  the  most  important  she 
should   cause  me   to   be   sent   for   immediately. 

I  also  explained  to  her  that  from  the  change  of  circum- 
stances to  which  all  fractured  limbs  are  necessarily  subjected, 
a  disagreeable  and  aunojdng  itching  or  tingling  in  the  part 
is  of  no  uncommon   occurrence. 

In  the  event  of  the  occurrence  of  this  sensation  to  a  dis- 
agreeable extent,  I  advised  the  application  of  a  stimulus, 
suggesting  at  the  same  time  the  use  of  cam2)hor,  alcohol  or 
brandy. 

In  the  use  of  the  stimulus  under  these  circumstances  I 
directed  that  it  might  be  allowed  to  slowly  penetrate  through 
the  bandages,   between   the   splints,   to   the   aflected  part. 

Mrs.  Drew  asked  me,  what  she  should  wet  the  boys  leg 
with,  hence  I  was  very  particular  in  giving  explicit  directions 
that  it  should  not  be  wet  at  all,  except  perhaps,  with  the 
stimulus  above  mentioned,  and  with  that,  only  just  sufficiently 
to   accomplish  the  desired  object]  as  above   explained. 


Malpractice^^  <bc.  751 

That  any  harm  resulted  to  the  boys  leg  in  consequence 
of  the  external  bandage  being  made  of  new  cotton  cloth,  as 
has  been  maintained,  is  simply  absurd.  The  same  destructive 
process  would  have  taken  place,  had  the  splints  been  retained 
in  position,   by  leathern   straps   or   strings   of  tow. 

On  the  next  Wednesday  (April  29th)  I  exposed  the  limb 
thoroughly,  examined  it  carefully,  and  readjusted  the  band- 
ages  and   splints. 

I  found  that  the  attendants  (the  parents  of  the  child), 
had  disregarded  my  instructions  and  kept  the  limb  constantly 
wet  with  brandy. 

As,  aside  from  the  discomfort,  the  limb  suffered  no  harm 
from  this  unauthorized  treatment,  neither  in  truth  nor  from 
the  testimony  of  any  of  Drew's  witnesses,  I  mention  the 
fact,  without  comment.  At  this  time  there  was  no  very  unu- 
sual  appearance  about  the  limb. 

Near  the  seat  of  the  fracture  were  to  be  seen  several 
small  vesicles  or  blisters.  Mr.  Drew  inquired  concerning  the 
cause   of  them. 

I  remarked  that  they  are  of  no  uncommon  occurrence  — 
that  very  few  fractured  limbs  indeed,  are  treated  to  a  termin- 
ation without  giving  rise  to  them. 

I  explained  to  him  that  they  consist  of  an  effusion  of  serum 
beneath  the  cuticle,  which,  upon  fractured  limbs,  usually  takes 
place  in  consequence  of  the  cutaneous  circulation  being  neces- 
sarily somewhat  impeded  by  the  bandaging,  and  that  such  was 
probably  their  cause  in  the  present  instance. 

For  the  sake  of  illustration,  I  directed  his  attention  to  the 
vesicles  that  occur  upon  the  limbs  of  invalids  who  have  been 
confined  to  their  beds  for  any  considerable  length  of  time,  where 
the  difficulty  is  caused  by  the  mere  pressure  of  their  own  weight 
upon  the  bed. 

This  is  the  true  statement  of  the]  conversation  that  was 
perverted  upon  the  witness  stand  into  an  acknowledgment  that 
I  had  bandaged  the  limb  too  tightly. 

I  do  not  pretend  to  accuse  any  individual  who  testified  in 
this  case,  of  knowingly  and  intentionally  swearing  falsely ;  but 
I  do  pretend  to  say  that  an  individual  who  is  entirely  ignor- 
ant of  physiology^  pathology.,  and  therapeutics.^  is  not  a  proper 
judge  of  the  principles  of  surgery.    There  would  be  no  more 


762  The  Peninsular  and  Independent. 

impropriety  in  compelling  our  statesmen  and  our  sailors  to  ex 
change  places. 

Let  me  appeal  to  our  enterprising  and  thrifty  farmers. 
Would  you  be  willing  to  trust  the  superintendence  of  your 
farms   to   men   bred    upon   the   decks   of  our  merhantmen? 

Would  you  willingly  act  as  a  committee  to  examine  the 
qualifications  of  the  commander  -  in  -  chief  of  the^  American 
army? 

At  this  visit  Mr.  Drew  informed  me  that  the  child  had 
sufi*ered  from  severe  pain,  and  that  he  had  neglected  to  send 
for  me,  as  directed,  because  it  was  a  long  distance  to  send 
and   he   had   no   horse   of  his   own. 

Whether  the  limb  actually  suffered  any  positive  harm  from 
this  entire  disregard  of  explicit  directions,  makes  no  manner 
of  difference  so  far  as  Mr.  Drew's  individual  culpability  is 
concerned.  At  the  third  dressing,  (Saturday,  May  2d,  ISSY, 
according  to  the  testimony  of  Dreio^s  oxon  witnesses)  the 
bandages  and  splints  were  entirely  removed,  and  the  limb 
placed  upon  a  double  inclined  plane,  or  in  a  fracture -box 
as  it   is   sometimes   termed. 

From  this  time  forward,  until  the  day  of  the  amputa- 
tion, there  was  no  bandage  of  any  description  applied  to 
the  limb.  The  fragments  were  kept  in  apposition  by  means 
of  cotton  batting  inserted  between  the  limb  and  the  sides 
of  the  fracture  -  box,  in  addition  to  extension.  Xeither  at 
this,  nor  at  either  of  the  next  two  subsequent  dressings.  May 
sixth  and  ninth,  was  there  any  very  alarming  appearance 
about  the  limb.  It  was  still  considerably  swolu,  and  to  all 
appearance   somewhat   infiltrated   with   blood. 

The  boy,  as  has  been  before  stated,  was  in  a  very  feeble 
condition  of  bodily  health,  and  hence  was  put  upon  tonics 
and   supporting  treatment  generally. 

Upon  the  thirteenth  day  of  May,  there  was  a  slight  ap- 
pearance of  gangrene  just  discoverable  at  the  ends  of  the 
toes,    and   a   little   sloughing  on   the  leg. 

It  will  be  observed  that  this  occurred  just  eighteen  days 
after  the  first  application  of  the  bandages,  and  eleven  days 
after  they  were  all  entirely  removed.  Mr.  Drew's  witnesses 
testified   concerning  the  disagreeable  condition  of  the  leg  upon 


Malpractice'^'  &c.  153 

the  seventeenth  day  of  May,  or,  "the  day  before  it  was  am- 
putated," but  did  not  state  that  it  was  "dead''  at  any  time 
previous,  although  mortification  actually  commenced  upon  the 
thirteenth. 

They  laid  particular  stress  upon  the  "loathsome"  condi- 
tion of  the  limb  at  this  time,  for  the  purpose  undoubtedly 
of  making  a  thorough  impression  upon  the  sympathies  of  the 
jurors,  which  object  they  probably  successfully  accomplished. 
The  jury  should  have  borne  in  mind,  however,  that  this  is 
the   very   reason   for   which   the   limb   was   amputated. 

Should  a  surgeon  amputate  a  soicnd  limb,  there  would 
then  most  certainly  be  a  very  good  reason  why  he  should 
be   prosecuted   for   malpractice. 

The  dastardly  and  fruitless  attempt  of  Mr.  Shaw  to  make 
it  appear  upon  the  witness  stand  that  it  was  my  desire  to 
leave  the  boy  to  die  without  giving  him  the  chance  of  an 
amputation,  convinces  me  more  thoroughly  than  ever  that 
justice   is   not   always  obtained  from   our  courts    of  law. 

I  have  no  recollection  of  meeting  Mr.  Thomas  McKernan 
on  my  return  home  from  the  residence  of  Mr.  Drew  upon 
the  seventeenth  day  of  May,  1857,  as  he  testified;  but  grant- 
ing that  I  did,  I  will  not  hold  myself  responsible  for  any 
answer  I  may  have  made  him  or  any  other  inquisitive,  med- 
dlesome  and  disinterested   person. 

Before  leaving  Mr.  Drew's  residence,  however,  upon  this 
identical  day,  I  informed  himself  and  family  that  it  would  be 
necessary  to  amputate  the  limb,  and  stated  that  I  would  pro- 
cure assistance  and  return  upon  the  next  day  prepared  to  make 
the  operation. 

Upon  the  next  day,  the  limb  was  amputated,  though  not 
until  the  bare  possibility  of  the  child's  ability  to  survive  the 
operation  had  been  thoroughly  discussed  by  Drs.  Ackley, 
Spencer,    and  myself. 

In  this  connection  it  may  be  well  to  call  the  attention  of 
the  reader  to  the  fact  that  Mr.  Drew  claims,  and  attempted  to 
show  upon  the  trial,  that  the  limb  was  bandaged  so  tightly  as 
to  cut  ofi"  the  circulation,  and  thereby  cause  mortification. 

Upon  the  defepce  it  was  conclusively  shown  by  reliable 
medical  testimony,  that  if  the  circulation  of  the  blood  in  a 
part,  he  sufficiently  interfered  with  to  produce  mortification   at 

Vol  IL  — 2X. 


754  The  Peninsular  and  Independent. 

all,  it  will  make  its  appearance  within  three  or  four  days  at 
most.  In  this  instance,  the  first  appearance  of  mortification  did 
not  occur  until  eleven  days  after  all  the  bandages  had  been 
entirely  removed. 

The  direct  testimony  in  relation  to  the  tightness  of  the 
bandages  was  given  by  the  Messrs.  Wilson,  who  testified  that 
in  their  opinion  the  bandages  were  too  tight.,  but  that  they 
did  not  know.,  as  that  was  the  only  broken  bone  they  have 
ever  seen  set. 

What  loas  the  exact  cause  of  mortification  in  this  instance, 
of  course  I  could  not  show  upon  the  trial  any  more  pointedly 
than  has  already  been  intimated  in  this  article,  as  no  physician 
or  surgeon  excepting  myself  saw  the  limb  from  the  day  it  was 
set  until  the  day  it  was  amputated. 

Substantial  and  abundant  medical  testimony,  adduced  both 
from  living  witnesses  and  medical  authorities,  was  produced  to 
show  that  tlie  mortification  might  have  resulted  from  any  one 
of  at  least  half  a  dozen  causes,  as  for  example,  severe  bncising 
and  laceration  of  the  soft  parts^  infiltrations  of  blood  from 
a  ruptured  vessel.,  erysipelatous  inflammations.,  debility  from 
any  cause,  various  co7istitutional  affections.,  and  even  from  the 
nervous  shock  caused  by  a  blow  iiisufflcient  to  produce  any 
perceptible  2)hysical  harm. 

Judge  Lawrence,  distinguished  alike  for  his  ability  and 
integrity,  both  as  a  lawyer  and  a  judge,  charged  the  jury  to 
the  effect  that  in  order  to  find  for  the  plaintifts,  they  must 
not  only  find  that  there  had  been  malpractice  (wrong  practice) 
in  the  case.,  but  that  the  mortification  and  loss  of  the  limb 
necessarily  residted  from  that  malpractice. 

He  further  charged  the  jury,  that,  inasmuch  as  it  is  a  com- 
mon principle  of  law  and  justice  that  no  man  shall  be  held 
responsible  for  the  misconduct  of  another,  in  order  to  find  for 
the  plaintifi*,  they  must  find  that  he  (the  plaintiff"),  was  nei- 
ther wholly  nor  in  part  at  fault  and  hence  responsible  for 
the   wrong   treatment. 

In  this  connection,  permit  me  to  state  that  it  was  proved 
upon  the  stand  that  Mr.  Drew  acknowledged  that  I  left  ex- 
plicit directions  to  be  sent  for  in  case  the  boy  should  suffer 
much  pain,  <fcc.,  and  that  the  reason  he  did  not  send  for  me 
is  because   the  roads   were   bad,  &c.,    as   before   stated. 


Malpractice^  &c.  755 

After  about  three  hours,  deliberations  the  jury  returned  a 
heavy  judgment  against  nie^  Concerning  the  fate  of  the  law 
and   evidence  in  this  case,  I  cannot  positively   affirm. 

The  reader  has  now  become  conversant  with  the  facts  and 
hence   is  justifiable   in   forming   an   opinion. 

It  is  not  to  be  presumed  that  as  a  general  rule  lawyers 
are   very   conversant   with   medicine   and   medical  terms. 

In  several  instances  during  the  trial,  my  medical  witnesses 
suggested  to  my  lawyers,  through  the  instrumentality  of 
pencil  and  paper,  questions  in  a  proper  form  to  be  asked 
the  witnesses. 

Since  the  trial,  I  have  been  informed  that  one  of  the  jurors 
at  least,  makes  bold  to  say  that  "^e  did  not  pay  any  atten^ 
Hon  to  what  the  doctors  swore  to  as  from  the  billets  and  slips 
of  paper  that  frequently  passed  between  thetn^  it  was  plainly 
to   be  seen   that  they  were  conniving  together.'''^ 

1  have  also  been  informed  that  it  was  remarked  in  the 
jury  room,  that,  "if  Dr.  Corbin  does  not  know  his  business, 
he  ought  not  to  advertise  himself  as  a  surgeon."  I  take  no 
exceptions  to  this  remark.  I  would  ask,  however,  whether 
men,  however  well  informed  they  may  be  in  their  respective 
spheres,  entirely  ignorant  of  the  pathology  and  therapeutics, 
men  who  have  never  spent  a  tithe  of  the  time  necessary  to 
obtain  a  license  to  practice  medicine  and  surgery,  and  who  in 
all  probability,  know  nothing  of  the  principles  of  physiology 
even,  are  competent  judges  of  Dr.  Corbin's  ability  to  practice 
surgery  ? 

In  case  such  men,  after  having  been  sworn  to  be  governed 
by  the  law  and  evidence  in  the  case,  should  entirely  lay  aside 
the  testimony  of  the  "  doctors,"  and  perhaps  that  of  other 
witnesses  also,  and  decide  upon  their  sympathies^  I  would 
ask,   who   should  be  liable  to  prosecution  for  m,alpractice  f 

Of  the  physicians  of  this  and  adjoining  counties,  I  would 
ask,  what  shall  be  done  to  protect  ourselves  from  such  fla- 
grant abuse  ?  A  thorough  knowledge  of  our  profession,  and  a 
careful  application  of  its  principles  to  the  alleviation  of  hu^ 
man   suffering,   and  the   cure   of   disease,  will    not  protect  us. 

Cases  will  occur  where  life  and  limb  must  be  sacrifioed 
in  spite   of  human   wisdom  and  human  power. 

Kone  but  the   Creator  can    stay    the    ravages  of    disease. 


756  The  Peninsular  and  Independent. 

The  physician   can   only   assist   nature   by   the   aid   of   science. 

The  quack  and  nostrum  vender  only  warrants   cures. 

I  can  see  but  one  way  to  prevent  j^rosecutions,  and  but 
one   way  to   insure  justice  when  prosecuted. 

Let  every  individual  when  called  upon  to  treat  a  surgical 
case,  insist  upon  the  execution  of  a  good  and  satisfactory 
bond,  conditioned  that  neither  the  patient  nor  his  friends 
shall   ever  prosecute   for  alleged    malpractice. 

I  would  suggest  that  a  meeting  of  the  physicians  of  this 
and  adjoining  counties  be  called  for  the  purpose  of  organiz- 
ing a  society  of  the  following  description.  Inasmuch  as  there 
is  no  law  providing  for  a  jury  of  physicians  in  cases  like  this, 
where  none  hut  physicians  are  really  qualified  to  judge^  I  would 
have  this  society  meet  at  least  once  a  year,  and  elect  a  com- 
mittee, whose  duty  it  shall  be  to  be  present  and  sit  in  care- 
ful and  impartial  judgment  upon  the  decision  of  each  jury 
in  every  case  of  prosecution  for  alleged  malpractice  within  the 
territory  of  the  society. 

At  stated  times  this  committee  shall  report  its  convictions, 
in  addition  to  complete  notes  of  all  the  testimony,  to  the  so- 
ciety. 

After  due  deliberation,  the  society  should  take  action  upon 
the  report,  and  if  it  be  found  that,  by  laying  aside  reliable 
medical  testimony^  and  deciding  upon  their  sympathies^  or 
from  other  cause,  the  jury  shall  have  rendered  an  unjust 
judgment  to  the  detriment  of  our  profession,  each  member  of 
the  society  should  be  obligated  to  refuse  to  attend  upon  any 
member   of  the  jury  under   any  circumstances  whatever. 

Under  existing  circumstances,  it  is  the  rare  exception  for 
a  physician  or  surgeon  to  avoid  a  heavy  judgment  when  prose- 
cuted for  alleged  malpractice,  however  judicious  may  have 
been  the  treatment.  Community  as  well  as  the  jury,  should 
keep   constnntly  in   mind   the   uncertainty   of  human   life. 

It  should  be  remembered  that  a  physician  does  not  con« 
tract  to  cure  disease.  He  merely  contracts  to  supply  (or 
rather  to  advise  in  the  use  of),  those  medicines  and  appli- 
ances which  are  best  calculated  to  assist  nature  in  the  case, 
A  mechanic  who  contracts  to  repair  a  broken  carriage  for 
a  stipulated  amount,  and  instead  thereof,  ruins  the  whole 
structure,   should  be  held  responsible  for  the  damages. 


Malpractice^  <&c.  157 

Vital  and  physical  laws  are  vastly  different. 

GILBERT  E.  CORBIN,  M.  D. 

Sworn  and  subscribed  to,  before  me,  this  eighth  day  of 
February  a.  d.  1860.  JOSEPH  B.  WALLACE, 

Justice  of  the  Peace. 

STATE  OF  MICHIGAN, )  ^^  ^j^. 
County  of  Ingham     ) 

Uri  Isbell,  of  the  town  of  Stockbridge,  in  the  county  afore- 
said, being  duly  sworn,  says  that  during  the  summer  of  1851, 
Isaac  C.  Drew,  of  the  town  of  White  Oak,  in  the  county  of 
Ingham,  and  State  of  Michigan,  informed  him  (Isbell)  that 
Dr.  G.  E.  Corbin  left  explicit  directions  with  his  (Drew's) 
family,  that  in  case  his  (Drew's)  son  should  suffer  much  pain 
from  his  (the  son's)  fractured  leg,  he  (Drew)  should  send  for 
Dr.  Corbin  immediately. 

Uri  Isbell  further  says  that  Isaac  C.  Drew  informed  him 
(Isbell)  that  his  (Drew's)  son  did  suffer  severe  pain,  but  that 
he  (Drew)  did  not  send  for  Dr.  Corbin  as  directed. 

URI  ISBELL, 

Sworn  to,  this  eighth  day  of  February  a.  d.  1860,  before 
me,  JOSEPH  B.  WALLACE, 

Justice  of  the  Peace. 

STATE  OF  MICHIGAN,)    ,        ., 
County  of  Ingham.    \^^^^^- 

Stillman  Noyes,  of  the  town  of  Stockbridge,  in  the  county 
aforesaid,  being  duly  sworn,  swears  to  substantially  the  same 
facts  that  Uri  Isbell  does,  and  in  addition,  that  Isaac  C.  Drew 
informed  him  (Noyes)  that  he  (Drew)  did  not  send  for  Dr. 
Corbin,  because  it  was  a  long  distance  to  send,  and  the  roads 
were  bad.  STILLMAN"  NOTES. 

Sworn  to,  this  tenth  day  of  February  a.  d.  1860,  before 
me,  JOSEPH  B.  WALLACE, 

Justice  of  the  Peace. 

Editorial  Remarks. — It  would  have  been  more  satisfactory 
to  the  professional  reader,  had  Dr.  Corbin  first  given  an 
abstract  of  the  testimony,  then  made  his  comments  thereon. 
Still  as  we  have  the  fullest  confidence  in  Dr.  C.'s  strict  in- 
tegrity, and  as  in  his  statement  all  the  material  facts  are  set 
forth,   we   do   not  hesitate  to  publish  his  article.     The  explana- 


758  The  Peninsular  and  Independent. 

tion  of  certain  technicalities  which  is  indulged  in,  we  sup- 
pose  to   be   for  the   benefit  of  certain  non  -  professional  readers. 

The  simple  question  is,  as  stated  by  the  judge  in  his 
charge:  Was  the  practice  incorrect?  and  Did  the  mortifica- 
tion occur  in  consequence  of  that  incorrect  practice  ?  There 
can  be  but  one  answer  to  ^  the  last  question.  How  the  testi- 
mony made  the  practice  appear,  we  cannot  say,  for  from 
Dr.  Corbin's  statement,  there  was  an  evident  attempt  to 
make  it  appear  as  badly  as  possible ;  but  from  the  evidence, 
it  appears  that  mortification  did  not  occur  until  eleven  days 
after  the  bandages  were  entirely  removed.  With  this  evidence 
before  them,  the  gentlemen  (?)  of  the  jury  must  have  been 
either  fools  or  knaves  to  have  returned  the  verdict  which 
they  did.  The  attending  physician  was  no  more  responsible 
for  the  mortification,  than  he  was  for  the  attack  of  puenmonia 
which  proceeded  the   accident. 

With  regard  to  the  question  of  self-  protection,  we  know 
of  no  better  course  to  pursue,  than  to  take  along  a  witness 
to  note  accurately  all  the  steps  of  treatment  and  make  a  full 
record  thereof ;  otherwise  the  surgeon  is  entirely  at  the  mer- 
cy of  ignorant  and  oftentimes  prejudiced  witnesses.  Such  an 
attendant  should  be  an  intelligent  person,  capable  of  making 
both  observation  and  record ;  a  student  would  be  convenient 
and  available,  but  if  a  student  of  medicine,  he  should  have 
nothing  to  do  with  the  treatment  of  the  case.  Of  course,  the 
evidence  of  such  a  person  would  be  of  great  weight  with 
the  court   and  an  intelUge7it  jury.     (A   rara  avis  we   confess). 

The  bond,  which  Dr.  Corbin  suggests,  icoidd  be  utterly 
lOorthless.     Ask   any    good  lawyer   if  that   is  not  so. 

In  this  particular  instance,  we  are  surprised  that  a  new 
trial  was  not  sought.  Certainly,  with  such  a  charge  as  the 
judge  gave,  there  can  be  no  doubt  but  that  it  would  have 
been  granted.  G. 


Tetanus.  759 

ART.  ILVII.-Tetanus. 


To  the  Editors  of  the  Peninsular  and  Independent: 

Dear  Sirs  :  —  I  have  been  for  some  time  a  reader  of 
your  valuable  Journal,  and  hope  you  will  excuse  the  liber- 
ty I  take  in  sending  you  an  account  of  a  case  of  Tetanus. 
In  your  number  for  December,  1859,  I  noticed  the  report 
of  an  interesting  case  in  N.  Y.  Hospital,  which  called  to 
mind  the  one  I  send. 

October  28th,  1856.  I  was  called  to  see  a  lad  about 
9  years  old,  who  had  been  injured  by  the  wheel  of  a 
car,  passing  over  the  foot,  crushing  and  lacerating  the 
parts  sadly.  The  lower  ends  of  both  bones  of  the  leg 
were  splintered,  which  compelled  the  removal  of  the  in- 
jured part,  about   the   lower   third. 

The  wound  was  brought  together  after  securing  the 
artery,  and  with  a  little  sloughing  of  the  injured  parts 
all  went  on  well;  ligature  came  away;  wound  looked  healthy. 
On  the  16  th  of  November  I  was  summoned  in  haste  at 
night  to  see  the  patient  (in  a  fit  as  stated  by  the  mes- 
senger). I  found  him  with  Tetanus,  jaws  locked,  his 
tongue  between  the  teeth  badly  cut,  and  his  person  co- 
vered with  blood.  His  head  and  heel  resting  on  the  bed 
in  a  state  of  complete  opistholonos.  I  resorted  to  chloro- 
form and  ether,  equal  parts  to  relax  the  spasm,  and  ordered 
stimulants  with  beef  tea,  and  commenced  giving  injections 
of  assafoetida.  This  treatment  was  adhered  to,  and  after 
four  days  of  great  anxiety  and  great  suffering  on  the  part 
of  the  little  patient  my  efforts  were  successful  in  relieving 
him  of  all  spasm.  During  this  time  the  wound  looked 
healthy ;  in  truth,  this  fact  urged  me  on.  He  was  fed 
through  a  tube  passed  between  his  teeth,  one  having  been 
removed  for  the  purpose. 

Truly  and  sincerely,  yours, 

H.  Caruthers. 

Tarrytown,  January  26th,  1860. 


ART.  XLYIII.  —  Meteorological  Register  for   Month  of  January. 

By  L.  S.  IIorton,  House  Physician  to  U.  S.  Marine  Hospital. 

Altitude  of  Barometer  above  the  level  of  the  sea,  597  feet.     Latitude,  42<'24'N  •   and 
Longitude.  82" 58' W.  of  Greenwich. 


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A  PRACTICAL  TREATISE  ON  FRACTURES  AND  DISLOCATIONS.  By 
Frakk  Hastings  Hamilton,  M.  D,,  Prof,  of  Surgery  in  the  University  of 
Buffalo ;  Surgeon  to  the  Buffalo  Hospital  of  the  Sisters  of  Charity ;  Con- 
sulting Surgeon  to  the  Buffalo  General  Hospital,  and  to  the  Buffalo  City 
Dispensary.  Illustrated  with  two  hundred  and  eighty -nine  wood -cuts. 
Philadelphia :  Blanchard  and  Lea.     1860, 

In  a  year  so  prolific  of  original  American  Books  on  Medical 
and  Surgical  subjects  as  the  last  has  been,  we  can  begin  to 
scrutinize  somewhat  closely  the  new  productions  as  they  em- 
enate  from  the  press.  But  the  book  before  us  sustains  the 
examination,  and  we  are  proud  to  point  to  it  as  a  home 
production.  In  many  respects  it  is  surprisingly  complete ;  par- 
ticularly so  in  all  that  pertains  to  the  details  of  surgical  ap- 
pliancies.  In  fact,  upon  this  point,  it  will  require  the  judg- 
ment of  experience  to  select  the  most  appropriate,  and  reject 
that  which  really  almost  obsolete.  Current  medical  literature, 
too,  has  been  made  to  yield  up  its  facts  and  theories  to 
such  an  extent  that  the  book  is  almost  a  complete  index 
rerum  referring   the   subjects   under    consideration. 

But  Avhile  we  are  proud  of  the  book  we  can  not  give 
it  unqualified  approbation.  Two  of  its  chapters  disappointed 
us.  That  upon  delayed  union  and  non-union  is  by  no  means 
in  keeping  with  the  completeness  which  characterizes  most 
of  the  work.  In  this  respect  it  will  not  bear^  comparison 
with  Malgaigne.  The  subject  as  a  whole  has  not  received 
that  attention  which  its  imjDortance  demands.  As  perfect  and 
as  speedy  a  union  as  possible  is  the  great  aim  of  the  sur- 
geon in  a  case  of  fracture ;  and  to  secure  it,  he  must  con- 
template and  guard  against  all  those  causes  which  endanger 
such  a  result.  These  causes  call  for  a  more  extended  no- 
tice than  Dr.  Hamilton  has  given  them;  and  the  means  of 
counteracting  them  should  also  have  been  more  fully  dwelt 
upon.     The  latter  defect  of  this  chapter  is,  however,  atoned  for 


762  The  Peninsular  and  Independent. 

in   some   degree    by   some   five    pages   upon   the   consideration 
of  delayed   union   in   the   humerus,  which   occurs   in   that  part 
of  special  fractures  devoted  to  this   bone.    It  is  a  well  known 
fact  that  the   humerus   is   greatly  more   liable  to   be   the   seat 
of   non  -  union   than   any   other    bone   in   the    body ;    and    the 
reason   of  such   liability  is   probably   to   be   found   in   a  trans- 
verse motion  at  the  seat   of  the   fracture  which  Dr.  Hamilton 
first  called   attention  to   in   1854.     This   transverse  motion,  ac- 
cording to  Dr.  Hamiltox,  is  produced  by  the  dragging  weight 
of  the  forearm  and  the  motions  imparted  to  it  by  the  patient 
in   his   efforts   to   support  it,  and  in  the  varied  motions  of  the 
body,   the  joint   at   the   elbow   having   undergone    "  a  tempor- 
ary  false   anchylosis"    arising    from     "a  rigidity   of    tlie   mus 
oles  and  other  structures."     Such   motions  of  the  forearm,  the 
joint    being    in   a   state    of    "temporary   false    anchylosis,"    of 
course   are  imparted  to   the   lower   fragment    of  the   fractured 
humerus.     We   can  not   fully   agree   with   our   author   here   as 
to  the   cause   of  these  transverse   motions.     AYe   must  also  at- 
tribute   them    largely  to  ^the   action   of    the  pectoralis   major, 
latissimus   dorsi,  and  teres   major  muscles,  which  act   at    right 
angles  with  the  shaft   of  the   humerus.     Dr.   Hamilton  takes 
pains  to   deny  the    peculiar   efficiency   of   these    muscles,   and 
in  proof  says :     "...  similar  muscles,  with  similar  attachments, 
on   the  femur   and  on  the   clavicle,   tending  always  powerfully 
to   the   separation   of    the    fragments,    occasion   deformity,   but 
they  seldom  prevent  union."     But  in  the  case   of  the   clavicle, 
not  a  muscle  acts   at  right  angles  loith  the  shaft  hut  has  its 
antagonist ;   and  in   the   femur,  all   the   muscles   to  which  Dr. 
Hamilton    refers,    arise   [from    the    pelvis,   which    during    the 
treatment     of   the    fracture    is    kept    very  nearly    immovable. 
They    act,   too,   at   a  much    less    advantage    than    the    above 
named   muscles  which    are   inserted   into   the  humerus.     On  the 
contrary,  to  appreciate  the  influence  of  these   last  named  mus- 
cles   upon    the    humerus,    we   have   but   to    call    to   mind   the 
part   which   they  play  in   various   motions   of  the   body.     In  a 
report  upon  this   subject  which  we  made  to  the  State  Society 
in   January,    1859,   we   held   the  following   language: 

"When  we  remember  the  insertion  of  the  pectoralis  major, 
and  latissimus  dorsi  muscles,  and  consider  their  great  power, 
and  the  fact   that  they   are   called    into   action  in   respiration 


Bihlio graphical  Record.  ^763 

and  in  the  various  movements  of  the  body,  it  will  be  seen 
that  they  must  necessarily  move  the  fragments  of  the  broken 
humerus  upon  one  another  in  a  most  energetic  manner,  and 
that  this  motion  is  also  transverse.  The  inability  to  apply 
dressings  in  such  a  manner  as  to  control  the  upper  frag- 
ment, adds,  also  to  the  danger  of  non-union.  Still  another 
reason  is  to  be  found  in  the  restlessness  of  all  patients.  In 
fractm-es  of  the  femur,  this  restlessness  produces  much  less 
influence  upon  the  fragments  than  in  fractures  of  the  hume- 
rus. In  the  latter  case,  the  least  movement  of  the  body,  or 
even  a  long  breath,  disturbs  the  fracture  through  the  muscles 
above  mentioned.  The  fatigue  of  maintaining  one  position 
constantly  provokes  an  effort  to  alter  the  position  of  the 
body.  This  effort  in ,  every  instance  tells  upon  the  fracture. 
Even  the  hixury  of  a  deep  drawn  breath  is  indulged  in  only 
at  the  expense  of  disturbing  the  fracture.  The  motions  thus 
resulting  are  all  traverse,  and  disturb  every  portion  of  the 
imiting  material  which  is  in  process  of  consolidation.  Such 
disturbance  must  necessarily  delay  union,  and  when  other 
causes  co-operate,  is  sufiicient  oftentimes  to  prevent  it  alto- 
gether.'' 

We  confess,  also,  to  something  of  a  feeling  of  disappoint- 
ment in  seeing  such  ^undue  prominence  given  to  the  old,  but 
necessarily  barbarous  method  of  reducing  dislocations  by  ex- 
tension and  counter  extension.  All  varieties  of  this  method 
are  fully  illustrated  and  dwelt  upon ;  while  but  a  single  illus- 
tration of  the  method  by  manipulation  (and  that  a  very  mean- 
ingless one)  is  given.  We  do  not,  by  any  means,  condemn  in 
toto  the  old  method ;  but  we  hesitate  not  to  say  that  it  should 
never  be  put  in  practice  till  the  more  scientific  and  humane 
method  of  manipulation  has  failed ;  and  we  believe,  that  used 
intelligently,  manipulation  will  rarely  fail.  To  manipulate  with 
success,  the  surgeon  should  first  consider  the  probable  position 
of  the  limb  at  the  moment  of  escape  from  the  joint,  and  the  di- 
rection in  which  the  dislocating  force  was  applied;  he  should 
then  place  it  hi  exactly  the  position  which  characterized  it  at 
the  tnoment  of  the  escape  of  the  joint  end  from  its  normal 
position  in  the  joint.  Its  reduction  loill  then  generally  he 
easy. 

Dr.  Hamilton  by  no  means  disapproves  of  the  manipulatory 


764  The  Peninsular  and  Independent. 

method,  but  he  thinks,  "  the  time  has  not  yet  arrived  in  which 
we  may  institute  a  rigid  comparison  between  the  relative  merits 
of  the  two  leading  plans." 

In  conclusion,  we  are  proud  of  the  book  as  an  American 
production.  Let  such  efforts  multiply,  and  let  puny  editors 
keep  their  names  off  the  title  pages  of  foreign  books.  Let 
Blanchard  and  Lea  or  any  other  enterprizing  publishers,  repro- 
duce for  us  good  foreign  books,  but  let  us  have  them  un- 
adorned ;  and  if  ambitious  men  have  ideas  to  ventilate  let  them 
do  as  Dr.  Hamilton  has  done. 

G. 


INTRODUCTORY  LECTURES  AND  ADDRESSES  ON  MEDICAL 
SUBJECTS,  delivered  chiefly  before  the  medical  cfasses  of  the 
University  of  Philadelphia,  by  Geo.  B.  Wood,  M.  D.,  LL.D.,  Presi- 
dent of  the  American  Philosophical  Society;  President  of  the  Col- 
lege of  Physicians  of  Philadelphia;  Prof  of  the  Theory  and  Prac- 
tice of  Medicine,  and  of  Clinical  Medicine,  in  the  University  of 
Pennsylvania,  etc.     Philadelphia:    J.  B.  Lippincott  &  Co.     1859. 

This  beautiful  volume  of  4C0  pages  is  dedicated  by  its 
venerable  and  accomplished  author  to  the  medical  graduates 
of  the  University  of  Pennsylvania.^  from  the  year  1836  to 
1860.  During  this  whole  period  Dr.  Wood  has  been  one  of 
the  brightest  ornaments  of  the  institution.  Of  the  eighteen  lec- 
tures and  addresses  in  the  volume,  two  are  on  Pharmaceutical 
subjects,  one  addressed  to  the  members,  and  the  other  to  the 
graduating  class  of  the  Philadelphia  College  of  Pharmacy ;  six 
are  lectures  introductory  to  the  course  on  Materia  Medica,  and 
four  to  that  of  Theory  and  Practice  in  the  University  of  Penn- 
sylvania; two  giving  the  Results  of  Professional  Observations 
Abroad;  three  parting  addresses  to  the  graduates  of  the  Uni- 
versity; and  two  Bibliographical  Memoirs,  one  of  Dr.  Joseph 
Paerish  —  Dr.  Wood's  old  preceptor  —  and  the  other  of  Dr. 
Samuel  Geoege  Moetox,  the  well-known   Ethnologist. 

We  have  examined  this  volume  with  very  great  pleasure  — 
a  pleasure  alloyed  only  by  the  reflection  that  the  public  labors 
of  its  excellent  author  are  soon  to  be  brought  to  a  close  — 
as   it  is   understood  that   Prof.  Wood  is   engaged   in  his  last 


Bibliographical  Record.  765 

course   of  lectures,  and   he   announced   some  time  ago  that  he 
had  written   his   last   book.      We   hope,  however,  that   he   has 
not  written   and   delivered   his   last   address,  and  that  he   may 
long  be  spared  to  encourage  by  his  precepts  and  his   example, 
science,  truth,  and  honor,  and  to  reprove  their  opposites  wher- 
ever  found.     The   profession   everywhere   are   acquainted   with 
Dr.  Wood's   great  scientific  and  practical  works  on  Pathology 
and  Therapeutics,  Materia   Medica   and   Pharmacy.      They  are 
acquainted   with   the   character   of  his   mind   as   manifested  in 
these   strictly  professional  productions,   but   they   may    not   all 
be   so   familiar  with  his   views   and   feelings   on   more   general 
topics   of  medical   polity  and   ethics — they  may  not   all   know 
so  well   the    qualities   of  his   heart  as   of  his   head.     This  col 
lection   of  lectures   and   addresses   brings   the   reader    more  in 
contact   with   his   sentiments   and  feelings,  and  a  more   purify- 
ing  and   elevating   contact   is   seldom   experienced ;    one   more 
absolutely  free   from   contamination   can  not   be  conceived.     It 
is   impossible    to   arise    from   the    perusal   of    these     addresses 
without   the   conviction   that   the   author   is  a  sensible,  a  pure, 
and   an  honorable   man,    having    the   deepest   interest    in    the 
welfare    of   the    profession,    and    of    its    actual    or    prospect- 
ive  members   with   whom    he   is   associated.      Adding  to   this 
the   impression   which   must    necessarily   be   obtained    by   per- 
sonal intercourse  with  Prof.  Wood,  his  venerable  and  dignified 
appearance,    his    gentlemanly    manners    and    kind   expressions ; 
and,  further,  adding  to   this,  as  we   are   able  to  do,  a  remem- 
brance  of    his   solicitous   and   skillful    professional    attendance 
during  a  severe   and   critical   illness,  and,  above   all,  a  grateful 
feeling   of  his   friendship  vouchsafed,  and  of  favors   bestowed 
our   admiration    rises    to    reverence,    and   our    regard    to   the 
sincerest  affection. 

While  we  regret  that  the  University  is  so  soon  to  be  de- 
prived of  the  valuable  services  of  Prof.  Wood,  we  can  but 
admire  the  wisdom  which  has  determined  him  to  retire  from 
his  public  duties  while  his  mental  faculties  are  in  their  full 
vigor,  and  before  the  question  is  even  raised  as  to  their  de- 
clension.    He  has   doubtless  been  impressed  with  the   painful- 


1QQ  The  Peninsular  and  Independent, 

ness  of  the  spectacle  of  men  of  superior  talents  and  reputa- 
tion liolding  on  to  important  positions  when  those  talents 
were  waning,  and  to  the  injury  of  tlieir  reputations,  and  is 
determined  to  avoid  that  •  error.  As  it  is,  he  will  carry 
into  his  comparative  seclusion,  the  consciousness  of  duty  well 
performed,  and  the  admiration  and  aifection  of  all  who  have 
known  him,  and  whose  opinions  are  of  value. 

We  most  heartily  commend  the  book  which  has  called 
forth  these  remarks  to  the  notice  of  all,  and  especially  to 
the  younger  members  of  the  profession,  feeling  assured  that 
by  its  perusal  they  will  be  made  both  wiser  and  better  men. 

A.  B.  P. 


AN  EPITOME  OF  BAITHWAITE'S  RETROSPECT  OF  PRACTICAL  ME- 
DICINE  AND  SURGERY.  Containing  a  condensed  summary  of  the  most 
important  cases;  their  treatment,  and  all  the  remedies  and  other  useful 
matters  embraced  in  the  forty  volumes — the  whole  being  alphabetically 
classified,  and  supplied  with  an  addenda,  comprising  a  table  of  French 
weights  and  measures,  reduced  to  English  standard  —  a  list  of  incompat- 
ibles — explanation  of  the  principal  occurring  in  pharmaceutical  formula} — 
a  vocabulary  of  Latin  words  most  frequently  used  in  prescriptions,  and  a 
copious  index.  In  five  parts.  \  By  Walter  S.  Wells,  M.  D.  Part  first. 
New  York:  W.  H.  Tinson,  Printer  and  Stereotyper.  18G0.  C.  T.Evan, 
Publisher,  114  Fulton  Street. 

The  title  page  given  above  explains  the  nature  of  the  publi- 
cation as  perfectly  as  we  can;  and  all  that  remains  to  be  said 
is  that,  from  the  indications  of  Part  first,  we  conceive  the 
work  to  be  of  the  utmost  value  to  all  who  have  not  already 
the  whole  forty  numbers  of  the  Retrospect,  and  even  then 
this  epitom  is  so  classified  as  to  present  many  advantages 
over  the   original. 


tfHt0rial  §t^utmt\ii. 


Valedictory. 


As  is  intimated  by  the  publishers,  on  another  page,  this 
journal  will  not  be  continued  beyond  the  present  number. 
The  volume  is  now  closed  and  all  obligations  to  subscribers 
cancelled. 

The  causes  which  have  resulted  in  this  conclusion  are  vari^ 
ous.  One,  the  publishers  have  stated,  —  it  does  not  pay: — ■ 
and  although  the  labor  involved  is  in  many  respects  both 
agreeable  and  profitable;  agreeable  from  its  placing  those  en- 
gaged  in  it  in  pleasing  connexion  with  many  minds, — gather 
from  some  and  distribute  to  others  —  and  profitable  from  its 
placing  before  them  so  many  sources  of  information  and  excit- 
ing to  an  increase  of  knowledge,  yet  in  the  developement  of 
events,  there  are  presented  to  us  pursuits  offering  greater  at» 
tractions,  and  obligations  are  upon  us  more  imperative. 

We  retire  then  from  these  relations  to  the  profession  with 
mingled  feelings ;  those  of  sadness  at  the  severance  of  many 
pleasant  ties,  and  those  of  pleasure,  in  the  anticipations  of  a 
release  from  many  cares  and  obligations. 

For  the  last  half  dozen  years,  we  have  given  a  portion  of 
our  time  and  means  to  the  support  of  a  medical  journal  iu 
this  State,  with  what  faithfulness  and  acceptance,  is  for  others 
to  judge ;    but    whatever   that   decision    may  be,  we  think  we 

have  continued  as  long  in  the  effort  to  serve ,  the  profession 
in  this  capacity  as  they  could  reasonably  expect,  and  we  feel 
no  compunctions  in  now  relinquishing  the  task. 

While  grateful  to  those  who  have  sustained  us  by  their 
pens  and  subscriptions,  we  cherish  a  spirit  of  Christianity 
and  forgiveness  to  others  in  our  midst,  who  having  the 
ability  to  write  have  neglected  to  do  so,  and  to  others  still 
who  having  received  the  journal,  have  not  forwarded  the 
money   due. 

During  our  editorial  career,  in  the  maintenance  of  what  we 
have    deemed    right,   we    have    occasionally   come  in   collision 


768  The  Peninsular  and  Independent. 

with  the  opinions  ahd  feelings  of  others,  and  a  spirit  of  con- 
troversy has  sometimes  been  aroused.  In  the  conduct  of 
such  discussions  we  have  always  thought  ourselves  in  the 
right,  and.  have  striven  to  be  entirely  just;  but  if  in  any 
instance  there  has  been  the  slightest  undue  severity  of  ex- 
pression, or  intensity  of  feeling,  none  could  more  regret  it 
than  ourselves,  and  few  we  think,  would  be  more  willing  to 
make  any   proj^er   acknowledgements. 

With  the  kindest  feelings  towards  our  editorial  brethren, 
and  so  far  as  we  know,  at  peace  and  in  good  will  with 
all,  we   now   extend   a  fraternal  parting  hand. 

A.  B.  P. 


Valedictory. 


Our  Valadictory  will  be  brief.  The  publishers  cannot  af- 
ford to  carry  on  a  losing  enterprize,  and  we  are  unwilling 
to  do  more  than  to  loorJc  for  the  maintenance  of  the 
journal. 

With  regard  to  the  past,  we  have  only  to  say :  "  What 
we  have  written,  we  have  written."  G. 


DISCONTmUANCE_OF  THIS  JOURNAL 

With    this  issue,  the    publication   of   the  Peninsular   and 
Independent  Medical  Journal  ceases. 

The  publishers  desire  to  state  that  when  induced  to 
undertake  the  publication  of  the  consolidated  Journals,  two 
years  ago,  they  hoped  by  effort  to  make  it  at  least  self- 
supporting,  if  not   remunerative. 

The  results  have  proved  contrary  to  these  expectations, 
and  the  outlay  the  past  year  has  been  so  much  larger 
than  the  receipts,  that  we  deem  it  unadvisable  to  con- 
tinue its  further   publication. 

HIGBY  &  STEAKNS. 


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